Contraception: male sterilization - not an easy decision

The consideration usually comes in the late 30s or early 40s, after family planning is complete: How should contraception continue? Many a man then wonders whether sterilization might be the right thing to do.

The topic came up again and again, mostly Heiko Otto's partner brought it up - now, after the birth of her third child, more often again. We're talking about sterilization in men, vasectomy is the name of this intervention in medicine

"The other contraceptive methods all have some catch, and sterilization is a bigger intervention for women than for men," says Otto. "The responsibility for prevention women often wear them, it's not entirely fair. My partner would like it if I had it done." But the 41-year-old is unsure and speaks of a "finding phase".

"Something triggers it in me," says the Berliner. "Not so much related to the fear of the procedure itself, even if that plays a bit into it. It has something final." During a vasectomy, the vas deferens are severed to ensure that a man does not have any children can produce more.

The procedure can still be reversed in the first two to three years with very good chances of success, but after that it becomes more and more difficult, says urologist Marc Armbruster from Kornwestheim in Baden-Württemberg. "It's a step that should be considered final." The fewest men wanted to undo it afterwards.

Men are not always sure

Occasionally, the question arises as to whether the erection or desire for sex will change negatively after the procedure. "But this can be denied," emphasizes Armbruster. "Because only the vas deferens are severed during the operation and not the nerves responsible for the erection." If there are disturbances, this is mostly psychological.

Timo Storck, Professor of Clinical Psychology and Psychotherapy, explains that it can be more difficult on an emotional level than on an anatomical or rational level - for example when someone asks themselves: "Is this a relinquishment of something that I think I will someday could ever regret?"

This aspect also drives father Otto: "Then it would really be over with more children." Actually, three children were always the number that he and his partner had imagined. "But I just can't say 100 percent that our family planning is complete. If our financial situation were to change, for example, then I would definitely want more children."

And then there is a second scenario, says the 41-year-old: "If we weren't supposed to go our own way together forever, which of course I don't hope, then further family planning would only be, if at all, in the course of a much more extensive second intervention possible."

Younger men are also showing interest

Storck from the Psychological University of Berlin emphasizes that it is definitely important not to dictate anything morally or psychologically to anyone on the subject, "because it is a very personal, individual decision that everyone should weigh carefully". "Sometimes it can be linked to other topics: How does someone generally deal with big steps, with committing to something?" Another important question is whether someone is having a surgical procedure that is not medically necessary.

Urologist Armbruster has been performing vasectomies for around 15 years. "When I started, I had the feeling that a patient only told his very best buddy about it," says the specialist. "It was already a taboo subject. Now someone is more likely to come and say: 'My neighbor recommended it, and someone at the football club did it too'. Men talk about it much more openly."

Psychoanalyst Storck says: "I think people aren't smiled at as much today as they were 10 or 20 years ago. There is more curiosity about the motives than rejection and ridicule. In 10 or 20 years there will be more openness again. Whether this openness is too more interventions, who knows?" Neither the Professional Association of German Urologists nor the German Society for Urology have exact figures on vasectomies. The background is that the vasectomy is usually a self-payer service and is mainly carried out on an outpatient basis.

Urologist Armbruster says that anyone who comes to him for a vasectomy is in their late 30s on average, has two children and has completed family planning. But there were also younger men who said "I don't have any children and I don't want any either". However, that is rather the exception. If you decide to have a vasectomy, you should be sure, says Armbruster. "The men who sit with me have already made their decision, they no longer have any concerns."

Father Otto gives himself time to think about it. If he does the surgery, it's primarily for his partner. "The process of reflection is definitely not over for me," he says. "My partner has now ordered the pill again. But I'm not saying one hundred percent: I won't do the vasectomy."


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