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

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.