There is considerable controversy over the sexual effects of circumcision. Anti-circumcision groups claim significant detrimental effects , though offer only anecdotal evidence.
Sexual Function
Three prospective studies have investigated effects of circumcision[2,3,4]. Fink et al[2] reported: "Adult circumcision appears to result in worsened erectile function (p = 0.01), decreased penile sensitivity (p = 0.08), no change in sexual activity (p = 0.22) and improved satisfaction (p = 0.04)."
Erectile Function
None of the other studies confirmed the finding of worsened erectile function (see table 1), and it is possible that this may reflect the consequences of aging rather than circumcision. Indeed, Laumann et al[7] reported that circumcised men exhibit less erectile dysfunction than uncircumcised men, particularly amongst older males.
Table 1: Summary of Findings on Erectile Function
| Study | No. of respondents | Erectile Function | ||
|---|---|---|---|---|
| Before | After | P value | ||
| Fink (all respondents)[2] | 40 | 12.4 | 10.5 | 0.01* |
| Fink (same partner)[2] | 30 | 12.3 | 11.1 | 0.05 |
| Brief Male Sexual Function Inventory Scoring | ||||
| Collins[3] | 15 | 9.7 | 9.8 | > 0.96 |
| Senkul[4] | 42 | 9.9 | 9.8 | 0.89 |
* Statistically significant (p < 0.05).
Penile Sensitivity
As Fink et al noted, the finding of decreased sensitivity "bordered on statistical significance". Confusingly, the scoring for sensitivity included time required to orgasm, including complaints of premature ejaculation. Senkul et al[4] reported an increase in time required to orgasm following circumcision. Laumann et al[7] found that uncircumcised men were more likely to experience premature ejaculation.
It is widely believed that the glans penis keratinises (cornifies) following circumcision, and this causes desensitisation. However, Szabo & Short examined this issue in 2000[6], and found no difference in level of keratinisation between circumcised and uncircumcised men. Masters & Johnson, in a 1966 investigation[8], found no difference in glans sensitivity between circumcised and uncircumcised men. Bleustein et al[1] confirmed this finding in a thorough 2003 investigation.
Taylor et al reported indirect evidence suggesting a sensory role for the foreskin[9,10], though it has not been demonstrated that this is associated with increased sexual pleasure[10].
Sexual Activity
While Fink et al[2] noted no change in sexual activity, Laumann et al[7] noted that circumcised men enjoy a greater variety of sexual practices.
Williamson & Williamson investigated women's preferences in sexual partners. 71% preferred circumcised partners for sexual intercourse, 83% for giving fellatio and 75% for giving manual stimulation. When asked for the reason for their preference, 92% responded that the circumcised penis stays cleaner, 90% that it looks sexier and 85% that it feels nicer to touch.
Kebaabetswe et al[13] found that in the generally non-circumcising Botswana, 50% of women preferred a circumcised penis (43% had no preference or were unsure). After an informational session, this figure rose to 79%. Echoing this, Bailey et al[14] found that 62% of women in the non-circumcising Luo tribe would prefer a circumcised partner. 90% said it was easier for circumcised men to keep clean. Both men and women believes that being circumcised made sex more pleasurable.
Another survey, by O'Hara and O'Hara, that found opposing results[11] has been criticised for surveying female members of an anti-circumcision organisation[12], and is probably not representative of the wider population.
References
- Bleustein CB, Eckholdt H, Arezzo JC, Melman A. Effects of circumcision on male penile sensitivity. Paper read at the American Urological Association 98th Annual Meeting at Chicago Illinois, April 26-May 1, 2003. Publishing ID 1260, Abstract ID: 100769.
- Fink KS, Carson CC, DeVellis RF. Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction. J Urol 2002 May; 167(5): 2113-6
- Collins S, Upshaw J, Rutchik S, Ohannessian C, Ortenberg J, Albertsen P. Effects of circumcision on male sexual function: debunking a myth? J Urol 2002 May; 167(5): 2111-2
- Senkul T, Iseri C, Sen B. et al. Circumcision in adults: effect on sexual function. Urology 2004; 63(1): 155-8
- Williamson ML, Williamson PS. Women's preferences for penile circumcision in sexual partners. J Sex Educ Ther 1988; 14: 8
- Szabo R. Short RV. How does male circumcision protect against HIV infection? BMJ 2000; 320: 1592-4
- Laumann, EO, Masi CM, Zuckerman EW. Circumcision in the United States. JAMA 1997; 277(13): 1052-1057
- Masters WH, Johnson VE. Human Sexual Response. Boston: Little, Brown & Co 1966: 189-91
- Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. Br J Urol 1996; 77: 2915
- Moses S, Bailey RC, Ronald AR. Male circumcision: assessment of health benefits and risks. Sex Transm Infect 1998; 74: 368-73
- O'Hara K, O'Hara J. The effect of male circumcision on the sexual enjoyment of the female partner. BJU Int 1999;83 Suppl 1: 79-84
- Morris B. Benefits of circumcision: medical, health and sexual [online]. [cited 2004 Sep 29]. Available at: http://www.circinfo.net.
- Kebaabetswe, Lockman S, Mogwe S, et al. Male circumcision: an acceptable strategy for HIV prevention in Botswana. Sex Transm Inf 2003; 79: 214-9
- Bailey R, Muga R, Poulussen R. Trial intervention introducing male circumcision to reduce HIV/STD infections in Nyanza province, Kenya: Baseline results. In: 13th International AIDS Conference. Durban, South Africa - 9-14 July 2000
