Vasectomies one of most effective birth control methods

This story first appeared in Healthy You - November 2025, The Gazette’s quarterly health publication.

One of the simplest, most effective and inexpensive birth control methods happens about a half-million times a year in doctors’ offices nationwide. But it’s not a routine matter for either the patients or their providers.

“It’s a personal decision for a man and a woman, presumably,” said Dr. Thomas Richardson. “For that reason, we don’t take it lightly.”

Richardson, a urologist who’s also president and medical director for the Physicians’ Clinic of Iowa, was discussing the vasectomy.

The vasectomy term comes from the vas deferens, the tube in the scrotum that allows sperm to move from the testicle to the penis. A surgeon performing a vasectomy cuts the tube and seals it, blocking the pathway. The operation takes under 30 minutes under a local anesthetic, supplemented by an oral sedative, to calm the patient.

But the process really begins with a referral to a urologist who counsels the patient on its effectiveness and purpose.

“We help them understand it is a permanent procedure, and they’re not without other potential (birth control) options,” Richardson said. “We take into account previous surgeries, medications they take that might need to be altered, and determine if it can be done in office.”

Just under 7 percent of American men ages 18 to 49 had a vasectomy in 2022-23, according to the Center for Disease Control. That share increases among men with two or more children, to just over 18 percent.

National politics may have spurred interest in the procedure. Following up on urologists’ anecdotal reports, Nature Magazine found Google Trends tracked a 121-percent increase in “vasectomy” web searches after the U.S. Supreme Court’s June 2022 decision overturning Roe v. Wade, which eliminated the federal constitutional right to abortion and allowed individual states to regulate and/or restrict medical abortions.

Richardson addresses family planning when patients inquire about the procedure.

“We address how many children they have,” he said. “We make sure they understand this is intended to be a permanent procedure. The failure rate is something a lot of people ask about. I usually say it’s about one in 4,000. We ask what kind of work they do, physical work versus a desk job.”

Providers have noted a pattern in vasectomy referrals, which tend to peak in November and December, and again in early March. The late-in-the-year surge is tied to a patient’s desire to have it done before their health insurance changes with the new year. The March “rush” is a matter of timing: the first week of the NCAA’s annual college basketball tournament can coincide male patients’ post-operative recovery.

“We will have, I would say, a slight uptick in requests for vasectomies during March,” Richardson said. “The philosophy of our practice is not to try and monetize or trivialize something like that.”

Still, three days of wall-to-wall basketball fits neatly into providers’ advice to men recovering from the procedure: put your feet up.

“We tell patients we want them to limit their strenuous activity for 48 to 72 hours,” Richardson said. “There’s generally no prescription, just Tylenol, and ice and limited activity. After that 72-hour period, we begin allowing them to get back to regular activity.”

There’s still an important step after that: a test to determine the procedure has indeed cut off the sperm’s pathway. That’s done with a simple in-home test for the patient that’s then mailed or delivered to the provider.

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“That has improved convenience and accuracy,” Richardson said.

Until a successful vasectomy is confirmed by the test, patients and their partners should continue to use their previous birth control method.

While vasectomy reversals are possible, “that’s much easier said than done,” according to Richardson. “If they indicate that’s in their thoughts, we tend to discourage them from having the procedure.”

“The procedure itself is done with a few exceptions in a very similar manner by all people who do them,” Richardson said. Complications such as minor infection are “very rare.”

A suspected link to prostate cancer was refuted when follow-up studies established that urologists performing vasectomies also routinely performed cancer screenings of their patients.

“That has been refuted, and we talk about that,” Richardson said. “We felt that tended to be more of a sampling error. It’s not really a cause and effect.”

Men considering a vasectomy should consult their insurance provider to confirm they’ll cover it. Most plans are required by law to cover all prescription birth control methods with no copay or out-of-pocket costs. That requirement doesn’t include vasectomies, but most carriers cover them, albeit often with some cost-sharing. Planned Parenthood care centers often offer at least partial coverage.

Even at full cost — usually no more than about $1,000, according to Planned Parenthood — a vasectomy costs far less than long-term prescription birth control or tubal ligation, the permanent surgical procedure for women.

“Generally speaking, a vasectomy is an easier, less invasive way to accomplish the same goal,” Richardson said.