From the Guidelines
A vasectomy does not affect testosterone levels. During a vasectomy, only the vas deferens (the tubes that carry sperm) are cut or blocked, while the testicles, which produce testosterone, remain completely intact and continue functioning normally 1. The procedure specifically targets the pathway for sperm without interfering with hormone production or release into the bloodstream. Men who undergo vasectomies maintain their normal testosterone levels, and consequently, there are no hormone-related side effects such as changes in sex drive, erectile function, muscle mass, or other testosterone-dependent characteristics.
Key Points to Consider
- The testicles, which produce testosterone, are not affected by the vasectomy procedure 1
- The endocrine function of the testes remains unaffected by the procedure
- Vasectomy is considered a form of contraception that affects only fertility without altering hormonal balance
- Any concerns about decreased testosterone following a vasectomy are unfounded from a physiological perspective
Clinical Implications
The fact that vasectomy does not affect testosterone levels is crucial for patient counseling and management. Patients can be reassured that psychosocial, sexual, and endocrine problems are rarely encountered following vasectomy 1. This information can help alleviate concerns and facilitate informed decision-making regarding vasectomy as a form of contraception.
From the Research
Effects of Vasectomy on Testosterone Levels
- The study published in 1976 2 found that mean plasma testosterone levels demonstrated a statistically significant elevation beginning at 6 months after vasectomy, and remained elevated at 2 years after vasectomy.
- Another study from 1976 3 measured plasma testosterone levels before and after vasectomy, and found that testosterone levels were similar at the three sampling times.
- A study published in 1995 4 found that men who underwent vasectomy 20 years or more ago had higher testosterone levels than age-matched controls.
- The studies 2, 3, 4 suggest that vasectomy may have varying effects on testosterone levels, with some studies finding elevated levels and others finding no significant change.
Hormonal Changes After Vasectomy
- The study published in 1976 2 found that mean plasma estradiol levels were lower, mean plasma luteinizing hormone (LH) levels were elevated, and mean plasma follicle-stimulating hormone (FSH) levels were unchanged after vasectomy.
- Another study from 1976 3 found that levels of LH at 12 months were significantly higher than pre-vasectomy levels, suggesting some degree of decreased Leydig cell function.
- A study published in 1995 4 found that men who underwent vasectomy 10 to 19 years previously had higher dihydrotestosterone levels than age-matched controls.
Testosterone Therapy and Vasectomy Reversal
- The study published in 2022 5 found that vasectomy reversal outcomes in men after testosterone therapy were favorable, with a high rate of vasovasostomy and sustained patency.
- Another study from 2014 6 found that testicular salvage medical therapy may play a role in the preoperative management of vasectomy reversal in men with prior testosterone supplementation therapy, and that vasectomy reversal after testosterone therapy can have outcomes comparable to those in the general population.