To avoid being driven bonkers by the viral and emotional sniffles of the average surgery, we GPs like to play little games. One involves making a snap judgment of the consultation before the patient's got the seat warm. So, elderly man hobbling in with sore foot in a slipper? Gout. Two teenage girls, one of whom says, “Go on...” while the other one giggles? Morning-after pill.

OK, try this one: determined-looking woman followed by blushing, sheepish man? No? A clue, then. He is protecting his gonads in the manner of a defender facing a Ronaldo free kick. The reason being that men “requesting” a vasectomy will attend the surgery only if dragged there by the short and curlies.

And no wonder, if you listen to Richard Madeley because on his chat show recently he was reminiscing about his vasectomy. Apparently, he claimed the pain it caused felt as if the doctors had amputated rather than snipped.

By implying that a simple vasectomy could leave the average bloke an unwilling member of the No Member Club, Madeley has given men an excuse they really don't need. Because they already have a long list of objections to trot out to dodge the scalpel - such as the concern that it might increase the risk of heart disease and prostate or testicle cancer.

Wrong, wrong and wrong. In fact, there is some evidence that vasectomised men actually live longer than average, though this probably reflects the detrimental effect of having more than two point four children rather than any magical benefits of the snip. There's also that male catch-all whine along the lines of: “I just don't like the idea of it.” This I view as normal. After all, any man who did like the notion of cold steel meeting warm scrotum probably needs a psychiatrist, not a surgeon.

Then there's the worry that “it will affect my sex life, doctor”. Well, yes, it will, for the better. Because what you lose in fertility you gain in spontaneity and safety. For example, you can say goodbye to flailing around in the dark, not knowing whether you've grabbed a pack of condoms or your new supply of contact lenses. Or you can stop panicking that an in-flagrante attack of cramp in your partner is a pill-induced DVT.

Despite these obvious advantages, men continue to vacillate about vasectomy. Which is why one patient I encountered - caught between a fear of the knife on the one hand, and of his wife on the other - requested having just one side done initially, to see how he got on.

Come on, guys: vasectomy is liberation from the physical and psychological shackles of other types of contraception. Besides, your other half has done her bit over the years by popping pills, wearing caps and coping with coils; now it's your turn. And if this guilt trip doesn't get you, the stats certainly should. Because the failure rate for female sterilisation is a staggeringly high one in 200. For vasectomy? One in 2,000 . Plus you get a day off work.

So you're looking at an operation that is easier, safer and ten times as reliable as the female version. What's stopping you? The answer, I think, is psychology. The exaggerated anxiety and lame excuses of the male are simply a sublimation of his instinct to spread his precious seed. Anything that blocks this is perceived as a threat to his masculinity. And the easiest way out is to revert to the male stereotype of the doctor-avoider, who comes over all woozy at the snap of a rubber glove.

After all, men don't seem to have any problems requesting a vasectomy reversal. From a psychodynamic perspective, that's probably because they see this as a restoration of machismo rather than a form of castration. Which is why, when they walk in with their new partner to request unvasectomising, they look pretty confident and relaxed. Or maybe it's just that they know it's not actually available on the NHS.

Dr Copperfield is a GP in Essex. He also writes for Pulse magazine and pulsetoday.co.uk

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