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What a urologist wants men to know about vasectomies
What a urologist wants men to know about vasectomies

Yahoo

time17 hours ago

  • General
  • Yahoo

What a urologist wants men to know about vasectomies

EDITOR'S NOTE: Dr. Jamin Brahmbhatt is a urologist and robotic surgeon with Orlando Health and an assistant professor at the University of Central Florida's College of Medicine. As a urologist, I've performed countless vasectomies. They are my profession's bread and butter. When I'm not doing the procedure, I'm seeing men either alone or with their partners to discuss its safety, simplicity and effectiveness. Like many men, I've found myself contemplating whether it's time to get one, too. Maybe it's the recent US Supreme Court decisions on reproduction prompting more men to actively consider their role in birth control. Or perhaps it's part of a larger cultural shift toward shared family-planning responsibility. Then again, as a urologist who sees a growing number of men seeking vasectomy consultations, I'm more attuned to how common this conversation has become. An estimated 500,000 men in the US choose vasectomies as a form of contraception every year. And if you are like me and considering a vasectomy — or if you're just curious about this procedure as a form of birth control — here are the top things you should know. A vasectomy is typically a minor office-based procedure that requires minimal preparation. You can eat the day of the procedure, wear your T-shirt and shorts, and try to be relaxed. (If you choose to have the vasectomy done in an operating room, more preparation may be needed.) Once you're in the doctor's office, it takes 10 to 20 minutes to perform. After numbing the scrotal skin with a local anesthetic, the urologist makes a small opening in the skin, often so small that no stitches or scalpels are needed. From there, the doctor will find the vas deferens — the tube that carries sperm (made in the testicle) from a tightly coiled duct called the epididymis to the urethra prior to ejaculation. The vas deferens feels a bit like a piece of cooked spaghetti. The tube is brought out through the small opening, cut, sealed or blocked, preventing sperm from mixing with semen. The procedure is done on both sides, on both vas deferens, in a similar fashion. The cut ends are placed back into the scrotum, and the openings may be sealed with skin glue. Then you can go home and rest. Expect some soreness in the scrotum and surrounding areas. I advise patients to rest for one or two days, wear supportive underwear, and apply an ice pack to the scrotum for about 20 minutes every hour. For pain or discomfort, I suggest taking over-the-counter ibuprofen or acetaminophen if needed. Avoid heavy lifting or strenuous exercise for about one to two weeks, or however long your doctor recommends. Post-vasectomy complications are rare but possible and include minor bruising, swelling and temporary discomfort around the area where the procedure was done. Though uncommon, infections can occur and are typically resolved quickly with antibiotics if caught early. Around 1% to 2% of men can experience chronic post-vasectomy pain, which usually improves over time but in rare cases may persist and require further treatment. An important point to remember is that you won't be sterile immediately. It typically takes several weeks — and around 30 ejaculations — to clear out your remaining sperm. Your urologist will confirm your sterility with a semen analysis, which can be done at a lab or using new at-home testing kits. Until you're officially cleared, though, continue to use another form of contraception — it takes only one sperm to achieve pregnancy, so making sure you are sterile is vital. I've heard all the myths about vasectomies, so I want to share the answers to some of the most common questions men ask me during our consultations. Many men worry that after a vasectomy they will have lower testosterone levels, sex drive or sexual function. Not true. In fact, many couples report increased sexual activity and satisfaction after a vasectomy since they no longer have to worry about pregnancy. You will still have an ejaculate — almost the same volume and sensation — but now you'll be 'shooting blanks,' since your semen no longer contains sperm. Despite what you've heard, March Madness isn't the only good time for a vasectomy. Many men choose to recover while binge-watching football or even their favorite show. The truth is, you can safely book the procedure whenever it fits your schedule. Some men assume vasectomies are expensive or not covered by insurance, but most insurance plans fully or partially cover the procedure. Even if you're paying out-of-pocket, the cost is often less than $1,000, though prices can range from $500 to $3,000 depending on your location and whether you opt for anesthesia. It's worth shopping around, but always choose a qualified urologist who is board-certified and experienced in performing vasectomies — your safety is never worth compromising just to save a few dollars. But let's face it: Compared with the monthly cost of diapers alone (about $100 per month until your child is potty-trained), a vasectomy is a financial win. Though it's less common, I'm seeing more men without children choosing to get a vasectomy. Why? Often it's a firm lifestyle decision, because of concerns over passing certain genetic conditions, or simply being absolutely sure that fatherhood is not in their future. During our consultation, we openly discuss the motivations for making this decision, and I review the pros and cons. One big con is the permanent nature of the procedure. Yes, vasectomy reversals exist — and I do them myself for patients — but I don't advise undergoing a vasectomy assuming it's temporary. Reversal procedures are expensive and not always successful. If you're not sure whether you want children, pause and seriously reconsider the decision. Ultimately, it remains your personal choice. Men who need birth control can use condoms or avoid sex altogether. There is also research on male birth-control pills, injections and 'switches,' which could be a long time away from being offered to men. For women, there are birth-control pills, intrauterine devices (IUDs), implants, injections, patches, vaginal rings and tubal ligation. Each of these methods has its own pros, cons and effectiveness rates, so a detailed discussion with your health care provider and partner can help you make the best choice. Deciding on a vasectomy isn't easy. I should know, because I'm right there with you. My advice is don't rush it. Talk with your partner, ask your doctor all the questions you have during your consultation and think through what this means for your future. Whatever decision you make, though, make sure it feels right for you. Get inspired by a weekly roundup on living well, made simple. Sign up for CNN's Life, But Better newsletter for information and tools designed to improve your well-being.

What a urologist wants men to know about vasectomies
What a urologist wants men to know about vasectomies

CNN

time19 hours ago

  • Health
  • CNN

What a urologist wants men to know about vasectomies

As a urologist, I've performed countless vasectomies. They are my profession's bread and butter. When I'm not doing the procedure, I'm seeing men either alone or with their partners to discuss its safety, simplicity and effectiveness. Like many men, I've found myself contemplating whether it's time to get one, too. Maybe it's the recent US Supreme Court decisions on reproduction prompting more men to actively consider their role in birth control. Or perhaps it's part of a larger cultural shift toward shared family-planning responsibility. Then again, as a urologist who sees a growing number of men seeking vasectomy consultations, I'm more attuned to how common this conversation has become. An estimated 500,000 men in the US choose vasectomies as a form of contraception every year. And if you are like me and considering a vasectomy — or if you're just curious about this procedure as a form of birth control — here are the top things you should know. A vasectomy is typically a minor office-based procedure that requires minimal preparation. You can eat the day of the procedure, wear your T-shirt and shorts, and try to be relaxed. (If you choose to have the vasectomy done in an operating room, more preparation may be needed.) Once you're in the doctor's office, it takes 10 to 20 minutes to perform. After numbing the scrotal skin with a local anesthetic, the urologist makes a small opening in the skin, often so small that no stitches or scalpels are needed. From there, the doctor will find the vas deferens — the tube that carries sperm (made in the testicle) from a tightly coiled duct called the epididymis to the urethra prior to ejaculation. The vas deferens feels a bit like a piece of cooked spaghetti. The tube is brought out through the small opening, cut, sealed or blocked, preventing sperm from mixing with semen. The procedure is done on both sides, on both vas deferens, in a similar fashion. The cut ends are placed back into the scrotum, and the openings may be sealed with skin glue. Then you can go home and rest. Expect some soreness in the scrotum and surrounding areas. I advise patients to rest for one or two days, wear supportive underwear, and apply an ice pack to the scrotum for about 20 minutes every hour. For pain or discomfort, I suggest taking over-the-counter ibuprofen or acetaminophen if needed. Avoid heavy lifting or strenuous exercise for about one to two weeks, or however long your doctor recommends. Post-vasectomy complications are rare but possible and include minor bruising, swelling and temporary discomfort around the area where the procedure was done. Though uncommon, infections can occur and are typically resolved quickly with antibiotics if caught early. Around 1% to 2% of men can experience chronic post-vasectomy pain, which usually improves over time but in rare cases may persist and require further treatment. An important point to remember is that you won't be sterile immediately. It typically takes several weeks — and around 30 ejaculations — to clear out your remaining sperm. Your urologist will confirm your sterility with a semen analysis, which can be done at a lab or using new at-home testing kits. Until you're officially cleared, though, continue to use another form of contraception — it takes only one sperm to achieve pregnancy, so making sure you are sterile is vital. I've heard all the myths about vasectomies, so I want to share the answers to some of the most common questions men ask me during our consultations. Many men worry that after a vasectomy they will have lower testosterone levels, sex drive or sexual function. Not true. In fact, many couples report increased sexual activity and satisfaction after a vasectomy since they no longer have to worry about pregnancy. You will still have an ejaculate — almost the same volume and sensation — but now you'll be 'shooting blanks,' since your semen no longer contains sperm. Despite what you've heard, March Madness isn't the only good time for a vasectomy. Many men choose to recover while binge-watching football or even their favorite show. The truth is, you can safely book the procedure whenever it fits your schedule. Some men assume vasectomies are expensive or not covered by insurance, but most insurance plans fully or partially cover the procedure. Even if you're paying out-of-pocket, the cost is often less than $1,000, though prices can range from $500 to $3,000 depending on your location and whether you opt for anesthesia. It's worth shopping around, but always choose a qualified urologist who is board-certified and experienced in performing vasectomies — your safety is never worth compromising just to save a few dollars. But let's face it: Compared with the monthly cost of diapers alone (about $100 per month until your child is potty-trained), a vasectomy is a financial win. Though it's less common, I'm seeing more men without children choosing to get a vasectomy. Why? Often it's a firm lifestyle decision, because of concerns over passing certain genetic conditions, or simply being absolutely sure that fatherhood is not in their future. During our consultation, we openly discuss the motivations for making this decision, and I review the pros and cons. One big con is the permanent nature of the procedure. Yes, vasectomy reversals exist — and I do them myself for patients — but I don't advise undergoing a vasectomy assuming it's temporary. Reversal procedures are expensive and not always successful. If you're not sure whether you want children, pause and seriously reconsider the decision. Ultimately, it remains your personal choice. Men who need birth control can use condoms or avoid sex altogether. There is also research on male birth-control pills, injections and 'switches,' which could be a long time away from being offered to men. For women, there are birth-control pills, intrauterine devices (IUDs), implants, injections, patches, vaginal rings and tubal ligation. Each of these methods has its own pros, cons and effectiveness rates, so a detailed discussion with your health care provider and partner can help you make the best choice. Deciding on a vasectomy isn't easy. I should know, because I'm right there with you. My advice is don't rush it. Talk with your partner, ask your doctor all the questions you have during your consultation and think through what this means for your future. Whatever decision you make, though, make sure it feels right for you. Get inspired by a weekly roundup on living well, made simple. Sign up for CNN's Life, But Better newsletter for information and tools designed to improve your well-being.

Thinking about a vasectomy? What you need to know before and after
Thinking about a vasectomy? What you need to know before and after

CNN

timea day ago

  • Health
  • CNN

Thinking about a vasectomy? What you need to know before and after

EDITOR'S NOTE: Dr. Jamin Brahmbhatt is a urologist and robotic surgeon with Orlando Health and an assistant professor at the University of Central Florida's College of Medicine. As a urologist, I've performed countless vasectomies. They are my profession's bread and butter. When I'm not doing the procedure, I'm seeing men either alone or with their partners to discuss its safety, simplicity and effectiveness. Like many men, I've found myself contemplating whether it's time to get one, too. Maybe it's the recent US Supreme Court decisions on reproduction prompting more men to actively consider their role in birth control. Or perhaps it's part of a larger cultural shift toward shared family-planning responsibility. Then again, as a urologist who sees a growing number of men seeking vasectomy consultations, I'm more attuned to how common this conversation has become. An estimated 500,000 men in the US choose vasectomies as a form of contraception every year. And if you are like me and considering a vasectomy — or if you're just curious about this procedure as a form of birth control — here are the top things you should know. A vasectomy is typically a minor office-based procedure that requires minimal preparation. You can eat the day of the procedure, wear your T-shirt and shorts, and try to be relaxed. (If you choose to have the vasectomy done in an operating room, more preparation may be needed.) Once you're in the doctor's office, it takes 10 to 20 minutes to perform. After numbing the scrotal skin with a local anesthetic, the urologist makes a small opening in the skin, often so small that no stitches or scalpels are needed. From there, the doctor will find the vas deferens — the tube that carries sperm (made in the testicle) from a tightly coiled duct called the epididymis to the urethra prior to ejaculation. The vas deferens feels a bit like a piece of cooked spaghetti. The tube is brought out through the small opening, cut, sealed or blocked, preventing sperm from mixing with semen. The procedure is done on both sides, on both vas deferens, in a similar fashion. The cut ends are placed back into the scrotum, and the openings may be sealed with skin glue. Then you can go home and rest. Expect some soreness in the scrotum and surrounding areas. I advise patients to rest for one or two days, wear supportive underwear, and apply an ice pack to the scrotum for about 20 minutes every hour. For pain or discomfort, I suggest taking over-the-counter ibuprofen or acetaminophen if needed. Avoid heavy lifting or strenuous exercise for about one to two weeks, or however long your doctor recommends. Post-vasectomy complications are rare but possible and include minor bruising, swelling and temporary discomfort around the area where the procedure was done. Though uncommon, infections can occur and are typically resolved quickly with antibiotics if caught early. Around 1% to 2% of men can experience chronic post-vasectomy pain, which usually improves over time but in rare cases may persist and require further treatment. An important point to remember is that you won't be sterile immediately. It typically takes several weeks — and around 30 ejaculations — to clear out your remaining sperm. Your urologist will confirm your sterility with a semen analysis, which can be done at a lab or using new at-home testing kits. Until you're officially cleared, though, continue to use another form of contraception — it takes only one sperm to achieve pregnancy, so making sure you are sterile is vital. I've heard all the myths about vasectomies, so I want to share the answers to some of the most common questions men ask me during our consultations. Many men worry that after a vasectomy they will have lower testosterone levels, sex drive or sexual function. Not true. In fact, many couples report increased sexual activity and satisfaction after a vasectomy since they no longer have to worry about pregnancy. You will still have an ejaculate — almost the same volume and sensation — but now you'll be 'shooting blanks,' since your semen no longer contains sperm. Despite what you've heard, March Madness isn't the only good time for a vasectomy. Many men choose to recover while binge-watching football or even their favorite show. The truth is, you can safely book the procedure whenever it fits your schedule. Some men assume vasectomies are expensive or not covered by insurance, but most insurance plans fully or partially cover the procedure. Even if you're paying out-of-pocket, the cost is often less than $1,000, though prices can range from $500 to $3,000 depending on your location and whether you opt for anesthesia. It's worth shopping around, but always choose a qualified urologist who is board-certified and experienced in performing vasectomies — your safety is never worth compromising just to save a few dollars. But let's face it: Compared with the monthly cost of diapers alone (about $100 per month until your child is potty-trained), a vasectomy is a financial win. Though it's less common, I'm seeing more men without children choosing to get a vasectomy. Why? Often it's a firm lifestyle decision, because of concerns over passing certain genetic conditions, or simply being absolutely sure that fatherhood is not in their future. During our consultation, we openly discuss the motivations for making this decision, and I review the pros and cons. One big con is the permanent nature of the procedure. Yes, vasectomy reversals exist — and I do them myself for patients — but I don't advise undergoing a vasectomy assuming it's temporary. Reversal procedures are expensive and not always successful. If you're not sure whether you want children, pause and seriously reconsider the decision. Ultimately, it remains your personal choice. Men who need birth control can use condoms or avoid sex altogether. There is also research on male birth-control pills, injections and 'switches,' which could be a long time away from being offered to men. For women, there are birth-control pills, intrauterine devices (IUDs), implants, injections, patches, vaginal rings and tubal ligation. Each of these methods has its own pros, cons and effectiveness rates, so a detailed discussion with your health care provider and partner can help you make the best choice. Deciding on a vasectomy isn't easy. I should know, because I'm right there with you. My advice is don't rush it. Talk with your partner, ask your doctor all the questions you have during your consultation and think through what this means for your future. Whatever decision you make, though, make sure it feels right for you. Get inspired by a weekly roundup on living well, made simple. Sign up for CNN's Life, But Better newsletter for information and tools designed to improve your well-being.

‘Femtech' takes on the women's health-care marketplace
‘Femtech' takes on the women's health-care marketplace

Washington Post

timea day ago

  • Business
  • Washington Post

‘Femtech' takes on the women's health-care marketplace

Could you use some discreet help with birth control from a $14.99-a-month period-tracking app? How about a hands-free, wearable breast pump, for $549; a $299 wristband to soothe hot flashes; or an extra-slim, temperature-neutral, LED-lit speculum to bring to gynecologists' appointments — part of a $125 kit including 'comfy socks'? These products and more are part of a fast-growing industry known as 'femtech' — high-tech solutions for women's health needs — whose many female founders say they're tackling age-old inequities.

What Medical Guidelines (Finally) Say About Pain Management for IUD Insertion
What Medical Guidelines (Finally) Say About Pain Management for IUD Insertion

Yahoo

time2 days ago

  • General
  • Yahoo

What Medical Guidelines (Finally) Say About Pain Management for IUD Insertion

Intrauterine devices, or IUDs, are an extremely effective and convenient form of birth control for many people—but it can also very painful to get one inserted. Current medical guidelines say that your doctor should be discussing pain management with you, and they also give advice to doctors on what methods tend to work best for most people. The newest set of guidelines is from ACOG, the American College of Obstetricians and Gynecologists. These guidelines actually cover a variety of procedures, including endometrial and cervical biopsies, but today I'll be talking about the IUD insertion portions. And in 2024, the Centers for Disease Control and Prevention's released new contraceptive recommendations that include a section on how and why providers should help you with pain relief. Before we get into the new recommendations and what they say, it's important to keep in mind that that not everybody feels severe pain with insertion—the estimate is that insertion is severely painful for 50% of people who haven't given birth, and only 10% of people who have, according to Rachel Flink, the OB-GYN I spoke with for my article on what to expect when you get an IUD. (She also gave me a great rundown of pain management options and their pros and cons, which I included in the article.) I'm making sure to point this out because I've met people who are terrified at the thought of getting an IUD, because they think that severe pain is guaranteed and that doctors are lying if they say otherwise. In reality, there's a whole spectrum of possible experiences, and both you and your provider should be informed and prepared for anything along that spectrum. Your provider should discuss pain management with you The biggest thing in both sets of guidelines is not just the pain management options they discuss, but the guideline that says there is a place for this discussion and that it is important! You've always been able to ask about pain management, but providers are now expected to know that they need to discuss this with their patients. The ACOG guidelines say: "Options to manage pain should be discussed with and offered to all patients seeking in-office gynecologic procedures." And the CDC says: Before IUD placement, all patients should be counseled on potential pain during placement as well as the risks, benefits, and alternatives of different options for pain management. A person-centered plan for IUD placement and pain management should be made based on patient preference. 'Person-centered' means that the plan should take into account what you want and need, not just what the provider is used to doing or thinks will be easiest. (This has sometimes been called 'patient-centered' care, but 'person-centered' is meant to convey that you and your provider understand that they are treating a whole person, with concerns outside of just their health, and you're not only a patient who exists in a medical context.) The CDC guidelines also say: 'When considering patient pain, it is important to recognize that the experience of pain is individualized and might be influenced by previous experiences including trauma and mental health conditions, such as depression or anxiety.' The ACOG guidelines, similarly, say that talking over the procedure and what to expect can help make the procedure more tolerable, regardless of how physically painful it ends up being. (Dr. Flink told me that anti-anxiety medications during insertion are helpful for some of her patients, and that she'll discuss them alongside options for physical pain relief.) Lidocaine paracervical blocks may relieve pain There's good news and bad news about the recommended pain medications. The good news is that there are recommendations. The bad news is that none of them are guaranteed to work for everyone, and it's not clear if they work very well at all. The CDC says that a paracervical block (done by injection, similar to the numbing injections used for dental work) 'might' reduce pain with insertion. Three studies showed that the injections worked to reduce pain, while three others found they did not. The CDC rates the certainty of evidence as 'low' for pain and for satisfaction with the procedure. The ACOG guidelines also mention local anesthetics, including lidocaine paracervical blocks, as one of the best options for pain management. Dr. Flink told me that while some of her patients appreciate this option, it's often impossible to numb all of the nerves in the cervix, and the injection itself can be painful—so in many cases, patients decide it's not worth it. Still, it's worth discussing with your provider if this sounds like something you would like to try. Topical lidocaine may also help Lidocaine, the same numbing medication, can also be applied to the cervix as a cream, spray, or gel. Again, evidence is mixed, with six trials finding that it helped, and seven finding that it did not. The ACOG guidelines note that sometimes topical lidocaine has worked better than the injected kind. Unfortunately, they also say that it can be hard for doctors to find an appropriate spray-on product that can be used on the cervix. The CDC judged the certainty of to be a bit better here compared to the injection—moderate for reducing pain, and high for improving placement success (meaning that the provider was able to get the IUD inserted properly). Other methods aren't well supported by the evidence (yet?) For the other pain management methods that the CDC group studied, there wasn't enough evidence to say whether they work. These included analgesics like ibuprofen, and smooth-muscle-relaxing medications. The ACOG guidelines say that taking NSAIDS (like ibuprofen) before insertion doesn't seem to help with insertion pain, even though that's commonly recommended. That approach does seem to work for some other procedures, though, and may help with pain that occurs after an IUD insertion. So it may not be a bad idea to take those four Advil if that's what your doc recommends, but it shouldn't be your only option. Or as the ACOG paper puts it: "Although recommending preprocedural NSAIDs is a benign, low-risk intervention unlikely to cause harm, relying on NSAIDs alone for pain management during IUD insertion is ineffective and does not provide the immediate pain control patients need at the time of the procedure." Both sets of guidelines also don't recommend misoprostol, which is sometimes used to soften and open the cervix before inserting an IUD. The ACOG guidelines describe the evidence as mixed, and the CDC guidelines specifically recommend against it. Moderate certainty evidence says that misoprostol doesn't help with pain, and low certainty evidence says that it may increase the risk of adverse events like cramping and vomiting. What this means for you The publication of these guidelines won't change anything overnight at your local OB-GYN office, but it's a good sign that discussions about pain management with IUD placement are happening more openly. The new guidelines also don't necessarily take any options off the table. Even misoprostol, which the CDC now says not to use for routine insertions, 'might be useful in selected circumstances (e.g., in patients with a recent failed placement),' it writes. Don't be afraid to ask about pain management before your appointment; as we discussed before, some medications and procedures require that you and your provider plan ahead. And definitely don't accept a dismissive reply about how taking a few Advil should be enough; it may help for some people, but that shouldn't be the end of the discussion. You deserve to have your provider take your concerns seriously.

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