High rate of dementia found in men who had vasectomies

Men may want to think twice about having a vasectomy.

A Northwestern University researcher announced yesterday there is a possible link between the procedure and two unusual forms of dementia that cause men to lose their ability to understand words and exhibit bizarre behaviors -- including compulsive gambling and shoplifting.

Symptoms of the two neurological diseases are distressing. Primary progressive aphasia (PPA) causes people to have trouble understanding speech and expressing themselves while frontotemporal dementia (FTD) prompts personality changes, lack of judgment and irrational actions.

One sufferer in the study, for example, was found by his sons on the floor of a restaurant men's room doing push-ups.

Evidence linking vasectomies with PPA and FTD began on a small scale, but grew in scope.

Sandra Weintraub, principal investigator and a professor of psychology at Northwestern's Feinberg School of Medicine, took note when a patient said he began having problems with words and language right after his vasectomy at age 43.

It prompted her to investigate a possible correlation. During a review of nine men suffering from PPA, Ms. Weintraub discovered that eight of them had had vasectomies. A larger study of almost 50 men with PPA revealed that 40 percent had had vasectomies.

"It doesn't mean having a vasectomy will give you this disease, but it may be a risk factor to increase your chance of getting it," Ms. Weintraub said.

While she describes the findings as "preliminary," a smaller study of 30 men with FTD found that 37 percent of them had undergone a vasectomy.

Ms. Weintraub theorizes a vasectomy may raise the risk of developing the conditions because the surgical procedure itself breaks down a protective barrier between the bloodstream and the testes; sperm continue to be produced but are disposed of in the body.

In 60 to 70 percent of men with vasectomies, the immune system mistakes sperm for foreign proteins and produces antibodies to counter these "invaders" once the barrier is gone. The antibodies, Ms. Weintraub says, may eventually enter and damage the brain.

In the United States, about a half million men annually undergo vasectomies, according to the National Institutes of Health -- normally a 30-minute out-patient procedure. Several studies indicate that about 90 percent are satisfied with the results and free of pain, infection or psychological problems.

Still, between 6 percent and 11 percent later regret their decision after they remarry or their financial fortunes change, according to statistics from the Mayo Clinic. More than half of the men seeking fertility treatments were seeking a vasectomy reversal.

Ms. Weintraub is preparing to apply her theory in a national study.

"I don't want to scare anyone away from getting a vasectomy," she said. "It's obviously a major birth-control connection. This is a correlational observation. We need to do more research."