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I know the risk of cancer is higher in men that have had it, as well as the increased likelihood of dementia. Of course there is also the drop in testosterone that comes later too.
None of those things appeal.
Vasectomy: You may be cutting off more than you think
By Thomas D. Fahey, EdD.
A vasectomy is the most popular method of birth control in the United States for married couples in the United States over the age of 30. A simple, relatively painless operation, a vasectomy involves cutting the tubes (vas deferens) that carry sperm from the testes to the penis. For couples who don't want to risk pregnancy, a vasectomy appears to be the perfect answer to birth control – no more pills to take or condoms to wear. A couple of snips and that's the end of it.
For years, medical experts assured us that the procedure was safe and virtually free of side effects. However, during the past five years, reports have surfaced that suggest this method of birth control may be linked to higher risk of prostate cancer, decreased levels of testosterone and even impotence.
The Downside of Vasectomies:
Some studies indicate that a vasectomy may cause problems with the prostate. The prostate is a gland that surrounds the urethra, which is the tube that delivers semen and urine in the penis. The prostate produces a fluid that mixes with sperm to form semen. The gland can become inflamed and cause difficulty or pain when urinating and urethral discharge, and tends to flare up in middle-aged or older men. Prostate problems can sometimes become so severe that the gland must be surgically removed. Since prostate cancer is quite prevalent, men should carefully consider anything that predisposes them to prostate disease.
Last year a study3 appeared in the Journal of the American Medical Association by Edward Gionvannucci, MD, and colleagues from Harvard Medical School that showed that men with vasectomies had a higher risk of developing prostate cancer than other men. In 1976, Giovannucci's research group sent questionnaires to more than 120,000 married female nurses ages 30-55 requesting information about their methods of birth control. More than 14,000 of the nurses' husbands had had vasectomies. These men were age-matched with husbands from the survey who hadn't had the operation.
Thirteen years later, the two groups were questioned about their health status. The groups, although similar in age, height, weight and alcohol consumption, showed a marked difference in the incidence of prostate disease. Men with vasectomies had an 89% greater risk of developing prostate cancer than men who didn't have the surgery. The scientists speculated that a vasectomy contributed to prostate cancer by interfering with the flow of fluid through the prostate gland, which increased its exposure to cancer-causing agents. They also suggested that a vasectomy may cause the body to have immune reactions against its own sperm cells. The study also showed that men who had vasectomies at least 20 years before had a higher risk of developing all forms of cancer than men who never had the surgery. Another study,6 conducted by Ann Hsing, MD. had similar results. In 12 cities in China, researchers evaluated the relationship between vasectomy and prostate cancer risk. Men who had undergone the procedure at least 10 years before the study were shown to have more than a 100 percent higher risk of developing the disease than men who hadn't had vasectomies and lived in the same areas.
VASECTOMY & REDUCED TESTOTERONE
A vasectomy may also decrease testosterone levels, which concerns bodybuilders because of the hormone's importance in muscle growth. Studies conducted in Japan by Sergei Antypas, MD.1 and in Germany by Bernard Geirerhaas. MD,2 showed that a vasectomy decreases testosterone levels by 33 percent. The hormone contributes to the development of the sex organs and male traits, such as facial hair, deepening of the voice, lower bodyfat and relatively rough skin texture.
Testosterone also promotes the growth of muscle, bone and blood cells. Adequate levels of testosterone are necessary for normal development of skeletal muscle in response to training, repair of muscle damage and maintenance of bone mass. If testosterone levels fall significantly, the capacity for muscle growth and tissue repair is reduced. Training becomes harder, injuries may occur more often, and the desire for heavy training wanes. Testosterone is important for maintaining lean body mass (mainly muscle) and low bodyfat. Bodyfat levels fall during male adolescence, the time when testosterone secretion accelerates. Castrated males typically have flabby body types, largely because of low testosterone levels. The decreased muscle mass and increased body-fat in older men are, in part, due to declining levels of testosterone.
Testosterone is also associated with aggressiveness, which is of obvious importance in athletic training and competition. Normal levels of testosterone may also be associated with a feeling of well-being, which is important for improvements in athletic training.
LIBIDO & SEXUAL PERFORMANCE
Testosterone has profound effects on sexual physiology in males. It contributes to sperm cell production and semen volume, libido (sex drive) and sexual potency. Men with decreased testosterone levels often report decreased sex drives and occasional impotence. Testosterone secretion in men often begins to decline after the age of 30. Low levels of testosterone have been associated with viropause, or male menopause, which is characterized by declining sexual performance and interest in sex in middle-aged men. Conversely, high testosterone levels are often associated with greater sexual interest and activity. Some evidence has been cited that a vasectomy may impair sexual capacity.
Richard Petty, MD,4 director of the Private Medical Center in London, which specializes in reproductive and androgen problems in males, has found a link between sexual dysfunction in men and vasectomies. He studied 445 men who had difficulty achieving erections. All of the patients had lower testosterone levels than normal. However, men who had had vasectomies at least 10 years earlier had the lowest levels.
Petty4 noted that some confusion exists among medical researchers regarding vasectomy and hormone levels. Shortly after a vasectomy, testosterone levels are typically unaffected or even increase. However, 5-10 years after the surgery, testosterone levels may drop dramatically, which can lead to sexual dysfunction, decreased physical vigor and emotional depression. In his studies Petty noted that 25 percent of his patients who had low testosterone levels also had had vasectomies, while only 13 percent of sexually active couples chose this method of birth control. This suggests that the lower testosterone levels in men who had the surgery were not by chance.
These days, many men can expect to marry more than once during their lifetime. Those who get a vasectomy because they don't want to risk pregnancy sometimes regret their decision when they divorce and marry someone else. The procedure is typically difficult to reverse.
Although millions of men have had vasectomies with-out apparent side effects, the negative effects that have been discovered are controversial. While only a handful of studies suggests this surgery may have unacceptable side effects, athletes should carefully consider all options before choosing this procedure. Many other research groups have published data that disagree with these theories. However, a birth-control measure that may be irreversible, is even remotely associated with prostate cancer or impotency and could possibly impair your ability to make gains in the weight room may not be the best solution to your birth-control needs. Medical researchers have a lot to learn about the safety and side effects of vasectomies. Learn the facts before you make a decision that may affect your health and capacity to exercise.
REFERENCES
1. Antypas, S., et al. Bilateral effect of unilateral vasectomy on testicular testosterone biosynthesis. Journal of Pediatric Surgery 29: 828-831, 1994.
2. Geirerhaas, B., et al. Morphological and hormonal changes following vasectomy in rats, suggesting a functional role for Leydig-cell associated macrophages. Hormone Metabolism Research 23: 373, 1991.
3. Giovannucci, E., et al. A retrospective cohort study of vasectomy and prostate cancer in U.S. men. Journal of the American Medical Association 269:878-882, 1993.
4. Petty, R. Erectile impotence. Practitioner 237: 828-832, 1993.
5. Reuters World Service. Vasectomies increase risk of male impotence study. London, October 5, 1994.
Webmasters Note:- the author references the studies below but chose not to include them in this reference list.
6. Hsing AW, Wang RT, Gu FL, Lee M, Wang T, Leng TJ, Spitz M, Blot WJ. Vasectomy and prostate cancer risk in China. Cancer Epidemiol Biomarkers Prev. 1994 Jun;3(4):285-8. |
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