Associations of vasectomy with sexual dysfunctions and the sex life of middle‐aged men

Abstract Background Vasectomy is a safe and effective form of contraception. However, fear of altered sexual function is still associated with vasectomy in many men. Objectives To assess the prevalence of vasectomy among middle‐aged men in Germany and to investigate possible associations between a previous vasectomy and sexual dysfunctions. Methods Data on lifestyle, sexual activity, satisfaction, and dysfunction from 5425 middle‐aged, heterosexual men were collected. Differences between vasectomized (VM) and non‐vasectomized men (NVM) were assessed. Multiple logistic regression analyses were calculated to determine variables associated with erectile dysfunction (ED), premature ejaculation (PE), and low libido. Results 5425 men with a mean age of 50.6 ± 0.8 years were included in this analysis. Vasectomy was performed in 12.5% (679/5425) on average 8.6 ± 5.8 years ago. 84.4% were sexually active in the last 3 months (93.0% in vasectomized men vs. 83.2% in non‐vasectomized men; p < 0.001), and 45.4% were satisfied with their sexual life (55.2% in vasectomized men vs. 44.0% in non‐vasectomized men; p < 0.001). The prevalence of erectile dysfunction was significantly lower in vasectomized men (12.1% vs. 20.1%; p < 0.001), and a previous vasectomy was associated with a decreased risk for erectile dysfunction in multivariable regression analysis (OR: 0.65 [0.40–0.83]). The prevalence of low libido (4.7% in vasectomized men vs. 7.1% in non‐vasectomized men; p = 0.02) was marginally higher among non‐vasectomized men. The prevalence of premature ejaculation (7.1% in vasectomized men vs. 6.1% in non‐vasectomized men, p = 0.5) did not differ significantly between vasectomized and non‐vasectomized men. Discussion A previous vasectomy is not associated with an increased risk for sexual dysfunction, and vasectomized middle‐aged men are more sexually active and satisfied compared to their non‐vasectomized counterparts. The main limitations are the retrospective design and missing pre‐vasectomy data. Conclusions Men can be reassured that the fear of sexual dysfunctions and diminished sex life after a vasectomy is unwarranted.