Vasectomy - Risks and Effect on Testosterone and DHT (Dihydrotestosterone)
Vasectomies - some guys just can't wait for the day their wives say to "cut the
ties" and other guys are very concerned. So who's right? Well, the bottom
line is that so far there has been no convincing evidence that vasectomies put
males, in general, at risk. However, there are some studies that will make you
think.
But before we discuss those studies, I want to mention one thing: anything
that gets you to have more sex will in general be healthy. Remember that
Sex is Good for Your Testosterone and
Sex is Good for Erectile Strength.
So the physical benefits are clearly there and a vasectomy, for some couples
anyway, can increase the chances of having sexual intercourse.
For males the reasons are probably 1) loss of concern about pregnancy and 2)
being able to orgasm inside of the woman without a condom (assuming you have no
concern about STD's), which is heaven on earth indeed. The most
prominent reasons
for females are undoubtedly 1) less need to use a condom so intercourse feels better and
2) less worry for the woman (or male) about pregnancy.
But, all of that said, I think a Vasectomy 101 might be in order here. Your
doctor will probably not tell you any of this and it's good to be fully
informed. (He or she often knows more about health insurance reimbursement
than about the multitude of studies regarding vasectomies.)
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First of all, one of the concerns about vasectomies was that they might somehow
affect hormone levels. One study in particular showed that "men who
underwent vasectomy 10 to 19 years previously had higher dihydrotestosterone
levels than age matched controls. In men who underwent vasectomy 20 years or
more ago testosterone was higher than in corresponding controls". [1]
However, subsequent studies have shown the opposite - no significant change in
various hormone levels. For example, one study [2] found that Luteinizing
Hormone (LH) levels increased 15% post-vasectomy, which almost for sure means
that testosterone decreased as the body usually will increase LH in response to
decreased testosterone levels, i.e. this is a common dampening effect for a
runaway decrease in testosterone. So the bottom line is that some studies
have shown a slight decrease and some a slight increase in hormonal levels and
researchers have been able to come to no meaningful conculsions.
Of course, another big concern has been vasectomies and prostate cancer.
The National Cancer Institute has a valuable study [3] that every male should
read before deciding on a vasectomy. This issue has been studied by teams
of scientists with largely inconclusive results. For example, in March
1993, the National Institute of Child Health and Human Development (NICHD) held
a conference and examined this issue. They found mixed study results and,
furthermore, "could not find any convincing biological explanation for a link
between vasectomy and an increased risk of prostate cancer". Similar large
scale studies in 1997 and 1998 have found similar results. But be aware:
there are a couple of studies that show a slight increase in prostate cancer
risk
Finally, there is the "dementia connection". There is a certain rather
obscure form of dementia called Primary Progressive Aphasia (PPA), that ends up
with the individuals having trouble remembering and understanding words.
One researcher, Sandra Weintraub, first posited this potential
connection. However, the contrasting argument is simply this:
millions of vasectomies have been done through the world, especially in China,
and there is simply not an army of men walking around with PPA. Again, though, it may be something to research if
you are concerned.
One other side effect that doctors frequently do not inform their patients about
is what's called congestive epididymitis. Basically, after a vasectomy, the
sperm is trapped in the epididymitis where it is reabsorbed into the body.
If sperm becomes "backed up", especially in (very lucky) men who have a lot of
sex or produce a lot of sperm, scientists call this "congestive epididymitis"
and it can cause some pain and discomfort to be sure. In fact, it can even
rupture in some cases.
Here's my final shocker: some guys actually regrow the tube back together -
yes, like a lizard's tail - and start pushing out sperm again. It is very
unlikely, but is almost impossible to detect since it could happen in six months
or in twenty years. Urologists call this "recanalization" or "spontaneous
connection of the vasa defentia", which is medical name for the thing that your
doctor took a big slice out of.
However, if those concerns all seem low risk and minor to you, especially
compared to the benefits, you may want to go
ahead. The procedure itself is relatively simple. Probably the most
painful thing is the initial anasthetic, which is like a bee sting into the
testicle area and usually repeated in the middle of the procedure. The
post-operative pain is relatively minor, assuming you don't have to drive
yourself home or have one of the kids welcome you home with a diving hug.
What might seem the worst part of it all for some guys is to go without sex for
seven to ten days. However, that's just about the time that you feel like
having sex, so that works out perfectly. (This is to avoid the "congestive
epididymitis" mentioned above.) Most guys can even return to work
after two to three days.
The decision is yours.
