An unusual form of dementia has been found to occur more frequently in men who have undergone a vasectomy. Known as Primary Progressive Aphasia (PPA), it causes sufferers to have trouble recalling and understanding words. Sufferers lose the ability to express themselves and understand speech. The researcher who uncovered the association, Sandra Weintraub, from Northwestern University, began investigating a possible link when one of her male patients, aged 43, himself connected the onset of his language problem to the period after his vasectomy. The patient in question had attended a PPA support group and asked the men there; "OK, guys, how many of you have PPA?" Nine hands went up. "How many of you had a vasectomy?" he demanded next. Eight hands were raised.
Weintraub herself then surveyed a larger group of men ranged from 55 to 80 years old and again found a strong correlation between PPA and the contraceptive procedure. But Weintraub is quick to put the findings in perspective. "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," she cautioned.
The study also connected another unusual form of dementia to the vasectomy procedure. In a smaller group of 30 men with a dementia called frontotemporal dementia (FTD), 37 percent had undergone a vasectomy. FTD symptoms include personality changes, lack of judgment and bizarre behavior. One of Weintraub's patients with FTD was eating lunch in a restaurant with his family and excused himself to go to the bathroom. When he hadn't returned after 10 minutes, his sons went to investigate. They found him doing pushups on the bathroom floor. Other FTD manifestations have included shoplifting, compulsive gambling, frittering away large amounts of money and odd sexual behaviors.
Like the brain, the testes exist behind the body's equivalent of a gated community. The testes are protected by a physical barrier of Sertoli cells which prevent blood-borne infections and poisonous molecules from entering the semen. Weintraub speculates that a vasectomy may raise the risk of PPA and FTD because the surgery breaches the protective barrier between the blood and the testes (the blood-testis barrier).
When semen mixes into the bloodstream, the immune system recognizes the sperm as invading foreign agents and produces sperm antibodies. Weintraub said these antibodies might cross the blood-brain barrier and cause neurological damage resulting in dementia. "There are other neurological models of disease which you can use as a parallel," Weintraub said. Certain malignant tumors produce antibodies that reach the brain and cause an illness similar to encephalitis, she noted. Weintraub hopes to launch a national study to see if her results are confirmed in a larger population.
Based on material from Northwestern University
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