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normalize et al. (AMA)
|date=1999-03
|accessdate=
}}</ref> In January 2007, The [[American Academy of Family Physicians]] (AAFP) stated "The effect of circumcision on penile sensation or sexual satisfaction is unknown. Because the epithelium of a circumcised glans becomes cornified, and because some feel nerve over-stimulation leads to desensitization, many believe that the glans of a circumcised penis is less sensitive. [...] No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction."<ref name="AAFP2007"/> Conversely, a 2002 review by Boyle ''et al.'' stated that "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision, with an inevitable reduction in sexual sensation experienced by circumcised males." They concluded, "intercourse is less satisfying for both partners when the man is circumcised".<ref>{{REFweb | quote= | url=http://www.cirp.org/library/psych/boyle6/ | title=Male circumcision: pain, trauma, and psychosexual sequelae | last=Boyle, Gregory J.;Svoboda, J. Steven; Goldman, Ronald; Fernandez, Ephrem | first= | publisher=Bond University Faculty of Humanities and Social Sciences | website=Circumcision Reference Library | date=2002-05-01 | accessdate=2019-12-02
}}</ref>-->
== Penile sensitivity and sexual sensation ==
Results of studies of the effect on penile sensitivity have been mixed. In a British study of 150 men circumcised as adults for penile problems, Masood ''et al.'' (2005) found that 38% reported improved penile sensation (p=0.01), 18% reported worse penile sensation, while the remainder (44%) reported no change.<ref name= "masood2005">{{REFjournal
|last=Masood
|init=S
|date=2005
|accessdate=
}}</ref> In a survey of men circumcised as adults for medical (93%) or elective (7%) reasons, Fink ''et al.'' (2002) found an association between adult circumcision and decreased penile sensitivity that "bordered on statistical significance" (p=0.08).<ref name="fink2002">{{REFjournal
|last=Fink
|init=KS
A number of studies have looked at the question of whether sensitivity of the glans is affected by circumcision.
Yang ''et al.'' (1998) concluded in their study into the innervation of the penile shaft and glans penis that: "The distinct pattern of innervation of the glans emphasizes the role of the glans as a sensory structure."<ref name="yang1998">{{REFjournal
|last=Yang
|init=CC
}}</ref>
Sorrells ''et al.'' (2007) measured the fine-touch pressure thresholds of 91 circumcised and 68 [[uncircumcised]], adult male volunteers, They reported "[the] glans of the [[uncircumcised]] men had significantly lower mean (sem) pressure thresholds than that of the circumcised men, at 0.161 (0.078) g (P = 0.040) when controlled for age, location of measurement, type of underwear worn, and ethnicity."<ref name="sorrells2007"/>
=== Foreskin sensitivity ===
}}</ref>
Boyle ''et al.'' (2002) argued that circumcision and frenectomy remove tissues with "heightened erogenous sensitivity," stating "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings—many of which are lost to circumcision."<ref name="boyle2002">{{REFjournal
|last=Boyle
|first=Gregory J.
}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."
Sorrells ''et al.'' (2007), in the study discussed above, measured fine-touch pressure thresholds of the penis, and concluded "The transitional region from the external to the internal prepuce is the most sensitive region of the [[uncircumcised]] penis and more sensitive than the most sensitive region of the circumcised penis. Circumcision ablates" (removes) "the most sensitive parts of the penis." According to Sorrells ''et al.'', the five penile areas most sensitive to fine-touch are located on the foreskin.<ref name= "sorrells2007" />
In 2009, Schober ''et al'' . reported on self-assessed sexual sensitivity in 81 men, 11 of whom were [[uncircumcised]]. When assessing areas producing sexual pleasure, the foreskin was ranked 7th, after the glans, lower and upper shaft, and the left and right sides of the penis, but above the area between scrotum and anus, the scrotum itself, and the anus.<ref name= "schober2008">{{REFjournal
|last=Schober
|init=JM
}}</ref><ref name="kimpang2006"/>
Fink ''et al.'' (2002), in an American study of 123 men, found that medically necessitated circumcision resulted in worsened erectile function (p=0.01).<ref name=fink2002/>
Kim & Pang (2007) reported no significant difference in erection.<ref name="kimpang2006">{{REFjournal
}}</ref>
Laumann ''et al.'' (1997) reported that the likelihood of having difficulty in maintaining an erection was lower for circumcised men, but only at the 0.07 level (OR 0.66; 95% CI, 0.42-1.03).<ref name="Laumann1997"/>
== Ejaculatory function ==
Waldinger ''et al.'' recruited 500 men (98 circumcised and 261 not-circumcised) from five countries: the Netherlands, United Kingdom, Spain, Turkey, and the United States and studied their ejaculation times during [[sexual intercourse]]. They found that the circumcised men in the study took on average 6.7 minutes to ejaculate, compared with 6.0 minutes for the [[uncircumcised]] men. This difference was not statistically significant. The comparison excluded Turkey, which was significantly different from the other countries studied.<ref name="Waldinger2005">{{REFjournal
|last=Waldinger
|init=MD
|date=2005
|accessdate=
}}</ref> Commenting on the study, Sorrells ''et al.'' (2007) said "Turkish men, the vast majority of whom are circumcised, had the shortest IELT [Intravaginal ejaculation latency time]."<ref name= "sorrells2007"/>
Collins ''et al.'' (2002) conducted a prospective study of 15 adult circumcision patients, using the Brief Male Sexual Function Inventory (BMSFI). The authors did not find a statistically significant effect on ejaculation scores.<ref name="Collins2002"/>
In a study of 42 Turkish men circumcised for religious reasons, Senkul ''et al.'' (2004) did not find a statistically significant difference in BMSFI ejaculation scores, but found a significant increase in the mean time to ejaculate. The authors suggested that delayed ejaculation may be seen as a benefit.<ref name="senkul2004">{{REFjournal
|last=Senkul
|init=T
In a study of 255 circumcised men and 118 intact men, Kim & Pang (2006) reported no statistically significant difference in ejaculation or ejaculation latency time between circumcised and intact participants.<ref name="kimpang2006"/>
In a study of men circumcised for benign disease, Masood ''et al.'' reported that of those who stated they had prior premature ejaculation, 13% reported improvement after circumcision, 33% reported that it became worse, and 53% reported no change.<ref name="masood2005"/>
In a study of 22 men circumcised as adults, Cortés-González ''et al.'' reported that 31.8% suffered from premature ejaculation before the procedure; this diminished to 13.6% afterwards.
== Sexual practice and masturbation ==
In a study by Korean researchers of 255 men circumcised after the age of 20 and 18 who were not circumcised, Kim & Pang reported that masturbatory pleasure decreased in 48% of the respondents and increased in 8%. [[Masturbation|Masturbatory]] difficulty increased in 63% but was easier in 37%. They concluded that there was a decrease in masturbatory pleasure after circumcision.<ref name="kimpang2006"/>
Laumann ''et al.'' reported that circumcised men in their survey displayed a greater rates of experience of various sexual practices, including oral sex, anal sex, and [[masturbation]].<ref name="Laumann1997">{{REFjournal
|last=Laumann
|init=EO
Published: April 2, 1997. New York Times. [http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C07E4D91F3AF931A35757C0A961958260]</ref>
Fink ''et al.'' did not find a change in sexual activity with adult circumcision (p=0.22).<ref name="fink2002"/>
== Sexual drive ==
Several studies have investigated the effect of circumcision on sexual drive. Studies that did not find a statistically significant difference include Kim & Pang,<ref name="kimpang2006"/> Collins ''et al.'',<ref name="Collins2002"/> and Senkul ''et al.''.<ref name="senkul2004"/> \
== Satisfaction ==
Kim & Pang (2007) found that 20% reported that their sex life was worse after circumcision and 6% reported that it had improved. They concluded that "there was a decrease ... sexual enjoyment after circumcision, indicating that adult circumcision adversely affects sexual function in many men, possibly because of complications of the surgery and a loss of nerve endings."<ref name="kimpang2006"/>
Masood ''et al.'', in their study mentioned earlier of men circumcised for benign disease, found that 61% reported satisfaction with the results, while 17% felt it made things worse, and 22% expressed neutral sentiments. 44% of the patients (p = 0.04) and 38% of the partners (p = 0.02) thought the penis appearance improved after circumcision. The authors of the study concluded that the satisfaction rate was a 'poor outcome,' given the pre-procedure penile disease state and recommended discussing with prospective patients the results of this study during the informed consent process.<ref name=masood2005/>
Shen ''et al.'' reported that adult circumcision appeared to result in improved satisfaction in 34 cases (of 95 adults being circumcised), the association was statistically significant.<ref name="shen2004"/>
Senkul ''et al.'' reported that they did not find a statistically significant difference in BMSFI satisfaction scores in their study of 42 adult circumcision patients.<ref name="senkul2004"/>
Collins ''et al.'' reported on a study of 15 adult circumcision patients. No statistically significant difference in BMSFI scores was observed.<ref name="Collins2002"/>
Fink ''et al.'' reported improved satisfaction (p=0.04). Half of the circumcised men reported benefits, while 38% reported harm. "Overall, 62% of men were satisfied with having been circumcised." Fink attributes the improved satisfaction to the respondee's aesthetic considerations and to a resolution of previous painful conditions.<ref name="fink2002"/>
==Female preferences and response==
}}</ref>
Williamson ''et al.'' (1988) studied randomly selected young mothers in Iowa, where most men are circumcised, and found that 76% would prefer a circumcised penis for achieving sexual arousal through viewing it.<ref>[http://www.circs.org/library/williamson/index.html Williamson ML, Williamson PS. Women's Preferences for Penile Circumcision in Sexual Partners.] J Sex Educ Ther 1988; 14: 8</ref>
O'Hara and O'Hara (1999) argue that foreskin is a natural gliding stimulator of the vaginal walls during intercourse, increasing a woman's overall clitoral stimulation and helping her achieve orgasm more quickly and more often. Without the foreskin's gliding action, they suggest, it can be more difficult for a woman to achieve orgasm during intercourse.<ref name= "OHara1999">{{REFjournal
}}</ref>
Morten ''et al''. (2013) surveyed a very large group of men and women in Denmark. They concluded:
<blockquote>
"Circumcision was associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in women, notably orgasm difficulties, dyspareunia and a sense of incomplete sexual needs fulfilment."<ref name="morten-lindholm2013">{{REFjournal