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Does a Vasectomy Lower Testosterone?

Written on August 1, 2023 by Sendra Yang, PharmD, MBA. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

Around 5% of married couples worldwide rely on vasectomy as a method of contraception.[1] In the United States, data collected from 2002 reported vasectomies (5.7%) as the fourth most commonly used contraceptive method for men 15 to 44 years of age.[2] Vasectomies follow condoms for men (29.5%), oral contraceptives for women (25.6%), and tubal ligation (8.1%) as common contraceptive methods in the United States. In 2002, there were approximately 500,000 vasectomies reported by healthcare providers in the U.S.

Does a vasectomy lower testosterone?[1,3] It’s important to understand what precisely a vasectomy is, the function of testosterone, and the relationship between the two to help answer the question.

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About Vasectomy

A vasectomy is a procedure that involves disrupting the flow of sperm through a duct that connects the testicles to the urethra, called the vas deferens.[4] The vas deferens is cut and blocked to inhibit sperm from mixing with ejaculation fluid.[5] A vasectomy is a form of male sterilization used as contraception to prevent future fertility.[4,6]

Vasectomies have a high success rate of 99.7%.[4,6] Vasectomy is faster than other contraceptive methods and cheaper than tubal ligation.[4] After the vasectomy, semen analysis is performed to ensure the procedure was successful.[6] Though vasectomy is technically reversible, it is intended to be permanent.[4,6]

Before a vasectomy, your healthcare provider will discuss your medical, sexual, and social history, along with the risk and benefits of the procedure.[4] Some key elements to consider [4]:

  • Vasectomy is considered a permanent procedure
  • To be considered sterile, a semen analysis must show no sperm or nonmotile sperm
  • Even with a negative semen analysis, the risk of getting pregnant is about 1 in 2000
  • A repeat vasectomy may be required and is estimated at a rate of 0.24%

Complications with vasectomy only occur in 1% to 2% of patients.[4] Hematoma, infection, chronic scrotal pain, epididymitis, and sperm granulomas are some risks associated with vasectomy. Patient education on pain control, wound care, diet, sexual activity, showering, and physical activity are typically provided as part of after-procedure care.[4]

Testosterone Function

Testosterone is the sex hormone mainly produced by the testicles in men.[7] It has a role in increasing sex drive and is vital for sperm production and fertility.[7,8] Testosterone also impacts muscle mass, bone mass, and the production of red blood cells. With increasing age in men, testosterone levels in the body tend to decrease.[8]

Relationship Between Vasectomy and Testosterone

The relationship between vasectomy and testosterone is as clear. Studies show testosterone and sex drive are unchanged after vasectomy.[4] But there are conflicting studies connecting vasectomy to lowering testosterone.[1,3,4,9,10] An older prospective study from 1979, including 54 men with follow-up for five years, found no significant difference in testosterone levels at multiple points in time after vasectomy.[9]

A long-term study aimed at understanding the effects of vasectomy analyzed lab parameters and questionnaires.[10] There was no significance in free testosterone levels between the vasectomy and non-vasectomy groups, while total testosterone was significantly different. However, an additional study using a linear model analysis showed no significant change in total and free testosterone levels between men without and after vasectomy.[1]

An article reviewing the literature on short-term and long-term complications of vasectomy, including implications on testosterone levels, reports that testicular reproductive hormones may decrease in the immediate timeframe after the procedure. [3] It is theorized that testosterone levels are temporarily reduced within three months after vasectomy because of the disruption to the blood and testes areas after the procedure.[3] However, the hormone levels will normalize in the long run.

Testosterone Testing with Everlywell

If you are wondering about your testosterone levels, you don’t have to guess. At Everlywell, you have the option for a testosterone test to check your levels via at-home sample collection (and sample testing at a lab). This test measures your total testosterone level. Test results will provide detailed information on whether your testosterone level is normal, low, or elevated. Along with your test result, you will receive lifestyle tips for supporting healthy testosterone levels and your overall wellness.

You may also want to consider a men's health online appointment via the Everlywell telehealth option.

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References

  1. Zhao K, Wu L, Kong X, Chen Y, Li H, Gu Y, Shang X, Xiong C. Long-term safety, health and mental status in men with vasectomy. Sci Rep. 2018;8(1):15703. doi: 10.1038/s41598-018-33989-5
  2. Vasectomy guideline. American Urological Association. https://www.auanet.org/guidelines-and-quality/guidelines/vasectomy-guideline. Accessed July 25, 2023.
  3. Yang F, Li J, Dong L, Tan K, Huang X, Zhang P, Liu X, Chang D, Yu X. Review of Vasectomy Complications and Safety Concerns. World J Mens Health. 2021;39(3):406-418. doi: 10.5534/wjmh.200073
  4. Stormont G, Deibert CM. Vasectomy. [Updated 2023 Apr 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549904/.
  5. Fainberg J, Kashanian JA. Vasectomy. JAMA. 2018;319(23):2450. doi:10.1001/jama.2018.6514
  6. Male sterilization. Centers for Disease Control and Prevention. https://www.auanet.org/guidelines-and-quality/guidelines/vasectomy-guideline. March 27, 2023. Accessed July 25, 2023.
  7. Testosterone: What it is, Function & Levels. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/24101-testosterone. Accessed July 25, 2023.
  8. Nassar GN, Leslie SW. Physiology, Testosterone. [Updated 2023 Jan 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. https://www.ncbi.nlm.nih.gov/books/NBK526128/.
  9. Whitby RM, Gordon RD, Blair BR. The endocrine effects of vasectomy: a prospective five-year study. Fertil Steril. 1979;31(5):518-20. doi: 10.1016/s0015-0282(16)43996-8
  10. Smith A, Lyons A, Ferris J, Richters J, Pitts M, Shelley J. Are sexual problems more common in men who have had a vasectomy? A population-based study of Australian men. J Sex Med. 2010;7(2 Pt 1):736-42. doi: 10.1111/j.1743-6109.2009.01565.x
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