Dear Dr G,

My wife and I are both working parents and we have three young children. During the current movement control order (MCO), we have both been working from home as the “new normal”.

However, life at home is a far cry from family bliss in the last six weeks – it has been near chaos on a daily basis.

A typical day starts with my wife and I fighting for the chance to have company zoom meetings, which is followed by household chores and looking after the kids.

The rest of the days will be supervising home-based learning and “deflecting World War III” among the boys.

With anticipation high about the MCO easing, we are now contemplating a visit to the doctor for a snip in my sacks.

I am really contemplating vasectomy and would like to put Dr. G on the spot about the snip.

Is vasectomy really better than condoms, pills or female sterilisation?

What exactly is done to my crown jewels by the doctors?

After the snip is done, will I be half the man I am?

Crown Jewel Charlie

The anxiety during the MCO and concerns of Covid-19 infection are affecting all of us in an unprecedented manner. Initial reports from around the world reveal an increase in condom consumption and morning-after contraception – some even predict a baby boom in nine months’ time!

Such statistics may reflect an increase in sexual behaviour, as couples turn to sex for comfort or as a temporary distraction. However, this sudden change in lifestyle, with enforced close proximity without other social interaction, can induce immense tension in any family.

In fact, experts predict the MCO will either “make or break” relationships if the strain is not handled properly. The typical challenges couples face include being forced to spend more time with each other, balancing the responsibility of working from home, childcare and household chores. Inability to see other friends and relatives for the relief of tension and also render couples feeling trapped and lastly, the worry about job security and uncertainty of financial status increase anxiety and cause frictions within households.

During such a stressful time, it’s not unusual for couples to consider family planning with expansion of family far from their minds.

Vasectomy is a surgical method for male sterilisation that is a “permanent” form of contraception. The vasa, which deliver the spermatozoa during ejaculation, are ligated to prevent passage of spermatozoa to fertilise eggs during intercourse. The procedure is straight forward, with minor incisions and minimal complication of less than 2%. Despite a short recovery period and ability to resume sexual activity in less than a week, many men are still fearful on taking responsibility of the male role of sterilisation.

The acceptance of vasectomy varies considerably between cultures and ethnicity. Globally, women tend to take the lead role in family planning, as reflected by the 223 million women who rely on tubal ligation, while only 28 million men have had vasectomies.

Vasectomy has an excellent efficacy rate, with fewer than one in 2,000 failures. Vasectomy is also more cost-effective, less invasive and significantly less complications than tubal ligation. Lastly, despite being a “permanent” form of contraception, microscopic technology now enables high success of reversal, which is still technically near impossible for tubal ligation.

Vasectomy has no adverse impact on the volume and texture of ejaculation. The procedure is also not associated with altered sexual functions including erectile rigidity, interval of intercourse and intensity of sexual climax. Despite no significant adversity, one study revealed 7% of men regret the decision of the snip. The men who regretted the decision tend to be younger and in less stable relationships.

To quote William Shakespeare’s Henry the Fourth: “Uneasy lies the head that wears a crown.”

It is often difficult for men who assume a man should be the “head of the family”, and shoulder the responsibility of “wearing the crown”. It is even more difficult for some men to make that important decision to accept the cessation of the function of their “crown jewels”, and accept vasectomy.

On one hand, fearing the accidental slip of the snip might end up with two more decades of childcare. On the flip side, the snips in the crown jewels might end up with regrets.

Dr G has advice for men still haunted by the dilemma of accepting the snips in their crown jewels is to be rest assured to “Ease the head that wears the crown, as the jewels in the sacks are just temporarily ceased despite the snip!”

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