Is There a Link Between Vasectomies and Erectile Dysfunction?

Vasectomies have been around since at least the 1800s, and they remain a popular method for preventing pregnancy to this day.

Every year in the United States, an estimated 500,000 men opt for the procedure, in which the cord that carries sperm from the testicles is snipped or tied off, preventing sperm from mixing with seminal fluid that leaves the penis when the man ejaculates.

While a vasectomy is a routine, outpatient procedure that most men walk away from with little more than a mild ache or soreness, the subject of whether it can be linked to erectile dysfunction (ED) comes up every so often.

We'll look at how vasectomies are performed and what men can expect when they go in for the procedure, but primarily we'll dig into whether vasectomies are known to be a contributing factor to ED.

How a vasectomy is done

A vasectomy is a 20-minute procedure that can be done on an outpatient basis. The doctor applies a local anesthetic to the man's scrotum and makes either two small incisions or a single hole in the scrotum. Then they feel for each vas deferens—the tube that carries sperm from each testes to mix with the rest of the seminal fluid—and tie them off, or sever and cauterize the two ends of each tube.

The man's ability to orgasm is unchanged. Sperm makes up only about 3 percent of ejaculate, so the volume is reduced infinitesimally. Everything is just as it was, except that now no sperm reaches the semen; sperm is still produced, but instead of being ejaculated, it is reabsorbed into the body.

Can a vasectomy cause ED?

The short answer is that vasectomies can't cause erectile dysfunction (ED), or at least not directly.

Unfortunately, false stories stating that they do cause ED are believed to have contributed to a sharp decline in the rates for the procedure, at least in England, leaving women to bear the brunt of reproductive responsibility.

According to an article in the Guardian, vasectomies in the United Kingdom declined 64 percent between 2004 and 2014, a drop that some attributed to hearsay about the procedure being painful, as well as that pesky ED question gaining traction.

However, the facts of how male reproductive plumbing works don't back up these ED stories. The vas deferens and the small incision or hole made in the scrotum have no direct bearing on erections.

Surgeries involving nerves, the penis or the prostate gland can and sometimes do lead to complications with erection response. But vasectomies involve no physical component that might cause ED.

Psychological and emotional effects

What some doctors speculate is that the psychological aspects of getting a vasectomy may affect some men adversely, and lead to ED that's born of depression or emotions about giving up on the possibility of fathering children for the immediate future (although vasectomy reversals are performed regularly.)

In fact, one National Institutes of Health study looked at a cohort of patients who had vasectomies, and specifically a subgroup of men that attributed their experiences with ED to the procedure. The study's findings mostly shone a light on men who were in partnerships where the woman "predominates," and suggested that the ED might have occurred because "the female may have demanded that the male undergo vasectomy," and the men experienced negative feelings as a result.

It's well known that feelings of depression, inadequacy and anxiety are connected with ED, so while there may be a correlation between post-vasectomy feelings and ED, the evidence suggests that blaming the vasectomy directly is off-base.

Conclusions

Vasectomies are a safe, quick and relatively pain-free procedure that millions of men have undergone with no ill effects in terms of their sexual response. Don't believe tales about vasectomies causing erectile dysfunction. If you are considering a vasectomy, speak with your doctor about all the implications of the decision.