Dr Zac Turner on whether men should get a vasectomy

Dr Zac Turner has some sage sex advice for a Queensland woman who describes her husband as “always on heat”.

Welcome to Ask Doctor Zac, a weekly column from news.com.au. This week, Dr Zac Turner talks about vasectomies and other contraceptives.

Question:Hi Dr Zac, I’ve just given birth to my fourth child – four boys in a row please let there be no more! I’ve begun researching contraceptives and have become confused by all the choices. What is the best form of contraception?

My hubby is always ‘on heat’ and likes to have regular sex (so do I just to be clear!), which is great but I’ve reached my limit of having children. My husband would like to have a girl. I would like him to have a vasectomy. We are at a crossroads, what do you think we should do?

He hates the idea of a vasectomy, he considers it being ‘neutered like a dog’. How can I explain to him this isn’t the case? – Angela, 38, Queensland

Angela wants to enjoy sex without worrying about having more kids.

Answer: Sexual health can be a tricky one, especially because we are all so wound up about openly discussing it! I applaud you for being open, and recommend bringing this up with your GP who can discuss your options in-depth and tailor your solution to fit your lifestyle.

I believe that both men and women should look into contraception once they become sexually active, and they should learn all about it. What usually happens these days is that women are more versed in contraceptives, while men lack any knowledge beyond condoms.

Before you consider what contraceptive works for you and your husband, take some time to think about your sexual activities. Do you have sex every day, once a week or every few months? Do you have sex in bed, or like to do it in other places? Do you have intercourse every time you have sex? When you have these answers, your discussion with your doctor will be a lot more guided and succinct.

Contraceptives come in all shapes and sizes, and they tend to fit into four different categories. I’ll take you through these categories, and then dispel your husband’s beliefs about vasectomies.

Before you consider what contraceptive works for you and your partner, take some time to think about your sexual activities. Image: Supplied

Barrier

Barrier method refers to when contraception is used when needed in the moment, with the most obvious example being a condom. It’s something you and your sexual partner use that goes into the body before sex to block sperm fertilising an egg.

Hormonal

A very common method for women including the birth control pill, the shot, the ring and the path. Typically a woman will need to use this method regularly, such as taking the pill daily. These methods work in many ways including stopping the ovaries from releasing eggs, or thickening the mucus around the cervix and thinning the lining of the uterus.

I highly recommend exploring your options with your GP if you decide to go down this route. Women present with an array of harmful side-effects due to these contraceptives.

Birth control pills, shots, rings and paths prevent the ovaries from releasing eggs but come with a heap of side effects for women. Image: Getty

Lifestyle

This refers to methods such as abstinence, outercourse and fertility awareness. Intimacy is a spectrum, and you can explore it with your sexual partner is many ways. You can have sex with someone without ever having intercourse.

Medical

This includes procedures such as vasectomies or tubal ligation. These methods will change your body and ultimately prevent it from fertilising or getting pregnant. Many people will steer clear of these methods due to stigma or fear, but you should be calm knowing they are very advanced and have been safe for quite some time.

Misconceptions around vasectomies

Now on to your husband’s misconceptions about vasectomies. I believe his connection to ‘neutering’ with getting a vasectomy is grounded in toxic masculinity. He, and millions of other men, feel that a vasectomy will take their masculinity along with their ability to have children.

This is not the case. Masculinity is no longer black and white, and I feel you may be able to overcome these fears with your husband if you speak with him. Ask him what it means to be a man, and tell him what you love about him that is masculine. After this discussion, you both will see that being a man is so much more than simply being able to fertilise eggs in a uterus.

Mature male patient sitting on exam table in discussion with doctor in exam room

A vasectomy is a simple procedure that involves blocking or cutting the tubes that carry sperm from the testicles to the penis. In most cases this procedure will be during the day, and will only take a few hours. The effectiveness is more than 99 per cent, which compared to the contraceptive pill being 93 per cent and condoms 87 per cent, seems like the safest option in that regard.

A vasectomy will not affect hormone levels, cause impotence, damage neighbouring sexual organs or cause severe lasting pain. Your husband should see his GP to discuss if he is still apprehensive.

Typically it’s only older men who have children who use this method as although it can be reversed, it is considered permanent. Reversal procedures are complex, require more time and don’t always work.

You may not feel strong enough to have children now, but down the line you may regain some strength and want to have another. I recommend you and your husband look into sperm freezing. Studies have shown that sperm health decreases with age, so your husband’s semen down the line may not be as healthy as it is now.

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Dr Zac Turner has a Bachelor of Medicine and Bachelor of Surgery from the University of Sydney. He is both a medical practitioner and a co-owner of telehealth service, Concierge Doctors. He was also a registered nurse and is also a qualified and experienced biomedical scientist along with being a PhD Candidate in Biomedical Engineering.