I am often asked if there are any choices for male birth control other than vasectomy. Unfortunately, the only effective, practical and safe alternatives that currently exist are abstinence, the use of condoms or other prophylactics, and withdrawal. However, I would predict that with the rapid rate of the advances we have seen in medical science, men will soon be able to simply take a pill to control the release of their sperm, just as women take a pill to control the release of their eggs.
There have been a number of research groups, particularly in China and the UK, that have explored experimental alternatives to vasectomy for male contraception. A few of these experimental concepts include injected plugs, heat methods, pharmaceutical methods, hormonal methods, and vas occlusion (blocking the vas deferens instead of cutting it, such as in vasectomy). Although these developments and discoveries are highly fascinating and offer an exciting glimpse of the future possibilities for male contraception, they still remain highly experimental. I want to state clearly that the FDA has approved none of these methods for use in the United States, and I would discourage taking foolish and dangerous risks with such a valuable appendage!
Vasectomy is safe and effective for all men who no longer wish to have children. The procedure involves interrupting the continuity of the vas deferens, the tube that carries sperm from the testicles, where sperm is made, to the seminal vesicles, where sperm is stored until ejaculation. Vasectomy stops the passage of sperm so that none is included in the semen that is ejaculated. The procedure is performed in less than 10 minutes in a doctor’s office, under local anesthesia, through a tiny nick in the scrotal skin (the “no scalpel” technique). The postoperative discomfort is minimal, and patients rarely require an analgesic.
As for penis power, absolutely no change occurs after vasectomy. There is no reduction in sensation, desire, circulating testosterone, the ability to get or keep an erection, or satisfaction when having an orgasm. The only difference after vasectomy is that no sperm is released. The sperm component is a minuscule portion of seminal fluid to begin with, so there is no reduction in the volume that is ejaculated.
In fact, a vasectomy has the potential to increase penis power in many men because they are no longer inhibited by concerns about pregnancy. Longtime partners often feel more spontaneous. They do not have to interrupt lovemaking to deal with diaphragms or condoms, and they often feel heightened sensation during intercourse because there is no latex between the penis and the vagina.
Some vasectomy patients change their minds about having children and request a reversal. This procedure, called a vasovasostomy, involves reconnecting the vas deferens. This operation is a bit more difficult than the original vasectomy. However, vasovasostomies have a high rate of success, and most patients are able to conceive children afterward. As with a vasectomy, the reversal does not diminish penis power. In fact, there is a potential bonus: after a vasovasostomy, a couple is now making love for the express purpose of conceiving a child, so lovemaking often becomes even more romantic than ever.
The typical vasovasostomy patient I see in my practice is reversing a vasectomy he obtained when he and his first wife decided not to have any more children. Now he is remarried, usually to a younger woman who wants to have a family with him—a terrific turn-on for a middle-aged man. For a man fitting this profile, I strongly encourage vasovasostomy. It is a safe and effective procedure. (Just for the record, the above example is not intended in any way to encourage men to seek divorce, but rather is a reflection of the demographic realities I have observed in my practice.)
At the end of the day, office vasectomy is a safe, simple, time-tested method of male birth control with virtually no downside.
Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).
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