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Sexual effects of circumcision

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The '''This article was borrowed from Wikipedia sexual effects of circumcision''' are now well documented. Studies have been conducted to investigate the effect of [[circumcision]] ([[amputation]] of the [[foreskin]]) on sexual drive, erectile function, premature and delayed [http://en[ejaculation]], sexual satisfaction, sexual sensation and penile sensitivity.wikipediaStudies have also assessed whether [[circumcision]] affects [[masturbation]] or other sexual practices, and the degree to which a heterosexual woman's experience of sex is affected by her partner's [[circumcision]] status.org/w/index.php?title=Sexual_effects_of_circumcisionCold &oldid=429623060 21Taylor (1999) stated:11<blockquote>The [[prepuce]] is primary, 17 May 2011]'''erogenous tissue necessary for normal sexual function.<ref name="cold-taylor1999">{{ColdCJ TaylorJR 1999}}</ref></blockquote>
The '''sexual effects of [[circumcision]]''' are ==History=====In the subject of some debate. Studies have been conducted to investigate whether circumcision has any effect on sexual drive, erectile function, premature and delayed ejaculation, sexual satisfaction, sexual sensation and penile sensitivity. Studies have also assessed whether circumcision affects masturbation or other sexual practices, and whether a heterosexual woman's experience of sex is affected by her partner's circumcision status. beginning===
Those reviewing the literature have reached differing conclusions. The American Academy of Pediatrics points human [[foreskin]] was once thought to a survey (self-report) finding circumcised adult men had less have little or no sexual dysfunction and more varied sexual practices, but also noted anecdotal reports that penile sensation and sexual satisfaction are decreased for circumcised malesfunction.<ref name="AAP1999">{{REFjournal | last= | first= | coauthors= | title=Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision | journal=Pediatrics | volume=103 | issue=3 | pages=686-93 | url= | quote= | pubmedID=10049981 | pubmedCID= | DOI=10 Sex researcher Alfred C.1542/peds.103.3.686 | date=March 1999 | accessdate=}}</ref> In January 2007, The American Academy of Family Physicians Kinsey (AAFP1948) stated "The effect of circumcision placed no importance 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 presence or satisfaction."<ref name="AAFP"/> 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&mdash;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://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1036&context=hss_pubs | 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= | date=2002 | accessdate=}}</ref> == Penile sensitivity and sexual sensation == Results of studies absence 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.'' found that 38% reported improved penile sensation (p=0.01), 18% reported worse penile sensation, while the remainder (44%) reported no changeforeskin.<ref name= "masood2005kinsey1948">{{REFjournalREFbook | last=MasoodKinsey | first=S | coauthors=Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK | title=Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly? | journal=Urol Internationalalis | volume=75 | issue=1 | pages=62-6 | url=http://www.cirp.org/library/sex_function/masood1/ | quote= | pubmedID=16037710 | pubmedCID= | DOI=10.1159/000085930 | date=2005 | accessdate=}}</ref> In a survey of men circumcised as adults for medical (93%) or elective (7%) reasons, Fink ''et al.'' found an association between adult circumcision and decreased penile sensitivity that "bordered on statistical significance" (p=0.08).<ref name="fink2002">{{REFjournal | last=Fink | first=K.S. | coauthors=C.Alfred C. Carson and R.F. DeVillis | title=Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction | journalinit=Journal of UrologyAC | volume=167 | issue=5 | pages=2113author-6 | url=http://www.circs.org/library/fink/ | quotelink= | pubmedIDlast2=11956453Pemeroy | pubmedCIDinit2=AC | DOI=10.1016/S0022author2-5347(05)65098-7 | datelink=May 2002 | accessdateyear=}}</ref> In a 2008 study, Krieger ''et al.'' stated that "Adult male circumcision was not associated with sexual dysfunction. Circumcised men reported increased penile sensitivity and enhanced ease of reaching orgasm."<ref name="Krieger2008">{{REFjournal | last=Krieger | first=JN | coauthors=Mehta SD, Bailey RC, Agot K, Ndinya-Achola JO, Parker C, Moses S1948 | title=Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction Behavior in Kisumu, Kenya | journal=The journal of sexual medicine | volume=Epub ahead of print | issue=11 | pages=2610–22the Human Male | url= | quotework= | pubmedIDeditor=18761593 | pubmedCIDedition= | DOIvolume=10.1111/j.1743-6109.2008.00979.x | datechapter=August 2008 | accessdatepages=}}</ref> In a 2009 study, Cortés-González ''et al.'' reported a statistically significant improvement in "perception of sexual events" (p=0.04).<ref name="cortes2009">{{REFjournal | last=Cortés-González JR, Arratia-Maqueo JA, Martínez-Montelongo R, Gómez-Guerra LS | firstlocation= | coauthorspublisher= | title=Does Circumcision Affect Male's Perception of Sexual Satisfaction? | journal=ArchA. Esp. UrolC.Saunders | volumeisbn=62 | issuequote=9 | pagesaccessdate=7332019-736 | url=http://www.arch12-espanoles-de-urologia.es/apartados/sumarios/popup.php?ano=2009&id=62-09-18 | quote=21 | pubmedID=19955598 | pubmedCID= | DOI= | date=November 2009 | accessdatenote=
}}</ref>
Masters & Johnson (1966) in their book, ''Human Sexual Response'',<ref name=== Glans sensitivity ==="masters-johnson1966" /> showed little interest or understanding of the human foreskin. One illustration, labelled normal [[penis]] anatomy, showed a drawing of a [[penis]] without a [[foreskin]]. A listing of penile pathology in their book included “[[uncircumcised]] [[penis]]”! Their work was done in St. Louis, located in the highly [[circumcised]] Midwest, and almost all of their subjects were [[circumcised]]. Their testing was quite limited. With regard to the [[foreskin]], they said only:<blockquote>Routine neurologic testing for both exteroceptive and light tactile discrimination were conducted on the ventral and dorsal surfaces of the penile body, with particular attention directed toward the [[glans]].</blockquote>
A number of studies have looked at the question of whether sensitivity of With regard to the [[glans is affected by circumcision.penis]], Masters and & Johnson (1966) reportedstated: "<blockquote>Routine neurologic testing for both exteroceptive and light tactile discrimination were conducted on the ventral and dorsal surfaces of the penile body, with particular attention directed toward the [[glans]]. No clinically significant difference could be established between the [[circumcised ]] and the [[uncircumcised ]] [[glans ]] during these examinations."<ref name="masters1966masters-johnson1966">{{REFbook
|last=Masters
|first=W.HWilliam L. |init=WL |author-link=
|last2=Johnson
|first2=V.Virginia E. |init2=VE |author2-link=
|year=1966
|title=Human Sexual Responsesexual response |url=http://www.circs.org/library/masters/index.html
|work=
|editor=
|chapter=
|pages=
|location=Toronto; , New York |publisher=Bantam Books
|isbn=0-553-20429-7
|quote=
|accessdate=2019-12-21
|note=
}}</ref> Sorrells ''et al.'' criticised this early study for being poorly documented and not subject to peer review.<ref name="sorrells">{{REFjournal
| last=Sorrells
| first=Morris L.
| coauthors=James L. Snyder, Mark D. Reiss, Christopher Eden, Marilyn F. Milos, Norma Wilcox and Robert S. Van Howe
| title=Fine-touch pressure thresholds in the adult penis
| journal=BJU International
| volume=99
| issue=4
| pages=864-869
| url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508429/PDFSTART
| quote=
| pubmedID=17378847
| pubmedCID=
| DOI=10.1111/j.1464-410X.2006.06685.x
| date=March 2007
| 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. Opinions differ about how this decreased sensitivity, which may result in prolonged time to orgasm, affects sexual satisfaction. An investigation of the exteroceptive and light tactile discrimination of the glans of circumcised and uncircumcised men found no difference on comparison. No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction."
<ref name="AAFP">{{REFweb
| quote=
| url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/circumcision.html
| title=Circumcision: Position Paper on Neonatal Circumcision
| last=
| first=
| publisher=[[American Academy of Family Physicians]]
| website=
| date=2007
| accessdate=2007-01-30
}}</ref>
</blockquote>
 
Therefore, it appears that Masters & Johnson (1966) performed little or no testing on the [[foreskin| foreskins]] of their few [[intact]] subjects and provided no useful information.<ref name="sorrells2007">{{Sorrells etal 2007}}</ref>
Yang ''et alThe inaccurate reports of Kinsey (1948) and Masters & Johnson (1966) have long distorted and minimized the sexual effects of [[circumcision]] and the loss of the [[foreskin]] in the American view. ===The dawning of the light=== There were, however, some other little noticed papers overlooked by Masters & Johnson, that told a different story.'' Winklemann (19981956) concluded in their study into investigated the innervation of the penile shaft [[prepuce]] and glans penis thatfound it to be highly innervated.<ref name="winkleman1956">{{REFjournal |last=Winkelmann |init=RK |title=The cutaneous innervation of human newborn prepuce |journal=Journal of Investigative Dermatology |volume=26 |issue=1 |pages=53-67 |url=http: //www.cirp.org/library/anatomy/winkelmann2/ |quote= |pubmedID=13295637 |pubmedCID= |DOI= |date=1956-01 |accessdate=2019-12-21}}</ref> Winkleman (1959) later identified the [[prepuce]] as "specific erogenous tissue".<ref name="winkleman1959">{{WinkelmannRK 1959}}</ref> [[William Keith Campbell Morgan| William Keith C. Morgan]], {{MD}} (1965), a Canadian physician practicing in the [[United States]], had a comment critical of the then American practice of non-therapeutic (routine) [[circumcision]] of infants. With regard to sexual function, he identified the ease of penetration and said:<blockquote> Now let us consider whether the operation is in any way harmful or contraindicated. The distinct pattern function of innervation the prepuce is to protect the glans, the latter being almost insensitive to most ordinary tactile and thermal stimuli. It has, however, specific receptors for other pleasurable sensations. Removal of the prepuce exposes the [[glans emphasizes ]] to foreign stimuli which dull these special receptors. During the role act of coitus the [[uncircumcised]] phallus penetrates smoothly and without friction, the prepuce gradually retracting as the organ advances. In contrast, when the [[circumcised]] organ is introduced during coitus, friction develops between the [[glans as ]] and vaginal [[mucosa]]. Penetration in the [[circumcised]] man has been compared to thrusting the foot into a sock held open at the top, while, on the other hand, in the intact counterpart it has been likened to slipping the foot into a sensory structuresock that has been previously rolled up."<ref name="yang1998morgan1965">{{REFjournal | last=YangMorgan | firstinit=CCWKC | coauthorsauthor-link=Bradley WEWilliam Keith Campbell Morgan | title=Neuroanatomy of the penile portion of the human dorsal nerve The rape of the penisphallus | journal=British Journal UrologyJAMA |date=1965 | volume=82193 | issue=1 | pages=109123-1134 | url=http://www.cirp.org/library/anatomygeneral/yang1morgan/ | quote= | pubmedID=969867114310332 | pubmedCID= | DOI=10.10461001/j.1464-410xjama.19981965.00669.x03090030045013 | date=July 1998 | accessdate=2019-12-21
}}</ref>
</blockquote>
 
Morgan (1967) addressed the issue again in the ''Medical Journal of Australia'':
<blockquote>
The subcutaneous tissue of the [[glans]] is provided with special sensory receptors that are concerned with appreciating the pleasurable sensations that occur during coitus. They are stimulated normally only when the glans is exposed. In the [[circumcised]] subject these receptors are constantly stimulated and lose their sensitivity. During the act of coitus, the [[uncircumcised]] phallus penetrates smoothly and without friction, the prepuce gradually retracting as the organ advances. In contrast, when the [[circumcised]] organ is introduced during coitus, friction develops between the glans and the vaginal [[mucosa]].<ref name="morgan1967">{{REFjournal
|last=Morgan
|first=William Keith C.
|init=WKC
|author-link=William Keith Campbell Morga
|etal=No
|title=Penile Plunder
|trans-title=
|language=
|journal=Med J Aust
|location=
|date=1967-05-27
|volume=1
|issue=21
|pages=1102-3
|url=http://www.cirp.org/library/general/morgan2/
|quote=
|pubmedID=4226264
|pubmedCID=
|DOI=
|accessdate=2019-12-21
}}</ref>
</blockquote>
An examination Falliers (1970) commented in a critical letter to the ''Journal of the American Mmedical Association'':<blockquote>The sensory pleasure induced by tactile stimulation of 7 circumcised and 6 uncircumcised males found no difference in the [[keratinforeskin]]ization is almost totally lost after its surgical removal. The surface of the exposed [[glans penis]], as we know, has no capacity to receive and transmit any fine sensations of touch, heat, etc. Consequently, the fundamental biological sexual act becomes, for the [[circumcised]] male, simply a satisfaction of an urge and not the refined sensory experience that it was meant to be.<ref name="Szabofalliers1970">{{REFjournal | last=Szabo | first=Robert | coauthors=Roger V. ShortFalliers | titleINIT=How does male circumcision protect against HIV infection?CJ | journal=BMJ | volume=320 | issue=7249 | pages=1592author-1594 | urllink=http://bmj.bmjjournals.com/cgi/reprint/320/7249/1592 | quote= | pubmedID=10845974 | pubmedCIDetal=1127372 | DOI=10.1136/bmj.320.7249.1592 | date=June 2000 | accessdate=2006-07-09}}</ref> Bleustein ''et al.'' (2003) tested the sensitivity of the glans penis, and found no difference between circumcised and uncircumcised men.<ref name="bleustein2003">{{REFconference | place=Chicago, Illinois | title=Effects of Circumcision on Male Penile Sensitivity(letter) | urljournal=http://www.circs.org/library/bleustein/ | last=Bleustein | first=Clifford B.JAMA | coauthorslocation=Haftan Eckholdt, Joseph C. Arezzo and Arnold Melman | source=American Urological Association 98th Annual Meeting | date=April 26-May 1, 2003 | accessdate=2019-09-29}}</ref> Bleustein ''et al.'' (2005) divided 125 patients (62 uncircumcised men and 63 neonatally circumcised men) into groups based on their sexual dysfunction using the [[Sexological_testing#IIEF_.28International_Index_of_Erectile_Function.29|IIEF]](International Index of Erectile Function). Twenty-nine were placed in the functional group, and 96 in the dysfunctional group. Quantitative somatosensory testing (including vibration, pressure, spatial perception, and warm and cold thermal thresholds) was used on the dorsal midline glans of the penis. In the dysfunctional group, circumcised men (49 +/1970- 16 years) were significantly younger (P <0.01) than uncircumcised men (56 +/12- 13 years). When controlling for age, hypertension, and diabetes, there was no difference in sensitivity.<ref name= "bleustein2005">{{REFjournal | last=Bleustein | first=Clifford B. | coauthors=Fogarty JD, Eckholdt H, Arezzo JC, Melman A | title=Effect of neonatal circumcision on penile neurologic sensation | journal=Urology21 | volume=65214 | issue=412 | pages=773–72194 | url=http://linkinghubwww.elseviercirp.comorg/library/retrievegeneral/piifalliers1/S0090-4295(04)01343-3 | quote= | pubmedID=15833526 | pubmedCID= | DOI=10.1016/j.urology.2004.11.007 | date=April 2005 | accessdate=2019-12-21
}}</ref>
</blockquote>
Sorrells ''et alAnd so began the investigation of the sexual effects of male [[circumcision]].'' <!--Only medical trade associations, such as the [[American Academy of Pediatrics]] (2007AAP) measured the fine-touch pressure thresholds of 91 circumcised and 68 uncircumcised, adult male volunteersa [[medical trade association]] which represents doctors who profit from carrying out circumcisions, They reported "still contend that [[thecircumcision]] glans does not harm sexual function. The American Academy of the uncircumcised men had significantly lower mean Pediatrics points to a survey (semself-report) pressure thresholds than that of the finding [[circumcised ]] adult menhad less sexual dysfunction and more varied sexual practices, at 0but also noted anecdotal reports that penile sensation and sexual satisfaction are decreased for [[circumcised]] males.<ref name="AAP1999">{{REFjournal |last= |first= |title=Circumcision policy statement.161 (0American Academy of Pediatrics.078) g (P Task Force on Circumcision |journal=Pediatrics |volume=103 |issue=3 |pages=686-693 |url= |quote= |pubmedID=10049981 |pubmedCID= |DOI= 010.1542/peds.103.3.040686 |date=1999-03 |accessdate=}}</ref> In January 2007, The [[American Academy of Family Physicians]] (AAFP) when controlled for agestated "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, location many believe that the glans of measurementa [[circumcised]] [[penis]] is less sensitive. [...] No valid evidence to date, type of underwear wornhowever, and ethnicitysupports the notion that being [[circumcised]] affects sexual sensation or satisfaction."<ref name="sorrellsAAFP2007"/> In Conversely, a letter 2002 review by Boyle et al. stated that "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to BJU International[[circumcision]], howeverwith an inevitable reduction in sexual sensation experienced by circumcised males." They concluded, on "intercourse is less satisfying for both partners when the basis man is [[circumcised]]".<ref>{{BoyleGJ GoldmanR SvobodaJS FernandezE 2002}}</ref>--> == Penile sensitivity and sexual sensation == Results of studies of the unadjusted dataeffect on penile sensitivity have been mixed. In a British study of 150 men [[circumcised]] as adults for penile problems, Waskett and Morris stated "we find no significant differences [Masood et al.(2005) found that 38% reported improved penile sensation (p=0..]01), 18% reported worse penile sensation, consistent with previous findingswhile the remainder (44%) reported no change."<ref name="waskett2007masood2005">{{REFjournal | last=WaskettMasood |init=S |last2=Patel |init2=HR | firstlast3=Himpson |init3=RC |last4=Palmer |init4=JH |last5=Mufti |init5=GR |last6=Jake H.Sheriff | coauthorsinit6=Brian JM. MorrisK | title=Fine touch pressure thresholds in the adult penisPenile sensitivity and sexual satisfaction after circumcision: are we informing men correctly? | journal=BJU InternationalUrol Internationalalis | volume=9975 | issue=61 | pages=1551–155262-66 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508593/HTMLSTARThttp://www3.intersciencewww.wileycirp.comorg/cgi-binlibrary/fulltextsex_function/118508593masood1/HTMLSTART | quote= | pubmedID=1753722716037710 | pubmedCID= | DOI=10.11111159/j.1464-410X.2007.06970_6.x000085930 | date=May 20072005 | accessdate=}}</ref> However, in In a further letter to ''BJU International'', Young responded to Waskett and Morrissurvey of men circumcised as adults for medical (93%) or elective (7%) reasons, stating that Sorrells ''Fink et al.'' (2002) found an association between [[adult circumcision]] and decreased penile sensitivity that one point, at least, "bordered on the glans of the circumcised penis was less sensitive than that of the intact penisstatistical significance" (p=0.08).<ref name="youngfink2002">{{REFjournal | last=YoungFink |init=KS |last2=Carson |init2=CC | firstlast3=HughDeVillis | coauthorsinit3=RF | title=Fine touch pressure thresholds in the adult penisAdult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction | journal=BJU InternationalJ Urol | volume=100167 | issue=35 | pages=6992113-2116 | url=http://www3.intersciencewww.wileycircs.com/cgi-binorg/fulltextlibrary/118508003fink/HTMLSTART | quote= | pubmedID=1766915011956453 | pubmedCID= | DOI=10.11111016/j.1464S0022-5347(05)65098-410X.2007.07072_1.x7 | date=July 20072002-05 | accessdate=
}}</ref>
Payne ''=== Glans sensitivity === A number of studies have looked at the question of whether sensitivity of the [[glans]] is affected by [[circumcision]]. Yang et al.'' (20071998), concluded in a their study into the innervation of the glans and penile shaft sensitivity of twenty circumcised and twenty uncircumcised men, reported [[glans penis]] that : "No differences in genital sensitivity were found between The distinct pattern of innervation of the glans emphasizes the role of the uncircumcised and circumcised groupsglans as a sensory structure."<ref name="payne2007yang1998">{{REFjournal | last=PayneYang | firstinit=KimberleyCC | coauthorslast2=Thaler, Lea; Kukkonen, Tuuli; Carrier, Serge; and [[Irving M. BinikBradley |Binik, Yitzchak]]init2=WE | title=Sensation and Sexual Arousal in Circumcised and Uncircumcised MenNeuroanatomy of the penile portion of the human dorsal nerve of the penis | journal=British Journal of sexual medicineUrology | volume=482 | issue=31 | pages=667109-674113 | url=http://www.blackwell-synergycirp.comorg/doilibrary/absanatomy/10.1111yang1/j.1743-6109.2007.00471.x | quote= | pubmedID=174198129698671 | pubmedCID= | DOI=10.11111046/j.17431464-6109410x.20071998.0047100669.x | date=May 20071998-07 | accessdate=
}}</ref>
An examination of 7 [[circumcised]] and 6 [[intact]] males found no difference in [[keratinization]] of the [[glans penis]].<ref name="Szabo">{{REFjournal |last=Szabo |first= Foreskin sensitivity Robert |init=R |last2=Short |first2=Roger V. |init2=RV |title=How does male circumcision protect against HIV infection? |journal=BMJ |volume=320 |issue=7249 |pages=1592-1594 |url=http://bmj.bmjjournals.com/cgi/reprint/320/7249/1592 |quote= |pubmedID=10845974 |pubmedCID=1127372 |DOI=10.1136/bmj.320.7249.1592 |date=2000-06 |accessdate=2006-07-09}}</ref>
Some recent researchers have asserted that Sorrells et al. (2007) measured the fine-touch pressure thresholds of 91 [[foreskincircumcised]] may be sexually responsive.<ref>{{REFjournal | last=Winkelmann | first=R.K. | coauthors= | title=The cutaneous innervation of human newborn prepuce | journal=Journal of investigative dermatology | volume=26 | issue=1 | pages=53-67 | url=http://www.cirp.org/library/anatomy/winkelmann2/ | quote= | pubmedID=13295637 | pubmedCID= | DOI= | date=January 1956 | accessdate=}}</ref><ref>{{REFjournal | last=Winkelmann | first=R.K. | coauthors= | title=The erogenous zones: their nerve supply and significance | journal=Proceedings 68 [[uncircumcised]], adult male volunteers, They reported "the [[glans]] of the staff meetings [[uncircumcised]] men had significantly lower mean (sem) pressure thresholds than that of the mayo clinic | volume=34 | issue=2 | pages=39-47 | url=http://www[[circumcised]] men, at 0.cirp161 (0.org/library/anatomy/winkelmann/ | quote= | pubmedID=13645790 | pubmedCID= | DOI= | date=January 1959 | accessdate=}}</ref><ref name="taylor">{{REFjournal | last078) g (P =Taylor | first=J0.R. | coauthors=A.P. Lockwood and A.J. Taylor | title=The prepuce: Specialized mucosa 040) when controlled for age, location of measurement, type of the penis underwear worn, and its loss to circumcision | journal=British journal of urology | volume=77 | issue=2 | pages=291-295 | url=http://wwwethnicity.cirp.org/library/anatomy/taylor/ | quote= | pubmedID=8800902 | pubmedCID= | DOI=10.1046/j.1464-410X.1996.85023.x | date=February 1996 | accessdate=}}</ref>"<ref name="taylorcold1999sorrells2007">{{REFjournal | last=Taylor | first=J.R. | coauthors=C.J. Cold | title=The prepuce | journal=British journal of urology | volume=83 | issue=Supplement 1 | pages=34–44 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091418/PDFSTART | quote= | pubmedID= | pubmedCID= | DOI= | date=February 1999 | accessdate=}}</ref> Opponents of circumcision have cited these studies, which report on the sensitivity or innervation of the foreskin, claiming a sexual role based upon the presence of nerve-endings in the foreskin sensitive to light touch, stroking and fluttering sensations.
=== [[Foreskin sensitivity]] === Some recent researchers assert that the [[foreskin]] is sexually sensitive highly-innervated erogenous tissue.<ref name="winkleman1956" /><ref name="winkleman1959" /> <ref name="taylor1996">{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref><ref name="cold-taylor1999" /> The [[foreskin]] has a large population of [[Meissner's corpuscles]].<ref name="garcía-mesa2021">{{REFjournal |last=García-Mesa |first=Yolanda |init= |author-link= |last2=García-Piqueras |first2=Jorge |init2= |author2-link= |last3=Cobo |first3=Ramón |init3= |author3-link= |last4=Martín-Cruces |first4=José |init4= |author4-link= |last5=Suazo |first5=Iván |init5= |author5-link= |last6=García-Suárez |first6=Olivia |init6= |author6-link= |last7=Feito |first7=Jorge |init7= |author7-link= |last8= |first8=Vega |init8=José A. |author8-link= |etal=no |title=Sensory innervation of the human male prepuce: Meissner's corpuscles predominate |trans-title= |language= |journal=Journal of Anatomy |location= |date=2021-10 |volume=239 |issue=4 |article= |page= |pages=892-902 |url=https://onlinelibrary.wiley.com/doi/full/10.1111/joa.13481 |pubmedID=34120333 |pubmedCID=8450466 |DOI=10.1111/joa.13481 |accessdate=2021-11-15}}</ref> Proponents of [[genital integrity]] have cited these studies, which report on the sensitivity or innervation of the foreskin, claiming a sexual role based upon the presence of nerve-endings in the foreskin sensitive to light touch, stroking and fluttering sensations. [[Circumcision ]] removes the [[Ridged band|ridged band]] at the end of the [[foreskin]].<ref name="taylortaylor1996" /> Taylor (1996) observed that the [[ridged band ]] had more [[Meissner's corpusclecorpuscles]]s — a kind of nerve ending that is concentrated in areas of greatest sensitivity {{Citation needed|date=August 2007}} — than the areas of the foreskin with smooth mucus membranes. <!-- commented out until someone can explain how blood vessels relate to sensitivity: and a rich blood supply to serve the neurological tissue. Taylor (intense vascularity2000)--> Taylor postulated that the ridged band is sexually sensitive and plays a role in normal sexual function. He also suggested that the [[gliding action]], possible only when there was enough loose [[shaft skin|skin on the shaft ]] of the penis, serves to stimulate the ridged band through contact with the corona of the [[glans penis]] during vaginal intercourse.<ref name="taylor2taylor2000">{{REFjournal | last=Taylor | firstinit=J.R.JR | coauthorsauthor-link=John R. Taylor | title=Back and forth (letter) | journal=Pediatric news | volume=34 | issue=10 | pagespage=50 | url=http://www.cirp.org/library/anatomy/taylor2/ | quote= | pubmedID= | pubmedCID= | DOI= | date=October 2000-10 | accessdate=}}</ref> This gliding action was also described by Lakshmanan (1980).<refname="lakshaman1980">{{REFjournal | last=Lakshmanan | firstinit=S. | coauthorslast2=Parkash |init2=S. Parkash | title=Human prepuce: some aspects of structure and function | journal=Indian journal of surgery | volume=44 | issue= | pages=134–137134-137 | url=http://www.cirp.org/library/anatomy/lakshmanan/ | quote= | pubmedID= | pubmedCID= | DOI= | date=1980 | accessdate=2019-12-19
}}</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&mdash;many of which are lost to circumcision."<ref name="boyle2002">{{REFjournal |last=Boyle |first=Gregory J. |init=GJ |last2=Bensley |first2=Gillian A. |init2=GA |title=Adverse Sexual and Psychological Effects of Male Infant Circumcision |journal=Psychological reports |volume=88 |issue=3, Part 2 |pages=1105-1106 |url=http://www.cirp.org/library/psych/boyle5/ |quote= |pubmedID=11597060 |pubmedCID= |DOI= |date=2001-07 |accessdate=}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well." [[Morris L. Sorrells| 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="sorrells" /> This is disputed by Waskett and Morris, who argue that when they re-analyse Sorrells' data, no significant differences are found; that light touch is only one form of sensitivity, and that sexual pleasure may sometimes require less sensitivity. They also criticized Sorrells' recruitment methods.<ref name="waskett2007"/> In response, Young criticizes Waskett and Morris's use of the [[Bonferroni correction]] and argues that the methods of selecting subjects would not affect the results, that the two most sensitive positions on the circumcised penis represent small areas of [[circumcision scar]], as compared to a much larger area of sensitive tissue on the foreskin, and that sales of sensation-dulling products do not necessarily indicate that such are widely used other than on scar tissue.<ref name="youngsorrells2007"/>  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.<refname= "schober2008">{{REFjournal | last=Schober |init=JM, |last2=Meyer-Bahlburg |init2=HF, Dolezal C | firstlast3=Dolezal | coauthorsinit3=C | title=Self-ratings of genital anatomy, sexual sensitivity and function in men using the 'Self-Assessment of Genital Anatomy and Sexual Function, Male' questionnaire | journal=BJU Int. | volume=103 | issue=8 | pages=1096–1031096-103 | url= | quote= | pubmedID=19245445 | pubmedCID= | DOI=10.1111/j.1464-410X.2008.08166.x | date=April 2009-09 | accessdate=
}}</ref>
Boyle ''García-Mesa et al.'' (20022021) argued reported that circumcision and frenectomy remove tissues with "heightened erogenous sensitivity," stating "the genitally intact male has thousands mechanical motion of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcisionthe [[foreskin]] generates pleasurable sexual sensation."<ref name="boyle2002garcía-mesa2021">{{REFjournal | last=Boyle | first=Gregory J. | coauthors=Gillian A. Bensley | title=Adverse Sexual and Psychological Effects of Male Infant Circumcision | journal=Psychological reports | volume=88 | issue=3, Part 2 | pages=1105–1106 | url=http://www.cirp.org/library/psych/boyle5/ | quote= | pubmedID=11597060 | pubmedCID= | DOI= | date=July 2001 | accessdate=}}</ref> They concluded, "Evidence has also started to accumulate that male circumcision may result in lifelong physical, sexual, and sometimes psychological harm as well."
==Erectile function==
Reports detailing the effect of [[circumcision ]] on [[erectile dysfunction]] have been mixed. Studies have variously found a statistically significant increase,<ref name=fink2002/><ref name="shen2004">{{REFjournal | last=Shen | firstinit=Z | coauthorslast2=Chen |init2=S, |last3=Zhu |init3=C, |last4=Wan |init4=Q, |last5=Chen |init5=Z | title=Erectile function evaluation after adult circumcision | journal=Zhonghua Nan Ke Xue | volume=10 | issue=1 | pages=18-919 | url= | quote= | pubmedID=14979200 | pubmedCID= | DOI= | date=January 2004-01 | accessdate=}}</ref> or decrease,<ref name="cortes2009"/><ref name= "richters2006">{{REFjournal | last=Richters | firstinit=J | coauthorslast2=Patel |init2=HR, |last3=Himpson |init3=RC, |last4=Palmer |init4=JH, |last5=Mufti |init5=GR, |last6=Sheriff |init6=MK | title=Circumcision in Australia: prevalence and effects on sexual health | journal=International Journal of Sexually Transmissible Diseases and AIDS | volume=17 | issue=8 | pages=547–554547-554 | url=http://www.cirp.org/library/general/richters1/ | quote= | pubmedID=16925903 | pubmedCID= | DOI=10.1258/095646206778145730 | date=2006 | accessdate=}}</ref><ref name="Laumann1997"/> in erectile dysfunction among [[circumcised ]] men, while other studies have shown little to no effect.<ref name="masood2005"/<ref name="senkul2004"/><ref name="krieger2008Collins2002">{{REFjournal | last=Krieger JN, Mehta SD, Bailey RC, ''et al.''Collins | firstinit=S | coauthorslast2=Upshaw | titleinit2=Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, KenyaJ | journallast3=The journal of sexual medicineRutchik | volumeinit3=5S | issuelast4=11Ohannessian | pagesinit4=2610-22C | urllast5=Ortenberg | quoteinit5=J | pubmedIDlast6=18761593Albertsen | pubmedCID= | DOIinit6=10.1111/j.1743-6109.2008.00979.x | date=August 2008 | accessdate=}}</ref><ref name="senkul2004"/><ref name="Collins2002">{{REFjournal | last=Collins | first=S | coauthors=Upshaw J, Rutchik S, Ohannessian C, Ortenberg J, Albertsen P | title=Effects of circumcision on male sexual function: debunking a myth? | journal=Journal of Urology | volume=167 | issue=5 | pages=2111–21122111-2112 | url=http://www.circs.org/library/collins/ | quote= | pubmedID=11956452 | pubmedCID= | DOI=10.1016/S0022-5347(05)65097-5 | date=2002 | accessdate=}}</ref><ref name="kigozi2007">{{REFjournal | last=Kigozi | first=G | coauthors=Watya S, Polis CB, Buwembo D, Kiggundu V, Wawer MJ, Serwadda D, Nalugoda F, Kiwanuka N, Bacon MC, Ssempijja V, Makumbi F, Gray RH | title=The effect of male circumcision on sexual satisfaction and function, results from a randomized trial of male circumcision for human immunodeficiency virus prevention, Rakai, Uganda | journal=[[British Journal of Urology|BJU International]] | volume=101 | issue=1 | pages=652020-70 | url=http://www3.interscience.wiley.com/cgi02-bin/fulltext/119420541/PDFSTART | quote= | pubmedID=18086100 | pubmedCID= | DOI=10.1111/j.1464-410X.2007.07369.x | date=January 2007 | accessdate=18}}</ref><ref name="kimpang2006kimpang2007"/>
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 and & Pang (2007) reported no significant difference in [[erection]].<ref name="kimpang2006kimpang2007">{{REFjournal | last=DaiSik | first=Kim | coauthors=Myung-Geol Pang | title=The effect of male circumcision on sexuality | journal=BJU International | volume=99 | issue=3 | pages=619–622 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508378/PDFSTART | quote= | pubmedID=17155977 | pubmedCID= | DOI=10.1111/j.1464-410X.2006.06646.x | date=March KimDS PangMG 2007 | accessdate=}}</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"/> Cortés-González ''et al.'' reported a statistically significant improvement in erectile function following circumcision (p=0.0007).<ref name="cortes2009"/>
== Ejaculatory function ==
Circumcision affects ejaculatory function in different ways. In some men, excision of the [[foreskin]] causes hyperstimulation of the corona glandis, resulting in [[premature ejaculation]]. In other men, excision of the foreskin and its [[Foreskin sensitivity| nerves]] seems to decrease PE.
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 | firstinit=M.D.MD | coauthorslast2=Quinn |init2=P, |last3=Dilleen |init3=M, |last4=Mundayat |init4=R, |last5=Schweitzer |init5=DH, |last6=Boolell |init6=M | title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice | journal=Journal of Sexual Medicine | volume=2 | issue=4 | pages=492–497492-497 | url=http://www3.interscience.wiley.com/journal/118719267/abstract | quote= | pubmedID=16422843 | pubmedCID= | DOI=10.1111/j.1743-6109.2005.00070.x | 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="sorrellssorrells2007"/>
Collins ''et al.'' (2002) conducted a prospective study of 15 [[Adolescent and adult circumcision| 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 | firstinit=T. | coauthorslast2=Iseri |init2=C. Iseri, |last3=Sen |init3=B. Sen, |last4=Karademir |init4=K. Karademir, |last5=Saracoglu |init5=F. Saracoglu and |last6=Erden |init6=D. Erden | title=Circumcision in Adults: Effect on Sexual Function | journal=Urology | volume=63 | issue=1 | pages=155–8155-158 | url=http://www.circs.org/library/senkul/ | quote= | pubmedID=14751371 | pubmedCID= | DOI=10.1016/j.urology.2003.08.035 | date=2004 | accessdate=
}}</ref>
In a telephone survey of 10,173 Australian men, 22% of uncircumcised [[intact]] men and 26% of [[circumcised ]] men reported reaching orgasm too quickly for at least one month in the previous year. The difference was not statistically significant.<ref name="richters2006"/>
Kigozi ''et al.'' reported that, in In a randomised controlled trial study of 4,456 255 [[circumcised]] men and 118 [[intact]] men of whom 2,474 were selected to be circumcised, the authors did not find a Kim & Pang (2006) reported no statistically significant effect on premature difference in [[ejaculation]] or ejaculation latency time between [[circumcised]] and [[intact]] participants.<ref name="kigozi2007kimpang2007"/>
Krieger ''In a study of men [[circumcised]] for benign disease, Masood et al.'' reported on a randomised controlled trial that of 2those who stated they had prior premature ejaculation,784 participants13% reported improvement after circumcision, of whom 133% reported that it became worse,391 were randomised to be circumcised. 54.5and 53% of circumcised men described their ease of reaching orgasm as "much more" at 24 months after randomisationreported no change.<ref name="krieger2008masood2005"/>
In a study of 255 circumcised men and 118 uncircumcised men, Kim and Pang reported no statistically significant difference in ejaculation or ejaculation latency time between circumcised and uncircumcised 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.<ref name="cortes2009"/>
== Sexual practice and masturbation ==
In a study by Korean researchers of 255 men [[circumcised ]] after the age of 20 and 18 who were [[Intact| not circumcised]], Kim and & Pang (2007) 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 [[Adolescent and adult circumcision| circumcision]].<ref name="kimpang2006kimpang2007"/>
Laumann ''et al.'' (1997) 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 | firstinit=E.O.EO | coauthorslast2=C.M. Masi and E.W. |init2=CM |last3=Zuckerman |init3=EW | title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice | journal=[[Journal of the American Medical Association|JAMA]] | volume=277 | issue=13 | pages=1052–71052-1057 | url=http://www.circs.org/library/laumann/ | quote= | pubmedID=9091693 | pubmedCID= | DOI=10.1001/jama.277.13.1052 | date=1997-04-02 | accessdate=2021-08-08}}</ref> For example, among whites the "estimated ratio of the odds of masturbating at least once a month for [[circumcised ]] men was 1.76 that for [[uncircumcised ]] men." Dr. Laumann provides two explanations for the difference in sexual practices. "One is that [[uncircumcised ]] men, a minority in this country, may feel a stigma that inhibits them. Another is that [[circumcision ]] reduces sensitivity in the [[penis]], leading [[circumcised ]] men to try a range of sexual activities."<ref>Study Is Adding to Doubts About Circumcision
By SUSAN GILBERT
Published: April 2, 1997. New York Times. [http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C07E4D91F3AF931A35757C0A961958260]</ref>
Fink ''et al.'' (2002) 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 and & Pang,<ref name="kimpang2006kimpang2007"/> Collins ''et al.'',<ref name="Collins2002"/> and Senkul ''et al.'',<ref name="senkul2004"/> and Cortés-González ''et al.''.<ref name="cortes2009"/>
== Satisfaction ==
Kim and & 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="kimpang2006kimpang2007"/>
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/>
Krieger ''Shen et al.'' reported that in a controlled trial of [[Adolescent and adult circumcision| adult circumcision ]] appeared to reduce HIV incidence result in Kisumu, Kenya, improved satisfaction in which 1,391 men elected to be 34 cases (of 95 adults being [[circumcised]]), more than 99% were "satisfied" with their circumcisionsthe association was statistically significant.<ref name="krieger2008shen2004"/>
Kigozi ''Senkul et al.'' reported finding "no trend in satisfaction among circumcised men". The authors concluded that "[they did not find a]dult male circumcision does not adversely affect sexual statistically significant difference in BMSFI satisfaction or clinically significant function scores in men"their study of 42 adult circumcision patients.<ref name="kigozi2007senkul2004"/>
Shen ''Collins et al.'' reported that on a study of 15 [[adult circumcision appeared to result in improved satisfaction ]] patients. No statistically significant difference in 34 cases (of 95 adults being circumcised), the association BMSFI scores was statistically significantobserved.<ref name="shen2004Collins2002"/>
Senkul ''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'' reported that they did not find s aesthetic considerations and to a statistically significant difference in BMSFI satisfaction scores in their study resolution of 42 adult circumcision patientsprevious painful conditions.<ref name="senkul2004fink2002"/>
Collins ''Uberoi et al.'' (2022) surveyed reports from [[circumcised]] men on social media. The authors reported on :<blockquote>The qualitative review of social media posts clearly demonstrates that some men are experiencing a study complex constellation of 15 adult circumcision patients. No statistically negative psychological, physical, and sexual associations that lead to significant difference in BMSFI scores was observedemotional distress directed both internally and externally.<ref name="Collins2002uberoi2022">{{REFjournal |last=Uberoi |first= |init=M |author-link= |last2=Abdulcadir |first2= |init2=J |author2-link= |last3=Ohi |first3= |init3=DA |author3-link= |last4=Santiago |first4= |init4=JE |author4-link= |last5= |first5= |init5= |author5-link= |last6= |first6= |init6= |author6-link= |last7= |first7= |init7= |author7-link= |last8= |first8= |init8= |author8-link= |last9= |first9= |init9= |author9-link= |etal=yes |title=Potentially under-recognized late-stage physical and psychosexual complications of non-therapeutic neonatal penile circumcision: a qualitative and quantitative analysis of self-reports from an online community forum |trans-title= |language= |journal=Int J Impot Res |location= |date=2022-10-23 |volume= |issue= |article= |page= |pages= |url=https://www.nature.com/articles/s41443-022-00619-8 |archived= |quote= |pubmedID=36274189 |pubmedCID= |DOI=10.1038/s41443-022-00619-8 |accessdate=2023-02-19}}</ref></blockquote>
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 =Female preferences and to a resolution of previous painful conditions.<ref nameresponse=="fink2002"/>
Cortés-González ''et al.'' found no statistically significant differences in terms of overall sexual satisfaction Wildman & Wildman (p=0.151976)surveyed 55 young women in Georgia, US, pain during intercourse reporting that 47 (p=0.2389%), or enjoyment of intercourse respondents preferred the [[circumcised]] [[penis]] (p=0.32the remainder preferred the [[intact]] penis).<ref name>{{REFjournal |last=Wildman |init=RW |last2=Wildman |init2=RW 2nd |last3=Brown |init3=A |last4=Trice |init4=C |title="cortes2009"Note on males' and females' preferences for opposite-sex body parts, bust sizes, and bust-revealing clothing |journal=Psychological Reports |volume=38 |issue=2 |pages=485-486 |url=https://pubmed.ncbi.nlm.nih.gov/1265180/ |quote= |pubmedID=1265180 |pubmedCID= |DOI= |date=1976 |accessdate=}}</ref>(There were very few [[intact]] males in Georgia in 1976 because of the prevalence of non-therapeutic infant [[circumcision]] so it is quite likely that few of the subjects tested had any experience with an [[intact]] male.)
==Female preferences Williamson et al. (1988) studied randomly selected young mothers in Iowa, where most men are [[circumcised]], and response==O'Hara and O'Hara argue found that foreskin is 76% would prefer 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, [[circumcised]] penis for achieving sexual arousal through viewing it can be more difficult for a woman to achieve orgasm during intercourse.<ref name= "OHara1999">{{REFjournal | last=O'Hara | first=K. | coauthors=J. O'Hara | title=The effect of male circumcision on the sexual enjoyment of the female partner | journal=BJU International | volume=83 | issue=Supplement 1 | pages=79–84 | url=[http://www3www.intersciencecircs.wiley.com/cgi-binorg/fulltextlibrary/119091407williamson/PDFSTART | quote= | pubmedID=10349418 | pubmedCID= | DOI=10index.1046/jhtml Williamson ML, Williamson PS.1464-410x.1999.0830s1079Women's Preferences for Penile Circumcision in Sexual Partners.x | date=January 1999 | accessdate=}}</ref> A study by psychologists Bensley & Boyle (2003) reported that vaginal dryness can be a problem when the male partner is circumcised.<ref>{{REFjournal | last=Bensley | first=Gillian A. | coauthors=Gregory ] J. Boyle | title=Effects of male circumcision on female arousal and orgasm | journal=New Zealand medical journal | volume=116 | issue=1181 | pages=595-596 | url=httpSex Educ Ther 1988; 14://www.nzma.org.nz/journal/116-1181/595/ | quote= | pubmedID=14581975 | pubmedCID= | DOI= | date=September 2003 | accessdate=}}8</ref> Boyle & Bensley (2001) reported that the lack There were very few [[intact]] males in Iowa in 1988 because of a foreskin in the male partner produces symptoms similar to those prevalence of female arousal disorder.{{Verify source|date=October 2008}} The authors hypothesized non-therapeutic infant circumcision so it is quite likely that few of the gliding action possibly involved intercourse subjects tested had any experience with an uncircumcised partner might help prevent the loss of vaginal lubricationintact male.{{Verify source|date=October 2008}} They stated that the respondents were self-selected, and that larger sample sizes are needed.<ref name="boyle2002" />)
Cortés-González O'Hara & O'Hara (1999) argue that [[foreskin]] is a natural gliding stimulator of the [[Vagina| vagina walls]] during intercourse, increasing a woman'et als overall clitoral stimulation and helping her achieve orgasm more quickly and more often.Without the [[foreskin]]'' studied 19 female partners of men scheduled s [[gliding action]], they suggest, it can be more difficult for circumcision. They reported a significant reduction in vaginal lubrication following circumcision, from 78% woman to 63%, but found no statistically significant differences in "general sexual satisfaction, pain achieve orgasm during vaginal penetration, desire, [or] vaginal orgasm"intercourse.<refname= "OHara1999">{{REFjournal | last=Cortés-González JR, Arratia-Maqueo JA, Gómez-Guerra LSO'Hara |init=K | firstlast2=O'Hara | coauthorsinit2=J | title=[Does The effect of male circumcision has an effect on the sexual enjoyment of the female's perception of sexual satisfaction?]partner | journal=Rev. Invest. Clin.BJU International | volume=6083 | issue=3Supplement 1 | pages=227–3079-84 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091407/PDFSTART | quote= | pubmedID=1880773510349418 | pubmedCID= | DOI=10.1046/j.1464-410x.1999.0830s1079.x | date=20081999-01 | accessdate= | language=Spanish; Castilian2020-04-27}}</ref>
Kigozi ''et al.'' Boyle & Bensley (2003) reported on that the lack of a prospective study [[foreskin]] in the male partner produces symptoms similar to those of 455 [[Vagina#Female_Sexual_Arousal_Disorder| female partners of men, in Rakai Uganda, circumcised as part of a randomised trial. 39.8% reported improved sexual satisfaction following circumcision, 57.3% reported no change, and 2.9% reported reduced sexual satisfaction after their partners were circumcisedarousal disorder]].<refname="bensley2003">{{REFjournal | last=Kigozi G, Lukabwe I, Kagaayi Bensley |first=Gillian A. |init=GA |last2=Boyle |first2=Gregory J, ''et al.'' | firstinit2=GJ | coauthorsauthor2-link=Gregory J. Boyle | title=Sexual satisfaction of women partners of circumcised men in a randomized trial Effects of male circumcision in Rakai, Ugandaon female arousal and orgasm | journal=BJU IntNew Zealand Medical Journal | volume=104116 | issue=111181 | pages=1698–701595-596 | url=http://www.cirp.org/library/sex_function/bensley1/ | quote= | pubmedID=1952286214581975 | pubmedCID= | DOI=10.1111/j.1464-410X.2009.08683.x | date=June 20092003-09-12 | accessdate=2020-04-27}}</ref> The authors hypothesized that the [[gliding action]] possibly involved intercourse with an [[intact]] partner might help prevent the loss of vaginal lubrication.<ref name="bensley2003" /> They stated that the respondents were self-selected, and that larger sample sizes are needed.<ref name="bensley2003" />
Williamson ''et al.'' A study by psychologists Bensley & Boyle (19882003) studied randomly selected young mothers in Iowa, where most men are circumcised, and found reported that 76% would prefer vaginal dryness can be 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> Wildman and Wildman (1976) surveyed 55 young women in Georgia, US, reporting that 47 (89%) of respondents preferred problem when the circumcised penis (the remainder preferred the uncircumcised penis).<ref>{{REFjournal | last=Wildman RW, Wildman RW, Brown A, Trice C | first= | coauthors= | title=Note on males' and females' preferences for opposite-sex body parts, bust sizes, and bust-revealing clothing | journal=Psychological Reports | volume=38 | issue=2 | pages=485-6 | url=http://circs.org/library/wildman/index.html | quote= | pubmedID=1265180 | pubmedCID= | DOI= | date=1976 | accessdate=}}</ref> Bailey ''et al''. report that there male partner is a preference by women for [[circumcised men, mentioning that the circumcised penis enters a woman more easily and is less likely to cause injury to the vagina]].<ref>''AIDS Care''. 2002 Feb;14(1):27-40. The acceptability of male circumcision to reduce HIV infections in Nyanza Province, Kenya. Bailey RC, Muga R, Poulussen R, Abicht H. [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmdname=Retrieve&db=PubMed&list_uids=11798403&dopt=Abstract]<"bensley2003" /ref>{{Verify source|date=October 2008}}
== Summary Effect of research findings (Wikipedia table) circumcision on heterosexual relations==
{| classAs previously reported, the [[foreskin]] reduces the force required for penetration of the female partner's [[vagina]] by as much as ninety percent,<ref name="wikitabletaves2002">{{REFjournal! scope |last="col" Taves | Studyinit=D! scope |author-link="col" | Designtitle=The intromission function of the foreskin! scope |journal="col" Med Hypotheses | Peer revieweddate=2002! scope |volume="col" 59 | Sample sizeissue=2! scope |pages="col" 180 | Findingurl=http://www.sciencedirect.com/science/article/pii/S0306987702002505! scope |quote="col" | Significant¹pubmedID=12208206 |-pubmedCID= | colspanDOI="7" style="bgcolor: #f2f2f2; font10.1016/s0306-9877(02)00250-weight: bold;" | Sexual drive5 |accessdate=2020-01-04! scope="row" | Collins (2002)}}</ref>, so the lack of the [[foreskin]] makes penetration more difficult. The [[gliding action]] of the foreskin reduces friction and abrasion, while conserving vaginal lubrication,<ref name="Collins2002warren-bigelow1994"/>{{REFjournal | Prospective; adult circumcision patientslast=Warren | Yes first=John |init=J | 15 author-link=John Warren |last2=Bigelow | No difference found first2=Jim || No; p > 0.68init2=J |author2-link=Jim Bigelow! scope |title="row" The case against circumcision | Senkul (2004)<ref namejournal="senkul2004"/>Brit J Sex Med | Prospective; adult circumcision patientsdate=1994-09 | Yes volume= |issue= | 42 pages= || No difference found || No; p url= 0http://www.cirp.32org/library/general/warren2/ |-quote=! scope="row" | Kim and Pang (2006)<ref namepubmedID="kimpang2006"/> | Prospective; adult circumcision patientspubmedCID= | Yes || 373 || No difference found || Not statedDOI= |accessdate=2020-01-04! scope="row" | Senol }}</ref> so the lack of the foreskin in the circumcised partner renders the female experience less satisfactory. In a first of its kind, O'Hara & O'Hara (20081999)carried out a retrospective survey of 138 women with experience of both [[intact]] and [[circumcised]] partners. The women overwhelmingly concurred that the mechanics of coitus was different for the two groups of men. Of the women, 73% reported that [[circumcised]] men tend to thrust harder and deeper, using elongated strokes, while unaltered men by comparison tended to thrust more gently, to have shorter thrusts, and tended to be in contact with the mons pubis and [[clitoris]] more, according to 71% of the respondents. Women with intact partners had a higher rate of orgasms than women with [[circumcised]] partners. O'Hara & O'Hara concluded:<blockquote>Clearly, the anatomically complete [[penis]] offers a more rewarding experience for the female partner during coitus. While this study has some obvious methodological flaws, all the differences cannot be attributed to them. It is important that these findings be confirmed by a prospective study of a randomly selected population of women with experience with both types of men. It would be useful to examine the role of the [[foreskin]] in other sexual activities. Because these findings are of interest, the negative effect of [[circumcision]] on the sexual enjoyment of the female partner needs to be part of any discussions providing '[[informed consent]]' before circumcision.<ref name="senol2008ohara1998">{{REFjournal | last=Senol MG, Sen B, Karademir O'Hara |init=K, Sen H, Saraçoğlu M | firstauthor-link= |last2=O'Hara |init2=J |author2-link= | coauthorsetal=no | title=The effect of male circumcision on pudendal evoked potentials and the sexual satisfactionenjoyment of the female partner | journal=Acta Neurol BelgBJU Int |location= |date=1999 | volume=10883 Suppl 1 | issue=3 | pages=9079-384 | url=https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.1464-410x.1999.0830s1079.x | quote= | pubmedID=1911567110349418 | pubmedCID= | DOI= | date=September 200810.1046/j.1464-410x.1999.0830s1079.x | accessdate=2019-10-22
}}</ref>
| Prospective; adult circumcision patients| Yes || 43 || No difference found || No; p = 0.11|-| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Erectile function|-! scope="row" | Fink (2002)<ref name="fink2002"/blockquote>| Cross-sectional; adult circumcision patients| Yes || 40 || Worse after circumcision || Yes; p = 0.01|-! scope="row" | Collins Solinis & Yiannaki (20022007)<ref name="Collins2002"/>| Prospective; adult circumcision patients| Yes || 15 || No difference found || Noconcluded; p > 0.96|-! scope="row" | Senkul (2004)<ref name="senkul2004"/>| Prospective; adult circumcision patients| Yes || 42 || No difference found || No; p = 0.89|-! scope="row" | Masood (2005)<ref name= "masood2005"/>| Not stated; adult [t]here was a decrease in couple’s sexual life after [[circumcision patients| Yes || 88 || No difference found || No; p = 0.40|-! scope="row" | Shen (2004)<ref name="shen2004"/>| Not stated; ]] indicating that [[adult circumcision patients| Yes || 95 || Worse after circumcision || Yes; p = 0.001|-! scope="row" | Laumann (1997)<ref name="Laumann1997"/>| National probability study| Yes || 1410 || Better ]] adversely affects sexual function in circumcised males || Yes; p < 0.10|-! scope="row" | Richters (2006)<ref name= "richters2006"many men or/>| Telephone survey| Yes || 10and their partners,173 || Better in circumcised males || Yes; p=0.022|-! scope="row" | Kim possibly because of complications of surgery and Pang (2006)<ref name="kimpang2006"/>| Prospective; adult circumcision patients| Yes || 373 || No difference found || Not stated|-! scope="row" | Senol (2008)<ref name="senol2008"/>| Prospective; adult circumcision patients| Yes || 43 || No difference found || No; p = 0loss of nerve endings.23|-| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Ejaculation|-! scope="row" | Collins (2002)<ref name="Collins2002"/>| Prospective; adult circumcision patients| Yes || 15 || No difference found || No; p > 0.48|solinis-! scope="row" | Senkul (2004)<ref name="senkul2004yiannaki2005"/>{{REFjournal | Prospective; adult circumcision patients| Yes| 42 || No difference found in BMSFI (Brief Male Sexual Function Inventory)<br>Greater time to ejaculate after circumcision| No; p = 0.85<br>Yes; p last= 0.02Solinis |-! scope="row" | Shen (2004)<ref namefirst="shen2004"/>| Not stated; adult circumcision patients| Yes || 95 || Greater time to ejaculate after circumcision || Yes; p=0.04 |author-! scope="row" | Laumann (1997)<ref namelink="Laumann1997"/> | National probability study| Yes || 1410 || Circumcised men less likely to ejaculate prematurely || Yes; p < 0.10|-! scopelast2="row" | Waldinger (2005)<ref name="Waldinger2005"/>Yiannaki | Multinational, stopwatch assessment| Yes || 500 || No difference found || No|-! scope="row" | Richters (2006)<ref namefirst2= "richters2006"/>| Telephone survey| Yes || 10,173 || Circumcised men more likely to ejaculate prematurely || No; p = 0.11 |author2-! scope="row" | Senol (2008)<ref namelink="senol2008"/> | Prospective; adult circumcision patients| Yes || 43 || No difference found in BMSFI<br>Greater time to ejaculate after circumcision|| No; p = 0.48<br>Yes; p etal= 0.001no |-| colspan="7" styletitle="bgcolor: #f2f2f2; font-weight: bold;" | Penile sensation|-! scope="row" | Fink (2002)<ref name="fink2002"/>| Cross-sectional, adult Does circumcision patients| Yes || 40 || Worse after circumcision || No; p = 0.08improve couple's sex life? |trans-! scope="row" | Masood (2005)<ref name= "masood2005"/>| Not stated; adult circumcision patients| Yes || 88 || Better after circumcision in 38%, worse in 18% || Yes; p = 0.01|-! scope="row" | Denniston (2004), cited by Denniston (2004)<ref nametitle= "Dennniston2004">{{REFjournal | lastlanguage=Denniston | firstjournal=G.C.Journal of Men's Health and Gender | coauthorslocation=Hill G. | titledate=Circumcision in adults: effect on sexual function | journal=Urology2007-09 | volume=644 | issue=63 | pages=1267361 | url=http://www.cirp.org/library/sex_function/denniston3/http://www.cirp.org/library/sex_function/denniston3solinis2007/ | quote= | pubmedID=15596221 | pubmedCID= | DOI=10.1016/j.urology.2004.03.059 | date=2006 | accessdate=}}</ref>| Not stated; survey of males circumcised in adulthood| No || 38 || Better after circumcision in 34%, worse in 58% || Not stated|2020-! scope="row" | Masters (1966)<ref name="masters1966"/>| Neurologic testing; subjects matched for age| No || 70<br>(35 c, 35 uc)² || No difference found || Not stated|01-! scope="row" | Bleustein (2003)<ref name="bleustein2003"/>| Quantitative somatosensory testing| No || 79<br>(36 c, 43 uc)² || No difference found when controlled for other variables || No; p = 0.08|-! scope="row" | Bleustein (2005)<ref name= "bleustein2005"/>| Quantitative somatosensory testing | Yes || 125<br>(63 c, 62 uc)² || No difference found when controlled for other variables || No|-! scope="row" | Richters (2006)<ref name= "richters2006"/>| Telephone survey| Yes || 10,163 || Better in circumcised males || No; p = 0.192|-! scope="row" | Yang (2008)<ref name="yang2008">{{REFjournal | last=Yang | first=DM | coauthors=Lin H, Zhang B, Guo W | title=Circumcision affects glans penis vibration perception threshold | journal=Zhonghua Nan Ke Xue | volume=14 | issue=4 | pages=328-330 | publisher = Nanjing Jun Qu Nanjing Zong Yi Yuan zhu ban, Zhonghua Nan Ke Xue Za Zhi Bian Ji Bu bian ji chu ban | location = China | url= | quote= | pubmedID=18481425 | pubmedCID= | DOI= | date=April 2008 | accessdate=16 April 200804
}}</ref>
| Used biological vibration measurement instrument to determine sensitivity
| Yes || 169 (73 uc, 96 c) || Worse after circumcision || Yes; p < 0.05
|-
! scope="row" | Payne (2007)<ref name="payne2007"/>
| Sensory testing to determine sensitivity to touch and pain
| Yes || 40 (20 uc, 20 c) || No difference found || No
|-
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Overall satisfaction
|-
! scope="row" | Fink (2002)<ref name="fink2002"/>
| Cross-sectional; adult circumcision patients
| Yes || 40 || Better after circumcision || Yes; p=0.04
|-
! scope="row" | Collins (2002)<ref name="Collins2002"/>
| Prospective; adult circumcision patients
| Yes || 15 || No difference found || No; p > 0.72
|-
! scope="row" | Senkul (2004)<ref name="senkul2004"/>
| Prospective; adult circumcision patients
| Yes || 42 || No difference found || No; p=0.46
|-
! scope="row" | Masood (2005)<ref name= "masood2005"/>
| Not stated; adult circumcision patients
| Yes || 88
| "Sixty-one percent were satisfied with the circumcision (p = 0.04) ... Fourteen patients (17%) were not satisfied with the circumcision, but only one patient in this group had any obvious post-operative complications (bleeding)."
| Not stated
|-
! scope="row" | Shen (2004)<ref name="shen2004"/>
| Not stated; adult circumcision patients
| Yes || 95 || Improved satisfaction in 34 cases || Yes; p = 0.04
|-
! scope="row" | Kim and Pang (2006)<ref name="kimpang2006"/>
| Prospective; adult circumcision patients
| Yes || 373 || Better after circumcision in 6%, worse in 20% || Yes; p < 0.05
|-
! scope="row" | Kigozi (2007)<ref name="kigozi2007"/>
| Randomised trial; adult circumcision patients
| Yes || 4456 || "no trend in satisfaction among circumcised men" || No; p = 0.8
|-
! scope="row" | Senol (2008)<ref name="senol2008"/>
| Prospective; adult circumcision patients
| Yes || 43 || No difference found || No; p = 0.07
|}
 
== Notes ==
# If stated, author's analysis is used. Otherwise, significance is considered to be p <= 0.05.
# c = circumcised; uc = uncircumcised.
<!-- commented out due to not being used in the article:* Denniston GC, Hill G Frisch et al. (20042013) surveyed a very large group of men and women in [[httpDenmark]]. They concluded://www.cirp.org/library/sex_function/denniston3/ <blockquote>"Circumcision was associated with frequent orgasm difficulties in adults: effect on Danish men and with a range of frequent sexual function]. ''Urology''difficulties in women, notably orgasm difficulties, '''64'''(6);1267dyspareunia and a sense of incomplete sexual needs fulfilment."<ref>{{FrischM LindholmM GroenbaekM 2011}}</ref>--</blockquote>
{{SEEALSO}}
* [[Circumcision]]
* [[Dyspareunia]]
* [[Foreskin]]
* [[Foreskin sensitivity]]
* [[Erection]]
* [[CircumcisionGliding action]]* [[Masturbation]]* [[Penis]]* [[Premature ejaculation]]
* [[Ridged band]]
* [[Psychosexual Effects of Circumcision]]
* [[The Penis - Sex Education 101]]
* [[Vagina]]
{{LINKS}}
* {{REFweb |url=https://intactamerica.org/lousy-sex/ |title=Lousy Sex |last=Chapin |first=Georganne |author-link=Georganne Chapin |publisher=Intact America |website= |date=2014-04-08 |accessdate=2021-04-02}}
* {{REFweb
|url=http://www.cirp.org/library/sex_function/
|publisher=circumcision Information Reference Library
|website=Foreskin Sexual Function/Circumcision Sexual Dysfunction
|date=2013-07-30 July 2013 |accessdate=2019-09-28 September }}* {{REFweb |url=http://www.circumstitions.com/Sexuality.html |title=The Foreskin, Circumcision and Sexuality |last=Young |first=Hugh |author-link=Hugh Young |publisher= |website=Circumstitions |date= |accessdate=2019-12-03}}* {{REFweb |url=http://www.intactaus.org/information/functionsoftheforeskin/ |title=Functions of the Foreskin |last=Helard |first=Lou |author-link=Lou Helard |publisher=Intact Australia |website=http://www.intactaus.org |date=2014-08-01 |accessdate=2020-06-05}}* [https://www.doctorsopposingcircumcision.org/for-professionals/sexual-impact Sexual impact of circumcision]. [[Doctors Opposing Circumcision (D.O.C.)]], 2018.* {{REFweb |url=https://sciencenordic.com/denmark-gender-hiv/male-circumcision-leads-to-a-bad-sex-life/1371590 |archived= |title=Male circumcision leads to a bad sex life |trans-title= |language= |last=Ebdrup |first=Niels |author-link= |publisher=ScienceNordic |website= |date=2011-11-14 |accessdate=2022-02-21
|format=
|quote=When the penis enters the vagina, the foreskin is pulled back. And on its way out again, the foreskin goes back to cover the penis head. This way the foreskin stimulates both the man and the woman.}}* {{REFweb |url=https://intactamerica.org/ask-marilyn-i-was-circumcised-and-theres-nothing-wrong-with-me-why-do-cut-men-complain/ |title=Ask Marilyn – I was circumcised, and there’s nothing wrong with me. Why do cut men complain? |last=Milos |first=Marilyn |init= |author-link=Marilyn Fayre Milos |publisher=Intact America |date=2022-06-27 |accessdate=2024-06-21
}}
{{ABBR}}
{{REF}}
* [https://www.doctorsopposingcircumcision.org/for-professionals/sexual-impact Sexual impact of circumcision]. Doctors Opposing Circumcision, 2018.
 
{{REF}}
[[Category:Education]]
[[Category:Parental information]]
[[Category:Circumcision]]
[[Category:Circumcision complication]]
[[Category:Sexuality]]
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