Between February 2007 and January 2010, 186 young adults (average age 21 years old) who were undergoing circumcision for religious and cultural/esthetic reasons were enrolled in the following study [1]. The average follow up period was 30.2 months (range 12 months to 52 months). The patients were tested at a follow up visit that took place between January and March of 2011  for overall sexual function and sexual pleasure. turkey

As the table indicates, the ability to get and maintain an erection was improved after circumcision and well as overall sexual problem assessment. In addition, there was a significant increase in overall sexual satisfaction after the men underwent circumcision.

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 decrease in pleasure would be noticed immediately by the men who underwent circumcision, but clearly the results were the opposite for these men. The second part of the question is if long term exposure of the glands of a circumcised penis can get ‘desensitized’. Again though we find that over time, the men report a higher level of sexual satisfaction even after an average of 2.5 years after circumcision occurred. This would indicated that this desensitization does not occur. Other studies (which are talked about in this blog) that have occurred over a longer follow up period have also found an increase in sexual pleasure with no indication that pleasure decreases overtime.

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

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] as well as concluding that the benefits of circumcision outweigh the risks.

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].

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] and there is, in fact, good evident that circumcision increases sexual pleasure. In light of this finding the Chinese researchers proposed the following, ‘The prepuce [foreskin] is a simple fold of skin composed of an outer keratinized (skin) and inner (mucosal) layers… Theoretically, partial or total surgical removal of the prepuce leaves the somatic penis sensory fibres exposed to direct stimulation and in theory could benefit sexual function.’ The Chinese researchers go on to state that their conclusion should provide assurance to parents considering circumcision for their children, as circumcision has been shown to be a desirable intervention to prevent HIV and other STD’s, various HPV related cancers, and urinary track infections, and the safest time for the procedure is early in life.

 

[1]Adult Male Circumcision Preformed with Plastic Clamp Tequenique in Turkey: Results on Long-Term Effects on Sexual Function. Senel et al. http://www.urologyjournal.org/index.php/uj/article/view/1802/693

[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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