PULSE - Europe beyond the beat

Rising numbers

The growth of vasectomy in Europe: a change in male contraception

Vasectomy is becoming increasingly popular in Europe as a definitive contraception choice for men, with an increase in interventions in several countries. This change reflects a different cultural approach to male contraception. Boom in France, especially among the under-40s. Rising numbers also in Spain and Austria

by Silvia Martelli (Il Sole 24 Ore), Francesca Barca (Voxeurop, France), Kim Son Hoang (Der Standard, Austria), Guillermo Cid (El Confidencial, Spain)

17 June 2025

4' min read

For decades, the definitive contraception was almost exclusively the preserve of women. Today, however, something is changing. In several European countries, more and more men are choosing to undergo a vasectomy, a small surgical procedure that permanently prevents conception.

While until a few years ago the topic remained marginal in the public debate, today vasectomy is becoming a real possibility for many men. The change is fuelled by increased awareness, a different cultural approach to sharing contraceptive responsibility, and a healthcare system that, in some states, accompanies patients on structured information paths.

The European comparison shows a multi-speed picture: while France and Austria record a constant increase in the number of operations, in Italy the spread remains limited, also due to an uneven offer in public services. The issue is intertwined with cultural and organisational issues, but also with numbers: in our country, according to the latest Ministry of Health report, about 20 thousand tubal ligations are performed on women every year, compared to less than 5 thousand vasectomies.

Italy: vasectomy remains a minority choice

In Italy, vasectomy continues to be an uncommon option. Estimates indicate that about 1% of men of childbearing age have chosen this route, one of the lowest rates in Europe.

There are several reasons behind this low uptake: a still limited knowledge of the operation, unfounded fears about the long-term effects, and a public health system that only guarantees the operation in certain regions. Often, for those who decide to do it, it is necessary to resort to private facilities, with a cost ranging from 300 to over 600 euros.

The contrast with women's numbers is obvious: in our country, around 20,000 tubal ligations are performed each year, a more invasive and complex operation than vasectomy, which is instead performed in an outpatient setting and with a very quick recovery time.

Family planning associations have also been speaking out on the subject for some time, calling for more information, a uniform offer throughout the territory and greater recognition of the male role in contraception.

France: interventions tripled, boom among the under 40s and under 30s

Over the past fifteen years, the number of annual vasectomies in France has risen from less than 2,000 to over 30,000. Today, the procedure accounts for about 25% of all definitive sterilisations.

The change also concerns the age of patients. In 12 years, the proportion of men under 40 among those choosing vasectomy in France has risen from 24% to 42%. The most remarkable figure, however, concerns the youngest: 13% of operations now concern men under 30, a sign of a profound change of mentality in the new generations.

In France, access is regulated by a compulsory information pathway: there is a preliminary interview and a four-month reflection period before proceeding. The aim is to ensure informed choices, especially among those who decide to intervene before having children. The rate of 'repentance' is still low, between 6% and 7%.

Spain: growing interest, driven also by younger people

In Spain, too, vasectomy is slowly coming out of the shadows. Although the public debate on the subject is still relatively recent, the numbers indicate a growing interest, especially among young men with children. One example is Javier and Andrés, aged 32 and 34 respectively, who after having two children each decided to undergo the procedure. "At first it seemed like a challenging step," they recount, "but we made the journey together, and in the end it was quick and painless.

In the Spanish context, the evolution is intertwined with a broader change in the male role in family planning. "In the past, male sterilisation was not even considered: it was taken for granted that everything related to contraception was the responsibility of women," explains Josep Torremadé, coordinator of the Andrology group of the Spanish Urology Association. 'When men started to participate in these decisions, the number of interventions started to increase'.

Awareness, however, is still partial. 'There is still a lot of misinformation, but we are talking about a simple and safe operation that does not alter sexual function and can even be performed using minimally invasive techniques, such as vasectomy without a scalpel,' Torremadé adds.

In the background, also in Spain, there are demographic dynamics: the average age of the first child for men is 34.5 years (33.1 for women) and the average number of children per couple is 1.06. In this context, for those who have already realised their family project, vasectomy begins to be perceived as a pragmatic and definitive choice.

Austria: growing numbers, despite costs

In Austria, vasectomy is only permitted from the age of 25 and requires a compulsory medical consultation. The cost, between 700 and 900 euros, is borne entirely by the patient.

Despite these barriers, the number of surgeries has increased significantly in recent years, especially among men who already have children and wish to avoid further pregnancies.

In Austria, too, there remains a certain reticence among the older generations, while among the younger generation the idea of shared contraception within the couple is becoming increasingly widespread.

Lithuania: growth held back by fears

In Lithuania, the use of vasectomy is still limited, held back by deep-rooted mistrust and often insufficient information. Many men prefer not to broach the subject even with their general practitioner. In recent years, however, attention to family planning has increased, driven in part by the experience of the pandemic. The choice of vasectomy is mainly of interest to men who have already had children and who want a definitive solution.The main resistance concerns the misconception that the procedure can compromise sexual well-being. The medical indications, on the other hand, are clear: vasectomy does not alter hormone production, does not affect sexual desire, and does not alter ejaculation.Here too, the associations are calling for more public information to overcome mistrust that has been overcome by the scientific literature.

Towards shared responsibility

The European picture shows a clear trend: definitive contraception is no longer just a women's issue. The increase in vasectomies tells of an important cultural change, which goes hand in hand with the growing demand by women not to shoulder the burden of family planning alone.

*This article is part of the European collaborative journalism project "Pulse"

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