Vasectomy (cont.)
Does a vasectomy protect against HIV/AIDS and other STDs?
Although it is extremely effective for preventing pregnancy, vasectomy does not offer protection against HIV/AIDS or other sexually transmitted diseases (STDs). Consequently, it is important that vasectomized men continue to use condoms, preferably latex, which offer considerable protection against the spread of disease, in any sexual encounter that carries the risk of contracting or transmitting infection.
How does a vasectomy affect sex?
A man can resume sexual activity within a few days after vasectomy, but precautions should be taken against pregnancy until a test shows that his semen is free of sperm. Generally, this test is performed after the patient has had 10 to 20 post-vasectomy ejaculations. If sperm are still present in the semen, the patient is told to return later for a repeat test.
Vasectomy does not affect the production or release of testosterone, the male hormone responsible for a man's sex drive, beard, deep voice, and other masculine traits. The operation also has no effect on sexuality. Erections, climaxes, and the amount of ejaculate remain the same.
Occasionally, a man may experience sexual difficulties after vasectomy, but these almost always have an emotional basis and can usually be alleviated with counseling. More often, men who have undergone the procedure, and their partners, find that sex is more spontaneous and enjoyable once they are freed from concerns about contraception and accidental pregnancy.
Are there immune reactions to sperm after a vasectomy?
After vasectomy, the testes continue to make sperm. When the sperm cells die, they are absorbed by the body, much like unused sperm in a nonvasectomized man. Nevertheless, many vasectomized men develop immune reactions to sperm, although current evidence indicates that these reactions do not cause any harm.
Ordinarily, sperm do not come into contact with immune cells, so they do not elicit an immune response. But vasectomy breaches the barriers that separate immune cells from sperm, and many men develop anti-sperm antibodies after undergoing the procedure. This has given rise to concern on the part of doctors and researchers because immune reactions against parts of one's own body sometimes cause disease. Rheumatoid arthritis, juvenile diabetes, and multiple sclerosis are just some of the illnesses suspected or known to be caused by immune reactions of this type.
Immune reactions can also contribute to the development of atherosclerosis, the clogging of arteries that leads to heart attacks. In the late 1970s, after a study of 10 monkeys showed an increased risk of atherosclerosis in vasectomized animals, doctors became concerned that vasectomy might increase the risk of heart disease in men.
Other, more persuasive research results, however, indicated that these concerns were not warranted. In particular, the HSAM study provided a high level of reassurance. Researchers conducting this study found no evidence that vasectomized men were more likely than others to develop heart disease or any other immune illnesses.
But just as concerns about heart disease and immune ailments following vasectomy were being laid to rest, worries about prostate cancer were taking their place.
Next: Is there an increased risk for prostate cancer after a vasectomy? »
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