Post Vasectomy Pain Forum

How are testosterone replacement therapy guys doing?

@etf42 What dose are you taking, how often, and how long have you been taking it? Your reversal surgeon didn’t have you stop the TRT prior to reversal? It has been explained to me that you should stop TRT 3 months prior to reversal to allow your testosterone/sperm production to start back up again and help keep things open.

I have been on therapy for 9 months. Currenlty I am on 60mg of test cyp 2x week and .25mg of anastrozole 2x/week to reduce estrogen. I tried HCG to preserve my sperm and testicle function but did not notice any benefits and it made made me bloated and caused E2 issues.

I dont think I could have survived stopping TRT prior to my reversal as I had debilitating brain fog, fatigue, and depression.

I’m with you on this one @Ethan_Scruples, sex lost its all appeal. Half of the time, I just can’t be bothered with it. My testosterone results came back early in the week, and are absolutely rubbish

TESTOSTERONE 8 nmol/L
FREE-TESTOSTERONE(CALCULATED)*0.177 nmol/L
BETA OESTRADIOL 67.5 pmol/L
SEX HORMONE BINDING GLOB 23.5 nmol/L
PROLACTIN 259 mIU/L

Helpful conversion between ng and nmol units for testosterone: Multiply or divide by 36.1

IOW, your T works out to 288.8 ng/dL and mine works out to 8.86 nmol/L

So we’re both 75-80yo

Yes, but the important thing to keep in mind at a time like this is that your vasectomy is surely NOT RELATED to your low T and any symptoms of low T coincidentally acquired shortly after your vasectomy. In fact, as my urologist patiently explained, not ALL of the the arteries to the testicles are severed by the vasectomy – so that shows that testosterone output is not affected by the procedure.

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“…not ALL of the arteries…”

I was under the impression only the two tubes carrying the sperm were cut and nothing else??? I just read the short mayo clinic article on what is done. Anyone care to clarify for me?

I don’t remember anymore what my urologist said about this, but there is an artery called the “artery of the vas deferens” which some doctors (as I understand it) leave intact, and other doctors ligate (cauterize) during vasectomy.


The main arterial supply to the testes and epididymis is via the paired testicular arteries, which arise directly from the abdominal aorta. They descend down the abdomen, and pass into the scrotum via the inguinal canal, contained within the spermatic cord.

However, the testes are also supplied by branches of the cremasteric artery (from the inferior epigastric artery) and the artery of the vas deferens (from the inferior vesical artery). These branches give anastomoses to the main testicular artery.

https://teachmeanatomy.info/pelvis/the-male-reproductive-system/testes-epididymis/


The blood supply of the vas deferens is from the artery of the vas deferens (deferential artery), a branch of the superior vesical artery that is also important in collateral circulation for the testicle. This artery is easily separated from the vas during vasectomy; however, it may be a source of hemorrhage during vasectomy if it is not separated or ligated.

https://www.glowm.com/resources/glowm/cd/pages/v6/v6c047.html


Now that you got me thinking about it, it would be really interesting to compare outcomes from surgeries where this artery is left undisturbed vs outcomes where this artery is ligated. It would be simultaneously validating and horrifying to discover that such a simple choice could be the difference between testicles that hurt all the time and have no sensation during sex vs. testicles that feel totally normal.

Note from the wikipedia page:

The artery arises from the superior vesical artery or the inferior vesical artery,

Just another reminder that although our bodies are similar, circulatory and nervous system anatomy vary to a surprising degree from individual to individual. No two people, or surgeries, are quite the same.

Thanks for the info. That would be an interesting study and one that you would think would have been done before saying thing like “vasectomies are a safe and reliable form of birth control”. I really don’t recall being warned about arteries being cut or potentially cut. They make it out to be extremely simple, vas deferens are cut via the tiniest of incision and that’s it. F’n liars.

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Maybe it’s one of those things where you try to separate it but if it starts bleeding you go ahead and ligate it so the guy doesn’t get a hematoma. And after all it’s such a small, inconsequential ARTERY that nobody will know any different.