For most men, the idea of vasectomy, a surgical procedure to cut and close off the tubes that deliver sperm from the testicles, is a complete no-can-do associated with being sexually dysfunctional in the male psyche.
According to the latest issue of Population Reports, titled “Vasectomy: Reaching Out to New Users,” published by the Johns Hopkins Bloomberg School of Public Health, vasectomy is simpler and more cost effective than female sterilization and offers men a way to share responsibility for family planning.
“The most entrenched and powerful rumors concern manhood, masculinity, and sexual performance. Many men confuse vasectomy with castration and fear, incorrectly, that vasectomy will make them impotent,” says the report. But in fact, “Castration involves removal of the testicles. In contrast, vasectomy leaves the testicles intact, and they continue to produce male hormones.”
The procedure which typically takes from 15-30 minutes and usually causes few complications and no change in sexual function is one of the most reliable forms of contraception. Though it does not offer protection against sexually transmitted infections or HIV, for couples it is a way for men to be directly involved in family planning. Family planning has been largely seen as the responsibility of women but vasectomies allow men to play a part.
The report states that the largest number of vasectomized men are in China, where almost 7% of women in relationships — or more than 17 million couples — rely on vasectomy for birth control.
Although the process of vasectomy does not usually pose any medical risks, the uptake of this contraceptive method is very low in many developing countries.
The report states that worldwide fewer than 3% of women ages 15 to 49 who are married or in partnerships rely on a partner’s vasectomy for contraception. In sub-Saharan Africa, less than one-tenth of 1% of women in union rely on a partner’s vasectomy for contraception. Even in developed countries overall the uptake of vasectomy is very low with less than 5% of women relying on vasectomy.
Due to traditional and cultural beliefs about male virility, many men shun vasectomy. The fear that vasectomy will cause impotence makes many men turn away from opting for vasectomy as a family planning method.
Also, in many parts of the developing world very few men have heard about the contraceptive method. But many men want to know that they are able to impregnate a woman whenever they choose to — thereby lessening the procedure’s appeal.
To promote vasectomy requires the mammoth task of dispelling the myths surrounding the contraceptive, in particular, reassuring men that their sexuality will not be effective after the procedure. It is critical to communicate the fact that a vasectomy will not affect a man’s sex drive, as the procedure does not affect the production of male hormones.
Another key message is that vasectomy is not an option for all men; it is only appropriate for men who no longer want to bear children. Following a vasectomy a man will continue to enjoy sex, and produce the same amount of fluid when he ejaculates — but the fluid will not contain sperm that can impregnate a woman.
The report recommends that mass media and interpersonal communication directed to clients can dispel myths and rumors, disseminate accurate information about the procedure, tell men where the method is offered, and prompt men to discuss vasectomy with family and friends.
Vasectomy also needs to be promoted throughout health care systems, and all clinic staff should receive general training to help them better understand vasectomy, and ultimately feel comfortable with male clients.