Post-Sterilization Intimacy: Sex after a Vasectomy

Updated on: August 12, 2019

Dr. Jeffrey Alan Moody is a urologist in Colorado Springs and also a vasectomy recipient, and he is happy to report both scientifically and personally that vasectomy does nothing to sex drive, erection or even ejaculation. "All we are doing with vasectomy is disconnecting the supply of sperm into the prostate. The prostate is where all of the fluid is made for ejaculation, so no change in that at all. Sperm is only about 1% of semen volume" he says. Still not convinced, here are some of the most common questions about post-vasectomy sex.

Will a vasectomy affect my sex drive or ejaculation?

"There is no change in sex life after vasectomy. In fact, sexual frequency has reportedly increased after vasectomy," according to Dr. Ranjith Ramasamy of the University of Miami Department of Urology.

Vasectomy works by preventing sperm from mixing with semen, but because it doesn't affect hormone production there should be no change in sex drive after a vasectomy. Nor should there be any change in the ejaculate. Sperm comprises only 2 to 5 percent of the fluid released at ejaculation, so removing them has little to no effect on the volume, appearance, color, or consistency of the seminal fluid. (According to one study, cigarette smoking appears to have more of an effect on semen volume than a vasectomy.)

Does vasectomy lower testosterone levels?

No. Although testosterone is produced in the testes--the same organ that generates sperm--the connection ends there. "A major concern for many men with vasectomy is testosterone production. Testosterone is made in a separate cell type in the testes, completely separate from the cells that make sperm, so absolutely no effect on those testosterone (Leydig) cells," according to Dr. Moody.

Does ejaculation after a vasectomy feel different?

No. Because the volume of semen changes so little, and because hormone production and the associated pathways remain the same, ejaculation after a vasectomy should feel no different than it did before. You should still experience just as much pleasure from orgasm, and should not notice a change in quality, intensity, sensitivity or duration of orgasm after the procedure.

How long until I can resume sex after a vasectomy?

Your testicles will continue to produce sperm after a vasectomy, but now instead of mixing with semen they are mostly reabsorbed by the body or travel through the vas deferens tube until they reach the blockage and can't go any further. Sperm can also build up in the epididymis, and when this happens small blockages and scarring can occur. (But this rarely causes symptoms and men are usually unaware that this is happening.)

It can take six weeks or longer--between 10 and 20 ejaculations--for the sperm remaining in the unblocked portion of the vas tube to be completely reabsorbed or eliminated via ejaculation. Your physician will perform the first sperm-count test about six weeks after the surgery and will continue to do them until your sperm count is zero. Until then, you or your partner should continue to use some other form of contraception.

Physicians usually suggest waiting until a week or two after the procedure before resuming normal sexual activity--basically, until you are comfortable and can ejaculate without pain. But keep in mind: It will take additional time before your sperm count is zero, and until then it's still possible to get someone pregnant.

It's important to use an alternate form of birth control until a semen analysis confirms that there is no sperm in your ejaculate. The first semen analysis is usually first obtained at the two- to three- month mark. If any sperm is present, your urologist will continue testing your semen until it's completely sterile. Click here for more information about what to expect after the vasectomy procedure.

Does the vasectomy procedure leave scars?

No. Vasectomies leave virtually no scar or noticeable difference to the feel or appearance of the scrotum.

Can a vasectomy make you more or less susceptible to sexually transmitted diseases?

Sexually transmitted diseases are transferred in body fluids, such as saliva or semen, and vasectomy surgery does not alter your ability to transmit or contract any of these infections. Use a condom if there is a potential risk for either partner to contract an STD.

Does the first time ejaculating after a vasectomy hurt?

No, most men do not experience pain when ejaculating the first time after their vasectomy surgery. The scrotum itself may still be sensitive, but the procedure itself does not create any circumstances that would cause discomfort with the first ejaculation.

Some men experience a condition called post-vasectomy pain syndrome, which occurs when sperm backs up into the epididymis and causes discomfort on ejaculation, but such a side effect is relatively uncommon. (Click here for more information on side effects.)

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Matson P.L., Myssonski K., Yovich S., Morrison L., et al. The density of human semen and the validation of weight as an indicator of volume: a multicenter study.? Reproductive Biology. 2010; 10(2):141-153.

Barone M.A., Nazerali H., Cortes M., Chen-Mok M., et al. A prospective study of time and number of ejaculations to azoospermia after vasectomy by ligation and excision.? Journal of Urology. 2003; 170(3):892-896.

Granisiotis, P., Kirk D. Chronic Testicular Pain: An Overview. European Urology. 2004; 45(4): 399-534.

Pasqualotto F.F., Sobreiro B.P., Hallak J., Pasqualotto E.B., & Lucon A.M. Cigarette smoking is related to a decrease in semen volume in a population of fertile men. BJU Int. 2006; 97(2):324-6.

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