Consider the facts: the presence of foreskin on the penis is natural. Males are born with it. They have been since humans walked the earth. So why are so many male babies circumcised to remove this protective structure? Is it truly a medically necessary procedure, as some claim, or a cruel practice without significant health benefits that is depriving men of sexual pleasure? Can circumcision ruin your sex life?
For some people, this last question isn’t even a consideration. Circumcision is a religious or cultural tradition that is not to be questioned. Others cite reported health benefits of having their child undergo circumcision. The choice is made for him; the male infant does not give informed consent, which he could do if he were allowed to keep his foreskin until he were older.
The prevalence of circumcision varies widely. Globally, approximately 30 percent of males have been circumcised, and an estimated two thirds of them are Muslim. In the United States, on the other hand, about 75 percent of males have been circumcised.
So when it comes to circumcision and sexual function, what’s the story?
Circumcision and sexual function
One of the more common questions surrounding circumcision is whether the procedure reduces a man’s sexual sensation. After all, circumcision involves the removal of thousands of nerve endings in the penis, which suggests sensation would be affected. One study, for example, reported that the glans of a circumcised penis was less sensitive to light touch than one of an uncircumcised penis.
However, subsequent studies as well as some others have reported that “there is no significant change in sensation in adult men who undergo circumcision,” as noted by Dr. Alex Shteynshlyuger, director of urology at New York Urology Specialists. One explanation may be that since sexual intercourse generally does not involved light touch, any change in sensation is not noticeable.
At least one study has examined the possible impact of circumcision on premature ejaculation. The meta-analysis included 12 studies with a total of 10,019 circumcised and 11,570 uncircumcised men. The reviewers found no significant differences in premature ejaculation and orgasm between circumcised and uncircumcised men. However, erectile dysfunction, pain during intercourse, and intravaginal ejaculation latency time were better among the men who were circumcised.
A systematic review and meta-analysis appearing in the Asian Journal of Andrology explored the question of the impact of adult male circumcision on sexual function. Ten studies (9,317 circumcised and 9,423 uncircumcised men) were analyzed. The authors found:
- No significant differences between the two groups in terms of sexual desire, painful sex, premature ejaculation, erectile dysfunctions, or orgasm difficulties.
- The authors concluded that “these findings suggest that circumcision is unlikely to adversely affect male sexual functions.”
Another interesting study of circumcision and sexual function appeared in the Journal of Sexual Medicine in 2017. The authors examined the sexual function and satisfaction of 1,509 newly circumcised men and 1,524 age-matched uncircumcised controls over a 24-month period. Overall, the authors saw a decline in sexual dysfunctions in both groups of men except for dyspareunia (painful sex), which decreased in circumcised men only. Sexual satisfaction increased in both groups as well, but there were greater improvements among circumcised men. Ninety-two percent of circumcised men rated sex as more enjoyable or no different after they were circumcised compared with before the procedure.
Overall, the authors concluded that voluntary medical male circumcision “has no significant detrimental effect or might have beneficial effects on male sexual function and satisfaction for the great majority of men circumcised as adults.”
Research findings indicate that circumcision does not have a significant adverse effect on male sexual function. However, it is worth also considering other pros and cons of circumcision.
Circumcision health benefits
There are varying degrees of evidence that circumcision:
- Reduces the risk of contracting sexually transmitted infections, especially HIV and HPV
- Is associated with a lower risk of penile cancer
- Lowers the risk of developing urinary tract infections, which can result in kidney infections if left untreated
- Reduces the risk of balanitis, which is inflammation of the foreskin and head of the glans penis. Balanitis is characterized by pain, a foul-smelling discharge from under the foreskin, and redness. Causes include infection, poor hygiene, uncontrolled diabetes, use of harsh soaps, and skin disorders.
- Eliminates the risk of paraphimosis, which occurs when the foreskin becomes lodged or trapped behind the glans. This situation can restrict blood flow to the glans
According to the American Academy of Pediatrics, “the health benefits of newborn male circumcision outweigh the risks.”
Downsides of circumcision
Not everyone, including some medical professionals, agree that circumcision is medically necessary and an overall healthy choice. This sentiment may be reflected in the fact that the number of newborns who are undergoing the procedure has declined from 84 percent in the 1960s to about 77 percent in 2010.
According to the American Academy of Pediatrics, the benefits of undergoing circumcision are not significant enough for people to consider it a routine procedure for all newborn males. In addition, both the American Academy of Family Physicians and the Centers for Disease Control and Prevention state there is not enough data to medically recommend or oppose circumcision. .
Circumcision also comes with risks imposed on the infant or young child during the procedure. Some of those risks include cutting the foreskin too long or too short, minor bleeding, improper healing, and infection.
Another downside of circumcision is that it increases the risk of inflammation of the opening of the penis, also known as meatitis. Although this is an uncomfortable condition, there is no evidence it leads to more serious problems.
Some debate exists over the validity of claims that circumcision reduces the risk of HPV infections. For example, a recent study looked at the notion that circumcision is associated with a higher risk of HPV infection. A total of 113 circumcised and 560 uncircumcised men ages 18 to 55 years were enrolled in the study. Based on the external genitalia samples that were collected and analyzed twice during a six-month interval, the authors concluded that the incidence of genital HPV infection is similar among circumcised and uncircumcised men.
What about hygiene? Uncircumcised men need to be more vigilant about their hygiene and clean underneath the foreskin daily to remove smegma, an odorless and harmless substance that gathers under the foreskin. A few moments to clean the penis well is all that is necessary.
When talking about circumcision and sexual function, one also needs to think about the other health related factors involved in making this decision.
References
American Academy of Pediatrics. Circumcision policy statement
Hutton L. The circumcision debate: to snip or not to snip. Family Education
Nordstrom MP et al. Medical male circumcision is associated with improvements in pain during intercourse and sexual satisfaction in Kenya. Journal of Sexual Medicine 2017 Apr; 14(4): 601-12
Sorrells ML et al. Fine-touch pressure thresholds in the adult penis. BJU International 2006 Oct 22; 864-69
Tian Y et al. Effects of circumcision on male sexual functions: a systematic review and meta-analysis. Asian Journal of Andrology 2013 Sep; 15(5): 662-66
Wei FX et al. The impact of male circumcision on the natural history of genital HPV infection: a prospective cohort study. Zhonghua Yu Fang Yi Xue Za Zhi 2018 May 6; 52(5): 486-92
World Health Organization. Male circumcision
Yang Y et al. Circumcision does not have effect on premature ejaculation: a systematic review and meta-analysis. Andrologia 2018 Mar; 50(2).
