Post Vasectomy Pain Forum

"It's psychological", my urologist says about my disappointing orgasms

I have had my vasectomy 10 months ago. To me, the procedure was painful, uncomfortable and nauseating. Over the next week everything was fine and I had no pain. After a couple of weeks I did feel a stabbing pain in my right testicle. Especially when I drove my car for long periods of time. I’m glad that that pain is mostly gone, altough I do have day’s it starts aching again. My urologist told me it’s a granuloma and that it will disappear eventually. And if not, I can have it get removed.

I was hesitant to have sex and it took me a couple of times to get to an orgasm. But when I finally did, the orgasm felt weird and weak. This feeling hasn’t changed. I do not feel “empty” or relieved after or even sleepy. The orgasm feels ok, but also very disappointing. I know most of it comes from the prostate and only 3 percent from the testicles itself, but the psychological effect of not being to able to empty my balls seem to have a great impact on the overall feel of the orgasm. My urologist says it’s only psychological and there ar no reasons why it should feel any different physically.

Is there someone that can give me some input on to how to deal with this psychologically? I want my old orgasms back, but I don’t know how.

Thank you for your time.

With kind regards,

Robert

2 Likes

I recommend seeing a counselor/therapist/psychologist who specializes in sexual issues.

https://www.psychologytoday.com/us/therapists

I’m not a doctor or a psychologist, but I am pretty sure that this experience is caused by a physical change, not a psychological change.

1

Guys have been reporting this for at least fifty years. Here is an article from the Berkeley Daily Gazette Feb 15, 1975, which says in part:

My husband agreed to a vasectomy about five years ago. … When he tried to perform sexually he had great difficulty achieving an erection. When he did he was unable to climax. When he discharged semen he would not experience the feeling of a climax. After these problems he started having chronic swelling of his testicles with pain and nausea. He still has this condition.

This is the earliest story I have found documenting a complaint about disappointing climax after vasectomy. The vasectomy was performed 51 years ago.

The comments in this article on wisegeek tell the story pretty well:

Here’s another one on NBC News:

My husband had a vasectomy 13 years ago. Ever since, he claims that his ejaculate is only half what it was and that his orgasms are diminished.

Here’s one from Julian in The Times:

My sex life was very different after my vasectomy, which I had nine years ago. Ejaculation felt different. There was an unpleasant sensation, like a blockage. It felt like a Warner Bros cartoon, with fingers in the end of a shotgun causing the barrels to blow up in the face of the gun-toter

This is from a talk show called The Doctors

First, Dr. Berman lets the cat out of the bag:

Dr. Jennifer Berman, Urologist and Sexual Health Expert:

I’ve heard in my practice that men will say that it’s a diminished sort of sensation, a decrease in the intensity of orgasm … likened to the lack of or decrease seminal fluid that’s being expulsed. So I’ve had men complain that it’s less intense less pleasurable. Certainly not the norm but it’s something that I tell men about before they have vasectomies.

Then, Dr. Spitz attempts to put the cat back into the bag:

Dr. Aaron Spitz, Urologist:

I would say more often what I hear is that it’s a little bit uncomfortable. A little bit of pain. Which is to be expected because when you actually operate on any tissue in the body it actually takes up to 18 months for all those changes to finish. And … we reassure our patients just give it time. If you’re feeling an abnormal sensation after vasectomy and it’s been less than a year, give it time because things do change and get better over time.

I have been collecting these stories for three years, and have coded the “DC = Disappointing Climax” on this timeline. There are 221 examples of “Disappointing Climax” on the list so far, and I know of more that are not on the list yet.

So this is something that some men report.

2

I don’t know of any positive evidence that this is psychological. Studies of men with vasectomy usually simply fail to detect reports of orgasm problems. It’s not like there is some robust psychological explanation. Rather, the assertion that it is psychological is usually supported by offering the reasoning that there is no known physical explanation. I think this is missing the forest for the trees. The physical explanation is roughly speaking, that the man had surgery on his genitals and it changed something in there that changed the way it feels. That seems pretty straightforward and plausible. The fact that we don’t know all the specific details about the mechanism isn’t really a valid reason to reject this picture.

The fact that 90% or more men report that nothing changed about their orgasm also provides approximately zero evidence that the phenomenon is psychological. You could give penicillin to 5000 men and 4999 of them will report that they feel fine. Only 1 will go into anaphylaxis. That isn’t evidence that the problem is psychological. There is a lot of physical variation from person to person.

3

There are a lot of changes from vasectomy that could constitute a physical basis for changed orgasm sensation. At least they seem reasonable to me.

  • Greater pressure in the epididymis. The epididymis is lined with muscle that contracts during ejaculation to expel sperm. Under pressure, this may feel different, and maybe this explains the lack of sensation that anything is “emptying” because it literally isn’t emptying.
  • Vasectomy severs about 50% of the nerves that travel down the spermatic cord. Apparently most men don’t notice, but how can a doctor tell me with straight face that nothing they did could possibly jeopardize sensation? Like, really? Um, cutting nerves can’t alter sensation?
  • Reduced semen viscosity. After vasectomy semen is measurably more watery than before. Perhaps it simply feels different travelling through the tubes.
  • Prostate change. This is less well documented, but so many men describe prostatitis post-vasectomy. There are other studies that Dr. Tony referred to but I haven’t dug up yet that talk about changes to prostatic secretion behavior.
  • Chronic pain and inflammation could inhibit sensation.
  • Changes in muscle tone. The bulbospongiosus muscle or other pelvic floor muscles can change their behavior after vasectomy due to pain.
  • Retrograde ejaculation. Several guys have reported this after vasectomy.
  • Pelvic plexus crosstalk. This nervous plexus is a busy intersection for nerves that control erection and also nerves that are damage during vasectomy. Really, nerves from all over the pelvic floor pass through this zone and can possibly influence each other.

So, yes, I think it is absurd to claim that vasectomy doesn’t change anything that could possibly be perceived as a change in ejaculatory sensation. Funny enough, you can get a urologist to admit that vasectomy causes pain during ejaculation before you can get them to admit that vasectomy reduces pleasure or satisfaction during ejaculation. They know deep down that any risk of this complication is an instant deal breaker for many of their potential customers.

4

What is a urologist supposed to say? They can’t do anything to fix the problem. Are they supposed to admit that they knew about this and didn’t warn you? Or is it safer to stick with the party line, that they know other urologists will defend, that there is no way to anticipate this sort of thing, and a man who complains about this perhaps has a psychological issue that needs sorting.

5

So what to do about it? Well I’d say you have two choices.

Choice #1: Mourn the loss of your old orgasm and try to work your way through the grief stages toward acceptance. Your suffering should reduce over time as a result of various factors. For one, sensation may improve for you over time as your body adapts to whatever is going on. For another, your perception that something is missing may diminish over time as you retrain to the new sensation. Finally, you may just not have the psychological response of feeling upset. After all, orgasms are great but there is a lot more to life than orgasms.

Choice #2: Roll the dice on a reversal. Most guys get at least some of their old orgasm back when they get a reversal. Some don’t see any improvement. Some get it all back. It’s a spin of the big wheel and it’s a totally valid and sensible choice in my opinion.

6

I’m sorry you’re in this boat. I’m in the same boat, as are many of us on this forum. It’s bullshit that urologists don’t warn us about this before giving us this surgery. “It won’t change anything” is simply a lie that they feel safe repeating for as long as enough of them stick to it. I felt like I had stepped through the looking glass when I realized the truth about this. But it was crystal clear from the first time I ejaculated after my vasectomy that something was very different and that I would never have gotten the operation if I had known.

8 Likes

Well said @Ethan_Scruples.

@mrrobertson, your urologist is playing mind games with you. Unfortunately, his/her opinion and/or response is really common.

Vasectomys don’t change anything and/or you won’t notice anything different about yourself in that department… That’s certainly not a one size fits all answer. What a crock of shit.

2 Likes

Bravo @Ethan_Scruples, very detailed, my orgasms were weak and horrible, thankfully nearly back to normal aftrt reversal, I’d say 75% there

1 Like

This is the sensation I noticed as soon as I started having sex again after the vasectomy and it remains 4 years later. I don’t get everything out and I wind up peeing it out later. I’ve seen several Uros and most said it was impossible. I was convinced that there was something physically wrong in the scrotum and had the doc look when I recently had an orchiopexy to prevent further occurrence of intermittent torsion, he found nothing out of the ordinary besides bellclapper lie of the testicle.

I’m not confident that ending the occurrences of intermittent torsion are going to help in the ejaculation department. If it doesn’t, I’m going to give a serious run at pelvic floor and mindfulness therapy before considering a reversal. I’ve already had 2 procedures down there. Not sure how many more the body will want to handle.

1 Like

This is the sensation I noticed as soon as I started having sex again after the vasectomy and it remains 4 years later.

Yeah, lots of guys have this experience. Plenty of surgical procedures, even just getting dental work done, can have complications. The thing that makes this experience so disorienting is that the urologists won’t acknowledge it. They won’t name it. They won’t do us the basic decency of giving us a label to grab on to so we can say to ourselves and to our partners “this is a thing.” Instead we are made to feel like our problems are unique to us. To us the urologist presents with stony silence and refusal to take any responsibility. Behind our backs they frame us as neurotic, delusional, or someone who didn’t really want the vasectomy, or has a low pain threshold, or is insecure in their masculinity.

This is abusive spouse behavior, and we are paying them to receive it.

2 Likes

The metallic taste is not caused by the reaction to the auto immune system breakdown that most men with vasectomies get, even the ones who denied it have them which I now believe is the cause of things going horribly wrong

A vasectomy is a physical procedure resulting in physical cuts so therefore its impossible that your weaker orgasms are psychological. Your reduction of the greatest pleasure in life is 100% physical due to the exact physical damage that occurred during the cuts. It is a cop out when doctors say its only in the mind and is just another way to ignore what truly happened to you as if doctors (and hospitals) don’t really care when it comes to a man’s sexual functioning and this is so wrong.

Maby this explains why doctors and hospitals lie to every man’s face when they incorrectly claim vasectomies cause no possible sexual differences or pain after actually hearing or reading reports that they do including directly from patients because they don’t really give a care or see that a man’s sexual functioning and orgasm is as important as everyone else’s when it is, as well as the other reason that they’re money hungry and are trying to hide the exact truth.

1 Like

Totally agree that we should never had a vasectomy. ,so many changes in your body. And it is sold s an easy fix. I know that it is the biggest lie

1 Like

Gents, I’m one of the few who experienced the regret of vasectomy (pain, reduced libido, ED, pathetic orgasm), had a reversal 9months later and regained my manhood and joy (over 2years now post reversal). I am back to normal. So to say is is physiological is the response of an idiot. It’s physical and the result of your vasectomy.

I know reversal does not always work for many but for some of us it has solved so much. I wake up everyday grateful that I spent the time researching and took the risk of reversal.

1 Like

The urologists are lying through their teeth. Complete crock of shit.

3 Likes

This is precisely why I respect the urologists who help us and occasionally post here. They admit the industry doesn’t completely know the reasons some of us contract PVPS but admit it exists and even categorize us into classes (neuropathic, auto-immune, congestive, etc.). It seems like the rest of the industry takes the position of “if we can’t explain it, it doesn’t exist.” Very self-serving because that position eases their conscience into doing 3-5 vasectomies every Friday and keeping the pipeline of pain management patients full.

While someone in marketing at the Cleveland Clinic clearly got over-eager when stating 1 in a Million on their website, my experience there even with general urology there is that they’ve been trained (1) to admit PVPS exists and (2) on the ladder of potential therapies we all know on this site.

Without a shadow of a doubt the vasectomy affects orgasm … I’m afraid ,if you are like me,it will never be the same again. I think there is a psychological issue but to what extent I do not know(probably self hatred for allowing this to happen in the first place ).Even a reversal hasn’t corrected the poor orgasm ,but at least ejaculation feels normal .Sorry for the gloomy post Atb Rob…

Of course a vasectomy affects orgasm. The whole point of an orgasm is to get sperm cells from the epididymus and out. When they cut the plumbing, common sense tells you that something will feel different. But we were all told that it wouldn’t affect the orgasm.

I’ve been looking at a lot of vasectomy information brochures. I think the whole “don’t affect the orgasm”-thing can be traced back to some study long ago (that I haven’t been able to find study). The rationale is - I think, I could be wrong here - that they couldn’t measure a statistical difference in sperm volume from men who have had vasectomy vs a control group. But from this have made the much broader conclusions that vasectomy “does not affect orgasm at all”. It is a misconseption that “statistically unaltered sperm volume” can be translated to “will feel the same as before”.

I honestly believe that the average urologist does not lie deliberately. They have been taught from the “highest authorities” - textbooks and AUA - that vasectomy is safe and has very little complications. Most doctors believe what they see written from respectable sources. But the vasectomy board of docs in AUA - those I think fit your description @earlium.

I haven’t read through this thread yet and not sure if anybody has mentioned it. You should work with a pelvic floor physiotherapist.

The problem is, alot of your muscles in that area are probably constantly triggered because it’s your body’s natural defense to protect the injured and vulnerable spot. So when you’re use to having nice orgasms, you’re not because your muscles are already tensed up. Make sense?

Thats the problem I’ve had too. I also developed severe muscle instability in my stomach and pelvic floor because my body was trying to compensate. Ive found alot of relief over the last few months

She poked and prodded my testicles and everywhere, and even pointed out that if I grab my scrotum and stretch it the opposite side of my pain, it’s noticeabley tighter compared to my non-pain side. Even my gfs mind was blown. So stretching my scrotum is literally part of my routine, along with alot of core work laying on a floor roller to get both of my sides to have the same strength. I also have to do stretches, massage my perineum with a ball, as well as work out the painful knot in my right abdomen with a ball. Even the pain that I thought was nerve pain shooting down the inside of my thigh was infact a problem with my hip adductor.

Pelvic pain messes the whole body up. My therapist works most of the time on women who have issues with child birth pains and such, as well as men who have prostate problems. She also helps hockey players and such.

Food for thought, hope this helps.

I’m perplexed by all these reports of diminished orgasms. I read hundreds of medical journals prior to my vasectomy and none of them can find a single physiological cause for reduction of orgasmic sensation after a vasectomy. Even people who have underwent spermatic chord denerviations rarely report diminished orgasm.

I’m 7 months out after having an open ended vasectomy and my orgasms are just as amazing as they always were. Even more so now that the fear of another child support payment is vanquished. Have you checked vitamin D or T levels? I started supplementing with 5000ug of VD with zinc and DHEA and my libido, erections and orgasms have been super charged. Healthy T levels are vital for sexual function in men and women. If you’re still noticing weak o’s I recommend getting a prostate massager.

I’m curious if you found any journals during your research that measured what percent of men who get a vasectomy say that their ejaculation experience becomes unsatisfying or painful?

Assuming anything you said was even true… If you had an uneventful post vasectomy experience and everything is just amazing as it always was - why are you on this website posting this? It really doesn’t make a whole lot of sense. Guy gets a vasectomy, everything seems to have went perfect. All of a sudden he gets an urge to get online and attempt to discredit those who posted a completely different personal account. Really?

Care to post some of those journals you speak of? You did say hundreds of journals right?

You must’ve missed this one and several others.

that powerful contraction of the proximal vas deferens and epididymis could be lacking

He is probably a urologist selling vasectomy as a carefree surgery. I would think he’s a troll all full of shit ,