Snip, Snip, Hooray! What to Expect from Sex After a Vasectomy

A vasectomy is a safe, reliable, and permanent form of male birth control. It’s a small surgical procedure to sever and block the vas deferens (the dual tubes in the scrotum that carry sperm from testicle to penis).

Vasectomies are more than 99 percent effective at preventing pregnancy, and they’re relatively inexpensive, as medical procedures go.

Although no surgical procedure is without risk, vasectomies are considered safe and common (about 500,000 are performed in the United States each year) and don’t generally cause long-term side effects.

The short answer: about 2 weeks after your vasectomy. As with any surgical procedure, the first priority is recovery. For a vasectomy, this means avoiding sex or even masturbation until any incision sites have fully healed and there’s no remaining discomfort.

This usually takes 2 weeks or less — not an unreasonable amount of time to remain “master of your domain.” Just think unsexy thoughts!

Afterward, you’ll need to clear out any remaining sperm that began the voyage from testicle to penis before the “cutoff.” This usually requires 15 to 20 ejaculations, which can take 6 to 8 weeks or longer, depending on how “committed” you are to getting rid of those swimmers.

It’s extremely important to continue using contraception during this time. Your doctor will schedule a follow-up test to verify that your semen is indeed free and clear of sperm. Mercifully, you’ll likely be asked to produce the sample at home and drop it off at a lab.

Until testing confirms a zero sperm count, you’ll need to use other forms of birth control to keep babies at bay. Using condoms or female birth control methods and exploring different ways of “getting it on” are all options to help you get through this transition.

Sex post-vasectomy might have you howling “Freeeeedommmm!!” in the bedroom, but the question remains: Will it be in agony or in pleasure?

Men are famously protective of their family jewels, so this is a common pre-op worry. But most people have no lasting pain after the procedure. Once you’re all healed, sex should feel the same as it did pre-snip.

As for the operation itself, you’ll get local anesthesia on your scrotum (a little pinch there, to be sure), and you may have the option of a light sedation (mostly awake but sedated by medication).

If you’re alert, you may feel a slight pressure and tugging as the surgeon works, but you’ll be spared most of the pain. Check out the personal account one man wrote for Esquire in 2018.

During the short recovery period after a vasectomy, you’ll likely experience these symptoms:

• manageable pain and discomfort
• bruising, soreness, or swelling around your scrotum
• bloody semen for the first few ejaculations

In rare cases, issues arise that require further medical attention, including:

• bleeding inside the scrotum (aka hematoma)
• leakage of sperm from the vas deferens into the scrotum (aka granuloma)
• infections in surgical wounds (fever and redness and tenderness of the scrotum are symptoms of this)

Chronic scrotal pain is another rare complication. An estimated 1 to 2 percent of vasectomy patients have pain that lasts at least 3 months, interferes with daily life, and requires medical attention.

This condition is called post-vasectomy pain syndrome (PVPS). PVPS isn’t yet fully understood, but it’s thought to be triggered by pressure from backed-up sperm production or nerve damage resulting from the body’s inflammatory response.

There are two methods of vasectomy:

• Conventional/traditional vasectomy: After administering a local anesthetic, the doctor makes two small incisions with a scalpel — one to access each vas deferens. The tubes are cut and sealed by tying or cauterization, and the incisions in the scrotum are stitched closed. (The stitches will usually dissolve and don’t require removal.)
  
• No-scalpel vasectomy: A local anesthetic is applied before the doctor makes a single small puncture hole in the scrotum through which both tubes can be reached. After the tubes are cut and sealed, there’s little bleeding and no need for stitches.

No-scalpel vasectomies generally involve less pain and fewer complications than conventional ones.

If you opt to have a vasectomy, realize that they’re difficult to reverse — this isn’t a choice to make on a whim. Reversal is possible, but it’s not always successful.

Pregnancy success rates after a vasectomy reversal vary from 30 percent to more than 90 percent, depending on how long ago the procedure was done, the experience of the surgeon, and the technique used.

There are also various techniques of surgical sperm retrieval — a method of harvesting sperm directly from the testicle to be used for in vitro fertilization. But be warned: Infertility treatments like these aren’t normally covered by insurance in the United States, and some can come with a ball-withering price tag.

In short: If you’re under 30, haven’t yet had children, and aren’t 99.9 percent sure you won’t want to, it may be wise to wait. You have other, less permanent options. Don’t forget that condoms are the only form of birth control that prevents the spread of sexually transmitted infections (STIs).

Getting a vasectomy involves severing the tubes that carry semen from your testicles to your penis, thus preventing sperm from exiting your testicles.

Neither these tubes nor the presence of sperm has anything to do with the mechanics of getting an erection or fueling your sex drive, so there’s no physiological reason getting a vasectomy would impact those areas.

In fact, some men find that their sex drive improves just because they know they can’t get their partner pregnant.

After a vasectomy, it’s common for your first few ejaculations to contain blood. This may look alarming, but it should stop within a short time.

After that, unless you’re fond of analyzing your semen under a microscope (hey, it takes all kinds), you shouldn’t notice any difference in the appearance or volume of your ejaculate from pre-op to post-op.

In men who haven’t had a vasectomy, sperm accounts for only about 5 percent of semen volume. The other 95 percent is a concoction of fluids from the seminal vesicles and prostate. Don’t worry — Old Faithful won’t dry up on you.

Dirty Harry once inquired, “I know what you’re thinking — did he fire six shots or only five? Well, to tell you the truth, in all this excitement I kind of lost track myself… you’ve got to ask yourself one question: ‘Do I feel lucky?’ ”

Well, do ya, punk?

The answer is irrelevant — you shouldn’t rely on luck.

In the weeks after a vasectomy, your semen will contain lingering sperm that, at the time of your procedure, had already made it past the point where the tubes were severed. So you won’t be shooting blanks immediately after the snip.

As we mentioned, experts estimate that it takes 15 to 20 ejaculations to clear all remaining sperm from the pipeline. But there’s no way to know for sure until the lab processes your sample and your doctor confirms that your sperm count is zero.

Once you’ve gotten this assurance, you’re cleared to have condomless sex without the risk of pregnancy. Other risks, such as STIs, still apply.

It’s important to note that while vasectomies have an extremely high success rate, approximately 1 in 2,000 will fail eventually, with most of these failures happening within the first few months after surgery. (Failure in this case means sperm has found a way back into your semen stream.)

The best advice is to take it slow. Don’t rush into sex if you haven’t yet recovered from the procedure — that could reopen the wound or allow bacteria to contaminate the site.

Your scrotum should heal and regain its former glory within 2 weeks, after which it’s safe to dip your toes (or whatever else) back into the pool.

Once you’ve recovered, it’s fine to resume sexual activity, with the understanding that it’s still possible to impregnate your partner until your doctor has confirmed a zero sperm count. Be sure to use an alternate form of birth control until you get the good news.

After that, your comfort is the limit! While you may be sterile now, the sex can still be dirty. But if you or your partner is intimate with multiple people, it’s still important to use condoms or another barrier method to prevent STIs.