One of three a randomized control trials regarding circumcision was conducted in Kenya from 2002 to 2005 [1], which we will be looking at in this blog post. The main goal of the study was to investigate if circumcision reduced the risk of contracting HIV, but at the time there was little known about the effects of circumcision on men’s sexual pleasure so the researchers closely followed how circumcision effected the sexual pleasure of the men who were picked to undergo circumcision. Following written informed consent, 2,784 participants were randomized 1:1 to either immediate circumcision, or having circumcision delayed until after the trial ends. Both groups were counseled on HIV prevention and given a free, unlimited supply of condoms. Evaluations on sexual pleasure were taken at 1, 3, 6, 12, 18, and 24 months on both groups after the study group underwent circumcision. Tables detailing sexual function and pleasure in regards to circumcision status are now given:

kenya-pt1kenya-pt2

As table 1 indicates, both groups experienced a significant decrease in sexual dysfunction. In addition, as table 1 also indicates, circumcision had no association with sexual dysfunction. Also, at the 6-month interview, only 6 men (1%) reported not being satisfied with their circumcision. For the 12 and 24 month follow ups, all men reported being satisfied with their circumcision. The second table also indicates a significant increase in sexual pleasure and penile sensitivity among circumcised men. The question of if circumcision decreases sexual pleasure can be broken down into two parts. The first is if the removal of nerve endings found in the foreskin decrease pleasure. Such a difference would be noticed immediately by the men who underwent circumcision, but as seen in table 2, very few men reported a decrease in sensitivity at the 6-month follow up (5.6% reporting somewhat less and 1.5% reporting much less) and significantly more men reported an increase in penile sensitivity at the 6-month follow up (50.1% reporting much more and 13.1% reported somewhat more). The second part of the question is if long term exposed of the glands of a circumcised penis can get ‘desensitized’. Again though, table two shows an increase in men in each stage of the follow ups reporting an increase in penile sensitivity and about the same amount men reporting a decrease in penile sensitivity, finally reaching 64% of men reporting their penis as much more sensitive, 7.8% reporting their penis as somewhat more sensitive at the 24-month interview. This finding indicates that long term exposure of the glands of a circumcised penis does not desensitize the penis to sexual pleasure.

The findings in this study are supported by the CDC’s own findings on circumcisions effect on sexual pleasure, that few men report a decrease in sexual pleasure after circumcision and there is a general trend toward an increase in sexual pleasure after circumcision [2].cdc

The findings in this study are also supported by the 2007 World Health Organization and UNAIDS  own findings on circumcisions effect on sexual pleasure, stating “Although it has been argued that sexual function may diminish following circumcision due to the removal of the nerve endings and subsequent thickening of the epithelium of the glans, there is little evidence of this”[3].

Again, the findings in this study are also supported by the 2012 American Academy of Pediatrics own findings on circumcisions effect on sexual pleasure, stating “The literature review does not support the belief that male circumcision adversely affects penile sexual function or sensitivity, or sexual satisfaction, regardless of how these factors are defined”[7].

These findings are also supported by: a 2016 systematic review conducted by Danish researchers that found grade A evidence that circumcision in fact increases penile sensitivity and rejected the hypothesis that circumcised men experience inferior sexual function [4], a 2013 systematic review conducted by Australian researchers which found that studies that were rated as high quality from the Scottish Intercollegiate Guidelines Network gave indicate circumcision does not negatively impact sexual function, sexual sensitivity, sexual sensation or sexual satisfaction [5], and a 2013  meta-analysis and systematic review conducted by Chinese researchers which found circumcision in unlikely to have an adverse effect on sexual function [6].

[1] Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya   https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3042320/?log$=activity#R36

[2] 2014 Center of Disease Control Guidlines on Male Circumcision   https://www.cdc.gov/hiv/pdf/prevention_research_malecircumcision.pdf

[3] 2007 World Health Organization and UNAIDS http://www.unaids.org/sites/default/files/media_asset/jc1360_male_circumcision_en_0.pdf

[4] Male Circumcision Does Not Result in Perceived Male Sexual Function – A Systematic Review. Shabanzadeh et al   https://www.ncbi.nlm.nih.gov/pubmed/27399981

[5] Does Male Circumcision Affect Sexual Function, Sensitivity, or Satisfaction? A Systematic Review   https://www.ncbi.nlm.nih.gov/pubmed/23937309

[6] Effects of Male Circumcision on Male Sexual Functions: A Systematic Review and Meta-Analysis. Tian et al     https://www.ncbi.nlm.nih.gov/pubmed/23749001

[7] The American Academy of Pediatrics 2012 evaluation of circumcision:
http://pediatrics.aappublications.org/content/pediatrics/130/3/e756.full.pdf

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