Although it is far less popular here than in the UK, more Irish men are opting for vasectomy as a contraceptive choice, writes MICHELLE McDONAGH
WHILE VASECTOMY is probably the most effective method of contraception that exists after abstinence, “the snip” is still a far less popular option with Irish men than with their neighbours in the UK.
Britain, where male sterilisation is available free through the NHS, has the highest number of vasectomies in the world at 16 per cent of the male population.
As the vast majority of vasectomies in Ireland are done privately in clinics around the country, there is no accurate estimate for the number of men who get the snip here.
There has been a slight increase reported by some Irish clinics in the numbers opting for vasectomy since the deepening of the economic crisis, but it has been nowhere near as dramatic as in the US where the fear of job losses, along with health insurance issues, has led to a sharp rise in men going for the procedure because they cannot afford to have any more children.
Gabrielle Malone, programme director for Marie Stopes Reproductive Choices in Dublin, says the demand for vasectomies has increased over the past six years, with the economy being a contributing factor in the last two years. They do a “couple of hundred” vasectomy procedures a year at their Dublin clinic.
“The men who come to us have decided that their family is complete. They want to ensure that they can give the children they have the best schooling, etc, and with one partner maybe out of work or on shorter hours, they can’t afford to have any more.”
The surgery involves far less risks than female sterilisation or tubal ligation, and it is a much more straightforward procedure with a failure rate of less than one per cent, says Malone.
The total cost of a vasectomy at Reproductive Choices is €400, which includes sperm testing 16 and 18 weeks later to ensure the procedure has been a success. Malone says this one-off fee is very good value when compared to the annual cost of alternative forms of contraception, including the Pill or the coil.
“The age of the men who come to us range from 30 to 60 years: I’ve ceased to be amazed,” Malone laughs.
“They’re in and out of here in an hour and a half. They have a cup of coffee and a few biscuits after the procedure and head off home. One woman came to collect her husband with a balloon saying, ‘Get Well Soon’.”
The Irish Family Planning Association carried out the first vasectomy in Ireland in 1973 at a time when other forms of contraception were banned, offering couples a permanent method of avoiding unwanted pregnancies.
Since then, the IFPA has completed more than 10,000 vasectomies, making it the country’s leading provider.
Although research carried out by the association in 2010 found that vasectomy was seen by many Irish men as a way to share the contraceptive burden in their relationships, IFPA medical director Dr Caitriona Henchion agrees that the procedure is far less popular here than it is in the UK.
“Vasectomies are all done on a private basis in Ireland, so there are no clear records of how many are being done, but it’s far more common for women to have sterilisation once their family is complete or to continue contraception up to menopause,” she says.
Although there are some cases where vasectomies have been carried out through the HSE by referral to a public urology department, Henchion says very few of these are being done and patients have to wait a long time.
Sex therapist with Relationships Ireland, Eithne Bacuzzi, suggests the reluctance of many Irish men to even entertain the idea of having a vasectomy could be down to a lack of knowledge about what the procedure actually involves and the residue of old-fashioned Catholic guilt around sexuality.
The idea of allowing anybody to “meddle around with their private parts frightens the living daylights out of them”, she says, adding that they don’t realise that having the snip could actually be of real benefit to their relationship.
“I think it’s a myth that we are all so relaxed about our bodies in this country and that Irish men are comfortable discussing all things sexual,” she says.
“We are still a good bit behind our European counterparts in our thinking, and there is a discomfort around sexual intimacy, sensuality and freedom with our bodies.
“Sometimes men can joke about all this until it comes to the serious stuff and then there is a complete shutdown.”
The average profile of the IFPA vasectomy client is over the age of 35, in a stable relationship with two or more children. The total cost of the procedure, including sperm testing, is €490.
Henchion advises: “A vasectomy should be considered not reversible. There are cases where they have been reversed, but the success rate is not guaranteed at all, so we ask clients to essentially accept that this is not reversible before they make the decision to have the procedure.”
The most common side effect of the procedure is a bit of bruising or soreness afterwards – many men have the snip on a Friday and are back to work the following Monday.
There is a risk of short-term bleeding or infection and a small percentage of men get chronic testicular pain syndrome.
Henchion says there is no evidence that a vasectomy increases the risk of prostate or testicular cancer.
THE KINDEST CUT: 'TO BE HONEST I WOULD RECOMMEND IT. I THINK IT'S THE RIGHT THING'
John (41), a married father from Kildare, underwent a vasectomy
Once I had my mind made up that I was going to have a vasectomy, that was it.
Our fourth baby was born on March 10th this year and I went in for the procedure in May. I didn’t waste any time – we had four kids and we knew we definitely did not want any more.
My wife did not put any pressure on me, she couldn’t believe I made the appointment. I felt it was time for me to do something in terms of contraception and it seemed like the safest option.
Five or six years ago, I probably would have said “no way” if somebody mentioned vasectomy, but as time goes on, things change. I knew a few more men who had the job done and even one who had it reversed.
After doing some research on the internet, I decided to go to the Clane Clinic. I understood what was involved and I knew it couldn’t be that bad. It used to be a much more complex procedure.
On the day itself, I went in at 10am to have the job done and was home again by 11am. The injection for the local anaesthetic was a bit sore, but the procedure wasn’t too bad overall. I had a little bit of discomfort that afternoon but was a lot better the next day.
You need to take it easy for a couple of days afterwards, especially if you’re doing manual labour. I was black and blue and very swollen.
Up until a month ago, I was still getting the odd twinge if I sat a certain way, but now I don’t notice anything. The vasectomy cost €495, which is a fair bit to pay in one go, but you do save in the longer term.
I know loads of men who wouldn’t touch a vasectomy and who would think I was mad. All the lads at work knew I had it done – they were calling me John Wayne because I was stiff afterwards.
I got a good old slagging when I sent off my samples and got the all-clear, but to be honest, I would recommend it. I think it’s the right thing.
VASECTOMY: WHAT IT ENTAILS
Vasectomy is the common name for male sterilisation – a permanent method of contraception. It is a simple surgical procedure which seals the sperm-carrying tubes (the vas deferens) to prevent sperm entering the fluid the man ejaculates. The operation is carried out under local anaesthetic and takes about 10 minutes to complete.
After the operation, a man will still be able to ejaculate, but his semen will no longer contain any sperm, so he cannot make his partner pregnant.
A vasectomy has no effect on sex drive or ability to enjoy sex.
