The vasectomy is the fourth most common form of birth control after condoms, oral pills, and tubal ligation (“getting the tubes tied”). It is a low-risk surgery that can be done in an everyday doctor’s office under local anesthesia (medicine that numbs the area), and patients can go home right after. A surgeon or family medicine physician will make one or two small cuts or a puncture in the scrotum. They then cut and seal the vas deferens, the tubes that carry sperm. The entire procedure takes around 20 minutes.
Vasectomies are considered safer and less expensive than a tubal ligation. They are also more cost-effective than birth control pills in the long term. Still, the idea of getting a vasectomy can raise plenty of questions. Some come from genuine concerns, while others may have been inspired by movies or television. Here are nine frequently asked questions and what the research says about them.
- Does a vasectomy affect your sex drive or erections?
No. The area in the scrotum where the procedure is performed is nowhere near the nerves for penile sensation or erections. Several studies on the subject have shown that sex drive (libido) remains largely unaffected. In fact, many studies report that sexual desire, frequency of sexual activity, and erectile function have either improved or stayed the same post-vasectomy. Researchers suggest this may be because men feel less anxious about unwanted pregnancies and more confident during sex. Additionally, if a female partner stops using their hormonal birth control, this could improve her libido.
- Will sex or orgasms feel different after a vasectomy?
It should not, but everyone's experience is different. These same studies report improved or unchanged orgasmic function and sexual satisfaction. Although studies suggest that sex and orgasms usually feel the same, some men may notice or perceive changes in their experience.
- Will you still ejaculate after a vasectomy?
100% yes, unless one has a preexisting ejaculatory dysfunction, such as anejaculation. A vasectomy only cuts and seals the tubes that carry sperm. The body still produces the fluids that make up most of semen (ejaculate). That means semen is still available, even though it carries no or little sperm. Only about 5% of ejaculate volume is due to contribution from the testicles and vas deferens, so the change should be imperceptible.
- Where does the sperm go?
It stays self-contained. The sperm are still produced, and they remain in the testicle or epididymis. One question urologists hear often is what happens to the sperm the body continues to produce after a vasectomy. A lot of concern surrounds whether or not the sperm will build up and begin floating around inside them. The truth is that the body breaks down and absorbs the unused sperm. This is also why a vasectomy can be reversed or why sperm can be obtained from the testicle or epididymis to use for fertilization with assisted reproductive technology.
- Does a vasectomy lower testosterone levels?
No. Testosterone is produced in the testicles and travels through the bloodstream, so a vasectomy does not interfere with its production or circulation. If testosterone levels drop after a vasectomy, it is likely unrelated to the surgery. A healthcare provider can help evaluate for other possible causes.
- Can a vasectomy increase your risk of prostate cancer?
No. Some early studies found an association between vasectomies and prostate cancer, which was picked up by the general media. However, this link becomes much weaker when researchers account for how often men get screened for prostate cancer. If someone receives regular preventative care (including prostate cancer screenings), then it is more likely that it will be caught. So, these studies showing an association essentially just confirmed that men who are appropriately going to the doctor identify prostate cancer at a stage where it is more treatable as opposed to men who never seek out care.
- Can a vasectomy cause long-term pain?
Yes, but it is uncommon. It is a rare but known potential side effect of vasectomy. Some men may experience pain or swelling for more than three months, regardless of the surgical method. However, for most men, studies report that symptoms of post-procedure pain are often mild and resolve on their own. Other times, the scrotal pain may be the result of some other underlying condition. If pain is persisting, a man should always seek out an evaluation and help.
- Can you still get someone pregnant after a vasectomy?
This is unlikely after the waiting period and semen analysis confirmation. The recommended wait time before resuming sexual activity is 7-10 days – strictly for recovery. After this initial recovery period, another form of birth control is needed. Between 8 and 16 weeks after surgery, patients typically provide a semen sample for testing. Once the results show zero or fewer than 100,000 non-motile sperm, then sex can resume without a second form of birth control. Most of the pregnancies after vasectomy are thought to be due to patients who misunderstood the importance of checking semen analysis after surgery.
- Can a vasectomy be reversed?
Yes. However, the longer someone waits after a vasectomy, the less likely a reversal may be to succeed. Within the first 10 years, chances of returning sperm to ejaculate by a microsurgery-trained specialist are upwards of 90%. At 15 or more years post-vasectomy, a more complex reconstruction may be required, and sperm recovery rates drop to around 60-70%. Pregnancy rates are hard to estimate, as they are heavily influenced by female partner factors. For couples who need to get pregnant sooner due to the female partner’s fertility concerns, or who have insurance coverage for in vitro fertilization (IVF), sperm can be collected from the testicle and used for IVF.
Key Takeaways
- The vasectomy is a minor surgery that is considered a permanent or long-term form of birth control.
- It is generally safe and costs less over time than other birth control methods.
- It is reversible, and the testicle continues making sperm, so options for fertility exist if life changes
- A vasectomy is not likely to affect one’s sex drive, erections, or orgasms.
- Men can still ejaculate after a vasectomy, and the procedure does not lower testosterone levels.
- The risk of pregnancy after a confirmed successful vasectomy is very low. Association with prostate cancer is due to men who appropriately use healthcare being screened for prostate cancer and catching issues early
- It may be beneficial to speak with a healthcare provider to consider whether a vasectomy is the right move.
Resources
Auyeung, A. B., Almejally, A., Alsaggar, F., & Doyle, F. (2020). Incidence of post-vasectomy pain: Systematic review and meta-analysis. International Journal of Environmental Research and Public Health, 17(5), 1788. PubMed Central. https://doi.org/10.3390/ijerph17051788
Baboudjian, M., Rajwa, P., Barret, E., Beauval, J.-B., Brureau, L., Créhange, G., Dariane, C., Fiard, G., Fromont, G., Gauthé, M., Mathieu, R., Renard-Penna, R., Roubaud, G., Ruffion, A., Sargos, P., Rouprêt, M., & Ploussard, G. (2022). Vasectomy and risk of prostate cancer: A systematic review and meta-analysis. European Urology Open Science, 41, 35–44. ScienceDirect. https://doi.org/10.1016/j.euros.2022.04.012
Davis, P. G., Preece, P. D., & Rees, R. W. (2024). Simplifying vasectomy reversal without compromising outcomes: A single-surgeon series. Translational Andrology and Urology, 13(7), 1173–1179. PubMed Central. https://doi.org/10.21037/tau-23-604
Helm, M., Pipinos, M., Glassman, J., Albers, G., & Deibert, C. M. (2025). A systematic review evaluating the effects of vasectomy on male and female sexual function and satisfaction. Translational Andrology and Urology, 14(12), 4002–4011. PubMed Central. https://doi.org/10.21037/tau-2025-494
Jiang, T., Li, S., & Eisenberg, M. L. (2026). Real-world live birth rates after vasectomy: Data from the national survey of family growth. The World Journal of Men’s Health, 44(4). XmLink. https://doi.org/10.5534/wjmh.250378
Khalafalla, K., Ho, C. C. K., Chung, E., Atmoko, W., Shah, R., & Agarwal, A. (2024). Post-vasectomy semen analysis: What’s all the fuss about? Diagnostics (Basel, Switzerland), 14(20), 2275. PubMed Central. https://doi.org/10.3390/diagnostics14202275
Mo, Z.-N., Huang, X., Zhang, S.-C., & Yang, J.-R. (1995). Early and late long-term effects of vasectomy on serum testosterone, dihydrotestosterone, luteinizing hormone and follicle-stimulating hormone levels. Journal of Urology, 154(6), 2065. Wolters Kluwer Health Inc. https://doi.org/10.1016/s0022-5347(01)66696-5
Urbanski, M., Walker, D., Morrison, J. C., & Islam, M. M. (2025). Post-vasectomy pain syndrome: A review of the literature and updated treatment algorithm. Cureus, 17(2), e79592. PubMed Central. https://doi.org/10.7759/cureus.79592
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