Q&A: Despite common misconceptions, more men opt for vasectomy after Dobbs decision

Key takeaways:

• Misconceptions about vasectomies include sexual dysfunction and low testosterone.
• An increasing number of patients are undergoing vasectomies.

Nov. 15 is World Vasectomy Day. It is held on the third Friday of each November to raise awareness about the role of male contraceptives in family planning.

According to background information from the Cleveland Clinic, more than 500,000 men in the U.S. opt to have a vasectomy annually.

Several recent studies have shown significant upward trends in vasectomies and other contraceptive options in response to the U.S. Supreme Court’s 2022 decision in Dobbs v. Jackson overturning a federal right to abortion.

For example, an abstract published in the Journal of Urology showed that the rate of vasectomies significantly increased in men who were single (incidence rate ratio [IRR] = 1.13) or under the age of 30 years (IRR = 1.59) post-Dobbs, while tubal sterilization rose in men aged under 30 years (IRR = 1.29).

Another analysis published in the International Journal of Impotence Research revealed increases in vasectomy consults, vasectomy completion rates, partnerless vasectomies and childless vasectomies post-Dobbs.

Healio spoke with Sarah C. Vij, MD, a urologist at the Cleveland Clinic who has performed approximately 1,500 vasectomies during her career, about this trend, as well as common misconceptions about vasectomies and vasectomy reversals, and more.

Healio: Have you seen an uptick in vasectomies following the Dobbs decision? If so, how long do you anticipate this trend will continue?

Vij: Yes, and many institutions reported this. We do not yet have data on whether this trend is continuing. We are doing more vasectomies year over year. Whether that is due to Dobbs is hard to tease out.

Healio: What are some common misconceptions about vasectomies and vasectomy reversals?

Vij: Common misconceptions about vasectomies are that these:

• can cause sexual dysfunction, low testosterone, prostate cancer and heart disease (none of these are true);
• often lead to tough recovery and prolonged discomfort; and
• require general anesthesia (most are done under local anesthesia).

Common misconceptions about vasectomy reversal include that these:

• rarely work (the success rate is very high, particularly if less than 15 years from vasectomy); and
• are covered by insurance (these rarely are).

Healio: What other male contraceptives are in the pipeline? What role do you think these will have in the future for family planning?

Vij: There are many options in the pipeline — injectable agents that are temporary, oral options. If these pan out, they will increase reversible contraceptive options for men.

Healio: What is your message to primary care providers on World Vasectomy Day?

Vij: Vasectomy is a great method of permanent contraception for men. It is a low-risk, office procedure with minimal down time. If your male patients are done fathering children, please refer them for this procedure if they are interested.

References:

• Bole R, et al. Int J Impot Res. 2023;doi:10.1038/s41443-023-00672-x.
• Nguyen V, et al. J Urol. 2024;doi:10.1097/01.JU.0001009484.98400.42.06.
• Schardein J, et al. O-45. Presented at: ASRM Scientific Congress & Expo; Oct. 14-18, 2023; New Orleans.
• Vasectomy. Available at: https://my.clevelandclinic.org/health/treatments/4423-vasectomy. Accessed Nov. 14, 2024.
• World Vasectomy Day. Available at: https://wvd.org/. Accessed Nov. 14, 2024.