Difference between revisions of "Sexual effects of circumcision"

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The '''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 [[ejaculation]], sexual satisfaction, sexual sensation and penile sensitivity. Studies 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. Cold & Taylor (1999) stated:
 +
<blockquote>
 +
The [[prepuce]] is primary, erogenous tissue necessary for normal sexual  function.<ref name="cold-taylor1999">{{ColdCJ TaylorJR 1999}}</ref>
 +
</blockquote> 
  
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'''This article was borrowed from Wikipedia on [http://en.wikipedia.org/w/index.php?title=Sexual_effects_of_circumcision&oldid=429623060 21:11, 17 May 2011]'''
+
==History==
 +
===In the beginning===
  
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The '''sexual effects of [[circumcision]]''' are 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.  
+
The human [[foreskin]] was once thought to have little or no sexual function.   Sex researcher Alfred C. Kinsey (1948) placed no importance on the presence or absence of the foreskin.<ref name="kinsey1948">{{REFbook
 +
|last=Kinsey
 +
|first=Alfred C.
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|init=AC
 +
|author-link=
 +
|last2=Pemeroy
 +
|init2=AC
 +
|author2-link=
 +
|year=1948
 +
|title=Sexual Behavior in the Human Male
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|url=
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|work=
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|editor=
 +
|edition=
 +
|volume=
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|chapter=
 +
|pages=
 +
|location=
 +
|publisher=A. C. Saunders
 +
|isbn=
 +
|quote=
 +
|accessdate=2019-12-21
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|note=
 +
}}</ref>
  
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Those reviewing the literature have reached differing conclusions. The American Academy of Pediatrics points to a survey (self-report) finding circumcised adult men had less sexual dysfunction and more varied sexual practices, but also noted anecdotal reports that penile sensation and sexual satisfaction are decreased for circumcised males.<ref name="AAP1999">{{REFjournal
+
Masters & Johnson (1966) in their book, ''Human Sexual Response'',<ref name="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:
−
  | last=
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<blockquote>
−
  | first=
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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>
−
  | coauthors=
+
 
−
  | title=Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision
+
With regard to the [[glans penis]], Masters & Johnson stated:
−
  | journal=Pediatrics
+
<blockquote>
−
  | volume=103
+
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="masters-johnson1966">{{REFbook
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  | issue=3
+
  |last=Masters
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  | pages=686-93
+
  |first=William L.
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| url=
+
  |init=WL
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  | quote=
+
  |author-link=
−
  | pubmedID=10049981
+
  |last2=Johnson
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  | pubmedCID=
+
  |first2=Virginia E.
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  | DOI=10.1542/peds.103.3.686
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  |init2=VE
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  | date=March 1999
+
  |author2-link=
−
  | accessdate=
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  |year=1966
−
}}</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="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
+
  |title=Human sexual response
−
  | quote=
+
  |url=
−
  | url=http://epublications.bond.edu.au/cgi/viewcontent.cgi?article=1036&context=hss_pubs
+
  |work=
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  | title=Male circumcision: pain, trauma, and psychosexual sequelae
+
  |editor=
−
  | last=Boyle, Gregory J.;Svoboda, J. Steven; Goldman, Ronald; Fernandez, Ephrem
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  |edition=
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  | first=
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  |volume=
−
  | publisher=Bond University Faculty of Humanities and Social Sciences
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  |chapter=
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  | work=
+
  |pages=
−
  | date=2002
+
  |location=Toronto, New York
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  | accessdate=
+
  |publisher=Bantam
 +
  |isbn=0-553-20429-7
 +
  |quote=
 +
  |accessdate=2019-12-21
 +
  |note=
 
}}</ref>
 
}}</ref>
 +
</blockquote>
  
−
== Penile sensitivity and sexual sensation ==
+
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>
 +
 
 +
The 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 (1956) investigated the innervation of the [[prepuce]] and found 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=
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|pubmedID=13295637
 +
|pubmedCID=
 +
|DOI=
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|date=1956-01
 +
|accessdate=2019-12-21
 +
}}</ref> Winkleman (1959) later identified the [[prepuce]] as "specific erogenous tissue".<ref name="winkleman1959">{{WinkelmannRK 1959}}</ref>
  
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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.'' 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
+
[[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:
−
  | last=Masood
+
<blockquote>
−
| first=S
+
  Now let us consider whether the operation is in any way harmful or contraindicated. The function of 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]] to foreign stimuli which dull these special receptors. 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 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 sock that has been previously rolled up.<ref name="morgan1965">{{REFjournal
−
| coauthors=Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK
+
  |last=Morgan
−
| title=Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?
+
  |init=WKC
−
| journal=Urol Internationalalis
+
  |author-link=William Keith Campbell Morgan
−
| volume=75
+
  |title=The rape of the phallus
−
| issue=1
+
  |journal=JAMA
−
| pages=62-6
+
|date=1965
−
| url=http://www.cirp.org/library/sex_function/masood1/
+
  |volume=193
−
| quote=
+
  |issue=
−
| pubmedID=16037710
+
  |pages=123-4
−
| pubmedCID=
+
  |url=http://www.cirp.org/library/general/morgan/
−
| DOI=10.1159/000085930
+
  |quote=
−
| date=2005
+
  |pubmedID=14310332
−
| accessdate=
+
  |pubmedCID=
−
}}</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
+
  |DOI=10.1001/jama.1965.03090030045013  
−
  | last=Fink
+
  |accessdate=2019-12-21
−
  | first=K.S.
 
−
  | coauthors=C.C. Carson and R.F. DeVillis
 
−
  | title=Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction
 
−
  | journal=Journal of Urology
 
−
  | volume=167
 
−
  | issue=5
 
−
  | pages=2113-6
 
−
  | url=http://www.circs.org/library/fink/
 
−
  | quote=
 
−
  | pubmedID=11956453
 
−
  | pubmedCID=
 
−
  | DOI=10.1016/S0022-5347(05)65098-7
 
−
  | date=May 2002
 
−
  | accessdate=
 
 
}}</ref>
 
}}</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 Morgan
 +
|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>
  
−
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
+
Falliers (1970) commented in a critical letter to the ''Journal of the American Mmedical Association'':
−
  | last=Krieger
+
<blockquote>
−
  | first=JN
+
The sensory pleasure induced by tactile stimulation of the [[foreskin]] is almost totally lost after its surgical removal. The surface of the exposed [[glans]], 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= "falliers1970">{{REFjournal
−
  | coauthors=Mehta SD, Bailey RC, Agot K, Ndinya-Achola JO, Parker C, Moses S
+
  |last=Falliers
−
| title=Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya
+
  |INIT=CJ
−
  | journal=The journal of sexual medicine
+
  |author-link=
−
  | volume=Epub ahead of print
+
  |etal=no
−
  | issue=11
+
  |title=Circumcision (letter)
−
| pages=2610–22
+
  |journal=JAMA
−
  | url=
+
  |location=
−
| quote=
+
  |date=1970-12-21
−
| pubmedID=18761593
+
  |volume=214
−
| pubmedCID=
+
  |issue=12
−
| DOI=10.1111/j.1743-6109.2008.00979.x
+
  |pages=2194
−
  | date=August 2008
+
  |url=http://www.cirp.org/library/general/falliers1/
−
| accessdate=
+
  |quote=
−
}}</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
+
  |pubmedID=
−
| last=Cortés-González JR, Arratia-Maqueo JA, Martínez-Montelongo R, Gómez-Guerra LS
+
  |pubmedCID=
−
| first=
+
  |DOI=
−
| coauthors=
+
  |accessdate=2019-12-21
−
| title=Does Circumcision Affect Male's Perception of Sexual Satisfaction?
 
−
| journal=Arch. Esp. Urol.
 
−
  | volume=62
 
−
  | issue=9
 
−
  | pages=733-736
 
−
  | url=http://www.arch-espanoles-de-urologia.es/apartados/sumarios/popup.php?ano=2009&id=62-09-18
 
−
  | quote=
 
−
  | pubmedID=19955598
 
−
  | pubmedCID=
 
−
  | DOI=
 
−
| date=November 2009
 
−
  | accessdate=
 
 
}}</ref>
 
}}</ref>
 +
</blockquote>
  
−
=== Glans sensitivity ===
+
And so began the investigation of the sexual effects of male [[circumcision]].
 +
<!--Only medical trade associations, such as the [[American Academy of Pediatrics]] (AAP), a [[medical trade association]] which represents doctors who profit from carrying out circumcisions, still contend that [[circumcision]] does not harm sexual function. The American Academy of Pediatrics points to a survey (self-report) finding [[circumcised]] adult men had less sexual dysfunction and more varied sexual practices, but 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. American Academy of Pediatrics. Task Force on Circumcision
 +
|journal=Pediatrics
 +
|volume=103
 +
|issue=3
 +
|pages=686-693
 +
|url=
 +
|quote=
 +
|pubmedID=10049981
 +
|pubmedCID=
 +
|DOI=10.1542/peds.103.3.686
 +
|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&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>{{BoyleGJ GoldmanR SvobodaJS FernandezE 2002}}</ref>-->
 +
 
 +
== Penile sensitivity and sexual sensation ==
  
−
A number of studies have looked at the question of whether sensitivity of the glans is affected by circumcision.
+
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
−
Masters and Johnson (1966) reported: "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="masters1966">{{REFbook
+
  |last=Masood
−
  | last=Masters, W.H.; Johnson, V.E.
+
  |init=S
−
  | first=
+
  |last2=Patel
−
  | year=1966
+
  |init2=HR
−
| title=Human Sexual Response
+
  |last3=Himpson
−
| url=http://www.circs.org/library/masters/index.html
+
  |init3=RC
−
| work=
+
  |last4=Palmer
−
  | editor=
+
  |init4=JH
−
  | edition=
+
  |last5=Mufti
−
  | volume=
+
  |init5=GR
−
  | chapter=
+
  |last6=Sheriff
−
  | pages=
+
  |init6=M.K
−
  | location=Toronto; New York
+
  |title=Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?
−
  | publisher=Bantam Books
+
  |journal=Urol Internationalalis
−
  | isbn=0-553-20429-7
+
  |volume=75
−
  | quote=
+
  |issue=1
−
| accessdate=
+
  |pages=62-66
−
| note=
+
  |url=http://www.cirp.org/library/sex_function/masood1/
−
}}</ref> Sorrells ''et al.'' criticised this early study for being poorly documented and not subject to peer review.<ref name="sorrells">{{REFjournal
+
  |quote=
−
  | last=Sorrells
+
  |pubmedID=16037710
−
| first=Morris L.
+
  |pubmedCID=
−
| coauthors=James L. Snyder, Mark D. Reiss, Christopher Eden, Marilyn F. Milos, Norma Wilcox and Robert S. Van Howe
+
  |DOI=10.1159/000085930
−
| title=Fine-touch pressure thresholds in the adult penis
+
  |date=2005
−
  | journal=BJU International
+
  |accessdate=
−
  | volume=99
+
}}</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
−
  | issue=4
+
  |last=Fink
−
  | pages=864-869
+
|init=KS
−
  | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508429/PDFSTART
+
|last2=Carson
−
  | quote=
+
|init2=CC
−
  | pubmedID=17378847
+
|last3=DeVillis
−
  | pubmedCID=
+
|init3=RF
−
  | DOI=10.1111/j.1464-410X.2006.06685.x
+
|title=Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction
−
  | date=March 2007
+
|journal=J Urol
−
  | accessdate=
+
|volume=167
−
}}</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."
+
|issue=5
−
<ref name="AAFP">{{REFweb
+
|pages=2113-2116
−
  | quote=
+
  |url=http://www.circs.org/library/fink/
−
  | url=http://www.aafp.org/online/en/home/clinical/clinicalrecs/circumcision.html
+
  |quote=
−
  | title=Circumcision: Position Paper on Neonatal Circumcision
+
  |pubmedID=11956453
−
  | last=
+
  |pubmedCID=
−
  | first=
+
  |DOI=10.1016/S0022-5347(05)65098-7
−
  | publisher=[[American Academy of Family Physicians]]
+
  |date=2002-05
−
| work=
+
  |accessdate=
−
  | date=2007
 
−
  | accessdate=2007-01-30
 
 
}}</ref>
 
}}</ref>
  
−
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
+
=== Glans sensitivity ===
−
| last=Yang
+
 
−
| first=CC
+
A number of studies have looked at the question of whether sensitivity of the [[glans]] is affected by [[circumcision]].
−
| coauthors=Bradley WE
 
−
| title=Neuroanatomy of the penile portion of the human dorsal nerve of the penis
 
−
| journal=British Journal Urology
 
−
| volume=82
 
−
| issue=1
 
−
| pages=109-113
 
−
| url=http://www.cirp.org/library/anatomy/yang1/
 
−
| quote=
 
−
| pubmedID=9698671
 
−
| pubmedCID=
 
−
| DOI=10.1046/j.1464-410x.1998.00669.x
 
−
| date=July 1998
 
−
| accessdate=
 
−
}}</ref>
 
  
−
An examination of 7 circumcised and 6 uncircumcised males found no difference in [[keratin]]ization of the [[glans penis]].<ref name="Szabo">{{REFjournal
+
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=Szabo
+
  |last=Yang
−
| first=Robert
+
  |init=CC
−
| coauthors=Roger V. Short
+
  |last2=Bradley
−
| title=How does male circumcision protect against HIV infection?
+
  |init2=WE
−
| journal=BMJ
+
  |title=Neuroanatomy of the penile portion of the human dorsal nerve of the penis
−
| volume=320
+
  |journal=British Journal Urology
−
| issue=7249
+
  |volume=82
−
| pages=1592-1594
+
  |issue=1
−
| url=http://bmj.bmjjournals.com/cgi/reprint/320/7249/1592
+
  |pages=109-113
−
| quote=
+
  |url=http://www.cirp.org/library/anatomy/yang1/
−
| pubmedID=10845974
+
  |quote=
−
| pubmedCID=1127372
+
  |pubmedID=9698671
−
| DOI=10.1136/bmj.320.7249.1592
+
  |pubmedCID=
−
| date=June 2000
+
  |DOI=10.1046/j.1464-410x.1998.00669.x
−
| accessdate=2006-07-09
+
  |date=1998-07
−
}}</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
+
  |accessdate=
−
| place=Chicago, Illinois
 
−
| title=Effects of Circumcision on Male Penile Sensitivity
 
−
| url=http://www.circs.org/library/bleustein/
 
−
  | last=Bleustein
 
−
  | first=Clifford B.
 
−
  | coauthors=Haftan Eckholdt, Joseph C. Arezzo and Arnold Melman
 
−
  | source=American Urological Association 98th Annual Meeting
 
−
  | date=April 26-May 1, 2003
 
−
| accessdate=
 
−
}}</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 +/- 16 years) were significantly younger (P <0.01) than uncircumcised men (56 +/- 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=Urology
 
−
  | volume=65
 
−
  | issue=4
 
−
  | pages=773–7
 
−
  | url=http://linkinghub.elsevier.com/retrieve/pii/S0090-4295(04)01343-3
 
−
  | quote=
 
−
  | pubmedID=15833526
 
−
  | pubmedCID=
 
−
  | DOI=10.1016/j.urology.2004.11.007
 
−
  | date=April 2005
 
−
  | accessdate=
 
 
}}</ref>
 
}}</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="sorrells"/> In a letter to BJU International, however, on the basis of the unadjusted data, Waskett and Morris stated "we find no significant differences [...], consistent with previous findings."<ref name="waskett2007">{{REFjournal
+
An examination of 7 [[circumcised]] and 6 [[intact]] males found no difference in [[keratinization]] of the [[glans penis]].<ref name="Szabo">{{REFjournal
−
  | last=Waskett
+
  |last=Szabo
−
  | first=Jake H.
+
  |first=Robert
−
| coauthors=Brian J. Morris
+
  |init=R
−
| title=Fine touch pressure thresholds in the adult penis
+
  |last2=Short
−
| journal=BJU International
+
  |first2=Roger V.
−
| volume=99
+
  |init2=RV
−
| issue=6
+
  |title=How does male circumcision protect against HIV infection?
−
| pages=1551–1552
+
  |journal=BMJ
−
| url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508593/HTMLSTARThttp://www3.interscience.wiley.com/cgi-bin/fulltext/118508593/HTMLSTART
+
  |volume=320
−
| quote=
+
  |issue=7249
−
  | pubmedID=17537227
+
  |pages=1592-1594
−
  | pubmedCID=
+
  |url=http://bmj.bmjjournals.com/cgi/reprint/320/7249/1592
−
  | DOI=10.1111/j.1464-410X.2007.06970_6.x
+
  |quote=
−
  | date=May 2007
+
  |pubmedID=10845974
−
| accessdate=
+
  |pubmedCID=1127372
−
}}</ref>  However, in a further letter to BJU International, Young responded to Waskett and Morris, stating that Sorrells ''et al.'' found that one point, at least, on the glans of the circumcised penis was less sensitive than that of the intact penis.<ref name="young">{{REFjournal
+
  |DOI=10.1136/bmj.320.7249.1592
−
| last=Young
+
  |date=2000-06
−
| first=Hugh
+
  |accessdate=2006-07-09
−
| coauthors=
+
}}</ref>  
−
  | title=Fine touch pressure thresholds in the adult penis
 
−
  | journal=BJU International
 
−
  | volume=100
 
−
  | issue=3
 
−
  | pages=699
 
−
  | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508003/HTMLSTART
 
−
  | quote=
 
−
  | pubmedID=17669150
 
−
  | pubmedCID=
 
−
  | DOI=10.1111/j.1464-410X.2007.07072_1.x
 
−
  | date=July 2007
 
−
  | accessdate=
 
−
}}</ref>
 
  
−
Payne ''et al.'' (2007), in a study of the glans and shaft sensitivity of twenty circumcised and twenty uncircumcised men, reported that "No differences in genital sensitivity were found between the uncircumcised and circumcised groups."<ref name="payne2007">{{REFjournal
+
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"/>
−
| last=Payne
 
−
| first=Kimberley
 
−
| coauthors=Thaler, Lea; Kukkonen, Tuuli; Carrier, Serge; and [[Irving M. Binik|Binik, Yitzchak]]
 
−
| title=Sensation and Sexual Arousal in Circumcised and Uncircumcised Men
 
−
| journal=Journal of sexual medicine
 
−
| volume=4
 
−
| issue=3
 
−
| pages=667-674
 
−
| url=http://www.blackwell-synergy.com/doi/abs/10.1111/j.1743-6109.2007.00471.x
 
−
| quote=
 
−
| pubmedID=17419812
 
−
| pubmedCID=
 
−
| DOI=10.1111/j.1743-6109.2007.00471.x
 
−
| date=May 2007
 
−
| accessdate=
 
−
}}</ref>
 
  
−
=== Foreskin sensitivity ===
+
=== [[Foreskin sensitivity]] ===
  
−
Some recent researchers have asserted that the [[foreskin]] may be sexually responsive.<ref>{{REFjournal
+
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=Winkelmann
+
  |last=García-Mesa
−
  | first=R.K.
+
  |first=Yolanda
−
  | coauthors=
+
  |init=
−
  | title=The cutaneous innervation of human newborn prepuce
+
  |author-link=
−
  | journal=Journal of investigative dermatology
+
  |last2=García-Piqueras
−
  | volume=26
+
  |first2=Jorge
−
  | issue=1
+
  |init2=
−
  | pages=53-67
+
  |author2-link=
−
  | url=http://www.cirp.org/library/anatomy/winkelmann2/
+
  |last3=Cobo
−
  | quote=
+
  |first3=Ramón
−
  | pubmedID=13295637
+
  |init3=
−
  | pubmedCID=
+
  |author3-link=
−
  | DOI=
+
  |last4=Martín-Cruces
−
  | date=January 1956
+
  |first4=José
−
  | accessdate=
+
  |init4=
−
}}</ref><ref>{{REFjournal
+
|author4-link=
−
  | last=Winkelmann
+
  |last5=Suazo
−
  | first=R.K.
+
  |first5=Iván
−
  | coauthors=
+
  |init5=
−
  | title=The erogenous zones: their nerve supply and significance
+
  |author5-link=
−
  | journal=Proceedings of the staff meetings of the mayo clinic
+
  |last6=García-Suárez
−
  | volume=34
+
  |first6=Olivia
−
  | issue=2
+
  |init6=
−
  | pages=39-47
+
  |author6-link=
−
  | url=http://www.cirp.org/library/anatomy/winkelmann/
+
  |last7=Feito
−
  | quote=
+
  |first7=Jorge
−
  | pubmedID=13645790
+
  |init7=
−
  | pubmedCID=
+
  |author7-link=
−
  | DOI=
+
  |last8=
−
  | date=January 1959
+
  |first8=Vega
−
  | accessdate=
+
  |init8=José A.
−
}}</ref><ref name="taylor">{{REFjournal
+
|author8-link=
−
  | last=Taylor
+
  |etal=no
−
  | first=J.R.
+
  |title=Sensory innervation of the human male prepuce: Meissner's corpuscles predominate
−
  | coauthors=A.P. Lockwood and A.J. Taylor
+
  |trans-title=
−
  | title=The prepuce: Specialized mucosa of the penis and its loss to circumcision
+
  |language=
−
  | journal=British journal of urology
+
  |journal=Journal of Anatomy
−
  | volume=77
+
|location=
−
  | issue=2
+
|date=2021-10
−
  | pages=291-295
+
  |volume=239
−
  | url=http://www.cirp.org/library/anatomy/taylor/
+
  |issue=4
−
| quote=
+
|article=
−
  | pubmedID=8800902
+
|page=
−
  | pubmedCID=
+
  |pages=892-902
−
  | DOI=10.1046/j.1464-410X.1996.85023.x
+
  |url=https://onlinelibrary.wiley.com/doi/full/10.1111/joa.13481
−
| date=February 1996
+
  |pubmedID=34120333
−
  | accessdate=
+
  |pubmedCID=8450466
−
}}</ref><ref name="taylorcold1999">{{REFjournal
+
  |DOI=10.1111/joa.13481
−
  | last=Taylor
+
  |accessdate=2021-11-15
−
| first=J.R.
+
}}</ref> <ref name="garret2024-02-17>{{REFweb
−
| coauthors=C.J. Cold
+
  |url=https://intactamerica.org/what-do-the-eyelids-lips-fingertips-the-intact-penis-have-in-common/
−
  | title=The prepuce
+
  |title=What Do The Eyelids, Lips, Fingertips & The Intact Penis Have in Common?
−
  | journal=British journal of urology
+
  |last=Garret
−
  | volume=83
+
  |first=Connor
−
| issue=Supplement 1
+
  |init=
−
  | pages=34–44
+
  |author-link=Connor Judson Garrett
−
  | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091418/PDFSTART
+
  |publisher=Intact America
−
| quote=
+
  |date=2024-02-17
−
  | pubmedID=
+
  |accessdate=2024-10-22
−
| pubmedCID=
+
}}</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.
−
| 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.
 
  
−
Circumcision removes the [[ridged band]] at the end of the foreskin.<ref name="taylor" /> Taylor (1996) observed that the [[ridged band]] had more [[Meissner's corpuscle]]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 (intense vascularity)--> 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 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="taylor2">{{REFjournal
+
[[Circumcision]] removes the [[Ridged band|ridged band]] at the end of the [[foreskin]].<ref name="taylor1996" /> Taylor (1996) observed that the [[ridged band]] had more [[Meissner's corpuscles]] — a kind of nerve ending that is concentrated in areas of greatest sensitivity — than the areas of the foreskin with smooth mucus membranes and a rich blood supply to serve the neurological tissue.  Taylor (2000) 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="taylor2000">{{REFjournal
−
  | last=Taylor
+
  |last=Taylor
−
  | first=J.R.
+
  |init=JR
−
  | coauthors=
+
  |author-link=John R. Taylor
−
  | title=Back and forth (letter)
+
  |title=Back and forth (letter)
−
  | journal=Pediatric news
+
  |journal=Pediatric news
−
  | volume=34
+
  |volume=34
−
  | issue=10
+
  |issue=10
−
  | pages=50
+
  |page=50
−
  | url=http://www.cirp.org/library/anatomy/taylor2/
+
  |url=http://www.cirp.org/library/anatomy/taylor2/
−
  | quote=
+
  |quote=
−
  | pubmedID=
+
  |pubmedID=
−
  | pubmedCID=
+
  |pubmedCID=
−
  | DOI=
+
  |DOI=
−
  | date=October 2000
+
  |date=2000-10
−
  | accessdate=
+
  |accessdate=
−
}}</ref> This gliding action was also described by Lakshmanan (1980).<ref>{{REFjournal
+
}}</ref> This gliding action was also described by Lakshmanan (1980).<ref name="lakshaman1980">{{REFjournal
−
  | last=Lakshmanan
+
  |last=Lakshmanan
−
  | first=S.
+
  |init=S
−
  | coauthors=S. Parkash
+
  |last2=Parkash
−
  | title=Human prepuce: some aspects of structure and function
+
|init2=S
−
  | journal=Indian journal of surgery
+
  |title=Human prepuce: some aspects of structure and function
−
  | volume=44
+
  |journal=Indian journal of surgery
−
  | issue=
+
  |volume=44
−
  | pages=134–137
+
  |issue=
−
  | url=http://www.cirp.org/library/anatomy/lakshmanan/
+
  |pages=134-137
−
  | quote=
+
  |url=http://www.cirp.org/library/anatomy/lakshmanan/
−
  | pubmedID=
+
  |quote=
−
  | pubmedCID=
+
  |pubmedID=
−
  | DOI=
+
  |pubmedCID=
−
  | date=1980
+
  |DOI=
−
  | accessdate=
+
  |date=1980
 +
  |accessdate=2019-12-19
 
}}</ref>
 
}}</ref>
  
−
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="young"/> 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>{{REFjournal
+
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=Schober JM, Meyer-Bahlburg HF, Dolezal C
+
|last=Boyle
−
  | first=
+
|first=Gregory J.
−
  | coauthors=
+
|init=GJ
−
  | title=Self-ratings of genital anatomy, sexual sensitivity and function in men using the 'Self-Assessment of Genital Anatomy and Sexual Function, Male' questionnaire
+
|last2=Bensley
−
  | journal=BJU Int.
+
|first2=Gillian A.
−
  | volume=103
+
|init2=GA
−
  | issue=8
+
|title=Adverse Sexual and Psychological Effects of Male Infant Circumcision
−
  | pages=1096–103
+
|journal=Psychological reports
−
  | url=
+
|volume=88
−
  | quote=
+
|issue=3, Part 2
−
  | pubmedID=19245445
+
|pages=1105-1106
−
  | pubmedCID=
+
|url=http://www.cirp.org/library/psych/boyle5/
−
  | DOI=10.1111/j.1464-410X.2008.08166.x
+
|quote=
−
  | date=April 2009
+
|pubmedID=11597060
−
  | accessdate=
+
|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= "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
 +
|last2=Meyer-Bahlburg
 +
|init2=HF
 +
  |last3=Dolezal
 +
  |init3=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=1096-103
 +
  |url=
 +
  |quote=
 +
  |pubmedID=19245445
 +
  |pubmedCID=
 +
  |DOI=10.1111/j.1464-410X.2008.08166.x
 +
  |date=2009-09
 +
  |accessdate=
 
}}</ref>
 
}}</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
+
García-Mesa et al. (2021) reported that the mechanical motion of the [[foreskin]] generates pleasurable sexual sensation.<ref name="garcía-mesa2021" />
−
| 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==
 
==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
+
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
+
  |last=Shen
−
  | first=Z
+
  |init=Z
−
  | coauthors=Chen S, Zhu C, Wan Q, Chen Z
+
  |last2=Chen
−
  | title=Erectile function evaluation after adult circumcision
+
|init2=S
−
  | journal=Zhonghua Nan Ke Xue
+
|last3=Zhu
−
  | volume=10
+
|init3=C
−
  | issue=1
+
|last4=Wan
−
  | pages=18-9
+
|init4=Q
−
  | url=
+
|last5=Chen
−
  | quote=
+
|init5=Z
−
  | pubmedID=14979200
+
  |title=Erectile function evaluation after adult circumcision
−
  | pubmedCID=
+
  |journal=Zhonghua Nan Ke Xue
−
  | DOI=
+
  |volume=10
−
  | date=January 2004
+
  |issue=1
−
  | accessdate=
+
  |pages=18-19
−
}}</ref>  or decrease,<ref name="cortes2009"/><ref name= "richters2006">{{REFjournal
+
  |url=
−
  | last=Richters
+
  |quote=
−
  | first=J
+
  |pubmedID=14979200
−
  | coauthors=Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK
+
  |pubmedCID=
−
  | title=Circumcision in Australia: prevalence and effects on sexual health
+
  |DOI=
−
  | journal=International Journal of Sexually Transmissible Diseases and AIDS
+
  |date=2004-01
−
  | volume=17
+
  |accessdate=
−
  | issue=8
+
}}</ref>  or decrease,<ref name= "richters2006">{{REFjournal
−
  | pages=547–554
+
  |last=Richters
−
  | url=http://www.cirp.org/library/general/richters1/
+
  |init=J
−
  | quote=
+
  |last2=Patel
−
  | pubmedID=16925903
+
|init2=HR
−
  | pubmedCID=
+
|last3=Himpson
−
  | DOI=10.1258/095646206778145730
+
|init3=RC
−
  | date=2006
+
|last4=Palmer
−
  | accessdate=
+
|init4=JH
−
}}</ref><ref name="Laumann1997"/> in erectile dysfunction among circumcised men, while other studies have shown little to no effect.<ref name="masood2005"/><ref name="krieger2008">{{REFjournal
+
|last5=Mufti
−
  | last=Krieger JN, Mehta SD, Bailey RC, ''et al.''
+
|init5=GR
−
  | first=
+
|last6=Sheriff
−
  | coauthors=
+
|init6=MK
−
  | title=Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya
+
  |title=Circumcision in Australia: prevalence and effects on sexual health
−
  | journal=The journal of sexual medicine
+
  |journal=International Journal of Sexually Transmissible Diseases and AIDS
−
  | volume=5
+
  |volume=17
−
  | issue=11
+
  |issue=8
−
  | pages=2610-22
+
  |pages=547-554
−
  | url=
+
  |url=http://www.cirp.org/library/general/richters1/
−
  | quote=
+
  |quote=
−
  | pubmedID=18761593
+
  |pubmedID=16925903
−
  | pubmedCID=
+
  |pubmedCID=
−
| DOI=10.1111/j.1743-6109.2008.00979.x
+
  |DOI=10.1258/095646206778145730
−
| date=August 2008
+
  |date=2006
−
| accessdate=
+
  |accessdate=
−
}}</ref><ref name="senkul2004"/><ref name="Collins2002">{{REFjournal
+
}}</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="Collins2002">{{REFjournal
−
| last=Collins
+
  |last=Collins
−
| first=S
+
  |init=S
−
| coauthors=Upshaw J, Rutchik S, Ohannessian C, Ortenberg J, Albertsen P
+
  |last2=Upshaw
−
  | title=Effects of circumcision on male sexual function: debunking a myth?
+
  |init2=J
−
  | journal=Journal of Urology
+
  |last3=Rutchik
−
  | volume=167
+
  |init3=S
−
  | issue=5
+
  |last4=Ohannessian
−
  | pages=2111–2112
+
  |init4=C
−
  | url=http://www.circs.org/library/collins/
+
  |last5=Ortenberg
−
  | quote=
+
  |init5=J
−
  | pubmedID=11956452
+
  |last6=Albertsen
−
  | pubmedCID=
+
  |init6=P
−
  | DOI=10.1016/S0022-5347(05)65097-5
+
  |title=Effects of circumcision on male sexual function: debunking a myth?
−
  | date=2002
+
  |journal=Journal of Urology
−
  | accessdate=
+
  |volume=167
−
}}</ref><ref name="kigozi2007">{{REFjournal
+
  |issue=5
−
| last=Kigozi
+
  |pages=2111-2112
−
| first=G
+
  |url=http://www.circs.org/library/collins/
−
| 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
+
  |quote=
−
| 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
+
  |pubmedID=11956452
−
| journal=[[British Journal of Urology|BJU International]]
+
  |pubmedCID=
−
| volume=101
+
  |DOI=10.1016/S0022-5347(05)65097-5
−
| issue=1
+
  |date=2002
−
| pages=65-70
+
  |accessdate=2020-02-18
−
| url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119420541/PDFSTART
+
}}</ref><ref name="kimpang2007"/>
−
| quote=
 
−
| pubmedID=18086100
 
−
| pubmedCID=
 
−
| DOI=10.1111/j.1464-410X.2007.07369.x
 
−
| date=January 2007
 
−
| accessdate=
 
−
}}</ref><ref name="kimpang2006"/>
 
  
−
Fink ''et al.'', in an American study of 123 men, found that medically necessitated circumcision resulted in worsened erectile function (p=0.01).<ref name=fink2002/>
+
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 reported no significant difference in erection.<ref name="kimpang2006">{{REFjournal
+
Kim & Pang (2007) reported no significant difference in [[erection]].<ref name="kimpang2007">{{KimDS PangMG 2007}}</ref>
−
| 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 2007
 
−
| accessdate=
 
−
}}</ref>
 
  
−
Laumann ''et al.'' 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"/>
+
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 ==
 
== 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
+
Waldinger et al. (2005) 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
+
  |last=Waldinger
−
  | first=M.D.
+
  |init=MD
−
  | coauthors=Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M
+
  |last2=Quinn
−
  | title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
+
|init2=P
−
  | journal=Journal of Sexual Medicine
+
|last3=Dilleen
−
  | volume=2
+
|init3=M
−
  | issue=4
+
|last4=Mundayat
−
  | pages=492–497
+
|init4=R
−
  | url=http://www3.interscience.wiley.com/journal/118719267/abstract
+
|last5=Schweitzer
−
  | quote=
+
|init5=DH
−
  | pubmedID=16422843
+
|last6=Boolell
−
  | pubmedCID=
+
|init6=M
−
  | DOI=10.1111/j.1743-6109.2005.00070.x
+
  |title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
−
  | date=2005
+
  |journal=Journal of Sexual Medicine
−
  | accessdate=
+
  |volume=2
−
}}</ref> Commenting on the study, Sorrells ''et al.'' said "Turkish men, the vast majority of whom are circumcised, had the shortest IELT [Intravaginal ejaculation latency time]."<ref name="sorrells"/>
+
  |issue=4
 +
  |pages=492-497
 +
  |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= "sorrells2007"/>
  
−
Collins ''et al.'' 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"/>
+
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.'' 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
+
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
+
  |last=Senkul
−
  | first=T.
+
  |init=T
−
  | coauthors=C. Iseri, B. Sen, K. Karademir, F. Saracoglu and D. Erden
+
  |last2=Iseri
−
  | title=Circumcision in Adults: Effect on Sexual Function
+
|init2=C
−
  | journal=Urology
+
|last3=Sen
−
  | volume=63
+
|init3=B
−
  | issue=1
+
|last4=Karademir
−
  | pages=155–8
+
|init4=K
−
  | url=http://www.circs.org/library/senkul/
+
|last5=Saracoglu
−
  | quote=
+
|init5=F
−
  | pubmedID=14751371
+
|last6=Erden
−
  | pubmedCID=
+
|init6=D
−
  | DOI=10.1016/j.urology.2003.08.035
+
  |title=Circumcision in Adults: Effect on Sexual Function
−
  | date=2004
+
  |journal=Urology
−
  | accessdate=
+
  |volume=63
 +
  |issue=1
 +
  |pages=155-158
 +
  |url=http://www.circs.org/library/senkul/
 +
  |quote=
 +
  |pubmedID=14751371
 +
  |pubmedCID=
 +
  |DOI=10.1016/j.urology.2003.08.035
 +
  |date=2004
 +
  |accessdate=
 
}}</ref>
 
}}</ref>
  
−
In a telephone survey of 10,173 Australian men, 22% of uncircumcised 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"/>
+
In a telephone survey of 10,173 Australian men, 22% of [[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 a randomised controlled trial of 4,456 men of whom 2,474 were selected to be circumcised, the authors did not find a statistically significant effect on premature ejaculation.<ref name="kigozi2007"/>
+
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="kimpang2007"/>
  
−
Krieger ''et al.'' reported on a randomised controlled trial of 2,784 participants, of whom 1,391 were randomised to be circumcised. 54.5% of circumcised men described their ease of reaching orgasm as "much more" at 24 months after randomisation.<ref name="krieger2008"/>
+
In a study of men [[circumcised]] for benign disease, Masood et al. (2005) reported that of those who stated they had prior premature ejaculation, 13% reported improvement after [[adult circumcision| circumcision]], 33% reported that it became worse, and 53% reported no change.<ref name="masood2005"/>
  
−
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 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>{{REFjournal
−
 
+
|last=Cortés-González
−
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"/>
+
|first=
−
 
+
|init=JR
−
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"/>
+
|author-link=
 +
|last2=Arratia-Maqueo
 +
|first2=
 +
|init2=JA
 +
|author2-link=
 +
|last3=Martínez-Montelongo
 +
|first3=
 +
|init3=R
 +
|author3-link=
 +
|last4=Gómez-Guerra
 +
|first4=
 +
|init4=LS
 +
|author4-link=
 +
|etal=no
 +
|title=[Does circumcision affect male's perception of sexual satisfaction?]
 +
|trans-title=
 +
|language=Spanish
 +
|journal=Arch Esp Urol
 +
|location=
 +
|date=2009-11
 +
|volume=62
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|issue=9
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|pages=733-6
 +
|url=https://www.aeurologia.com/EN/10.4321/S0004-06142009000900008
 +
|archived=
 +
|quote=
 +
|pubmedID=19955598
 +
|pubmedCID=
 +
|DOI=10.4321/s0004-06142009000900008
 +
|accessdate=2024-08-19
 +
}}</ref>
  
 
== Sexual practice and masturbation ==
 
== 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 and 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"/>
+
In a study by Korean researchers of 255 men [[circumcised]] after the age of 20 and 18 who were [[Intact| not circumcised]], Kim & 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="kimpang2007"/>
  
−
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
+
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
+
  |last=Laumann
−
  | first=E.O.
+
  |init=EO
−
  | coauthors=C.M. Masi and E.W. Zuckerman
+
  |last2=Masi
−
  | title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
+
|init2=CM
−
  | journal=[[Journal of the American Medical Association|JAMA]]
+
|last3=Zuckerman
−
  | volume=277
+
|init3=EW
−
  | issue=13
+
  |title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice
−
  | pages=1052–7
+
  |journal=JAMA
−
  | url=http://www.circs.org/library/laumann/
+
  |volume=277
−
  | quote=
+
  |issue=13
−
  | pubmedID=9091693
+
  |pages=1052-1057
−
  | pubmedCID=
+
  |url=http://www.circs.org/library/laumann/
−
  | DOI=10.1001/jama.277.13.1052
+
  |quote=
−
  | date=1997
+
  |pubmedID=9091693
−
  | accessdate=
+
  |pubmedCID=
−
}}</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
+
  |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
 
By SUSAN GILBERT
 
Published: April 2, 1997.  New York Times. [http://query.nytimes.com/gst/fullpage.html?sec=health&res=9C07E4D91F3AF931A35757C0A961958260]</ref>
 
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"/>
+
Fink et al. (2002) did not find a change in sexual activity with adult circumcision (p=0.22).<ref name="fink2002"/>
  
 
== Sexual drive ==
 
== 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="kimpang2006"/> Collins ''et al.'',<ref name="Collins2002"/> Senkul ''et al.'',<ref name="senkul2004"/> and Cortés-González ''et al.''.<ref name="cortes2009"/>
+
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="kimpang2007"/> Collins et al.,<ref name="Collins2002"/> and Senkul et al.<ref name="senkul2004"/>
  
 
== Satisfaction ==
 
== Satisfaction ==
  
−
Kim and Pang 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"/>
+
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="kimpang2007"/>
  
−
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/>
+
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 ''et al.'' reported that in a controlled trial of circumcision to reduce HIV incidence in Kisumu, Kenya, in which 1,391 men elected to be circumcised, more than 99% were "satisfied" with their circumcisions.<ref name="krieger2008"/>
+
Shen et al. reported that [[Adolescent and adult circumcision| adult circumcision]] appeared to result in improved satisfaction in 34 cases (of 95 adults being [[circumcised]]), the association was statistically significant.<ref name="shen2004"/>
  
−
Kigozi ''et al.'' reported finding "no trend in satisfaction among circumcised men". The authors concluded that "[a]dult male circumcision does not adversely affect sexual satisfaction or clinically significant function in men".<ref name="kigozi2007"/>
+
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"/>
  
−
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"/>
+
Collins et al. reported on a study of 15 [[adult circumcision]] patients. No statistically significant difference in BMSFI scores was observed.<ref name="Collins2002"/>
  
−
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"/>
+
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"/>
  
−
Collins ''et al.'' reported on a study of 15 adult circumcision patients. No statistically significant difference in BMSFI scores was observed.<ref name="Collins2002"/>
+
Uberoi et al. (2022) surveyed reports from [[circumcised]] men on social media. The authors reported:
 +
<blockquote>
 +
The qualitative review of social media posts clearly demonstrates that some men are experiencing a complex constellation of negative psychological, physical, and sexual associations that lead to significant emotional distress directed both internally and externally.<ref name ="uberoi2022">{{REFjournal
 +
|last=Uberoi
 +
|first=
 +
|init=M
 +
|author-link=
 +
|last2=Abdulcadir
 +
|first2=
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|init2=J
 +
|author2-link=
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|last3=Ohi
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|first3=
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|init3=DA
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|author3-link=
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|last4=Santiago
 +
|first4=
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|init4=JE
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|author4-link=
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|last5=
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|first5=
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|init5=
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|author5-link=
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|last6=
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|first6=
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|init6=
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|author6-link=
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|last7=
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|first7=
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|init7=
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|last8=
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|first8=
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|init8=
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|author8-link=
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|last9=
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|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 and to a resolution of previous painful conditions.<ref name="fink2002"/>
+
==Female preferences and response==
 +
 
 +
Wildman & Wildman (1976) surveyed 55 young women in Georgia, US, reporting that 47 (89%) of respondents preferred the [[circumcised]] [[penis]] (the remainder preferred the [[intact]] penis).<ref>{{REFjournal
 +
  |last=Wildman
 +
|init=RW
 +
|last2=Wildman
 +
|init2=RW 2nd
 +
|last3=Brown
 +
|init3=A
 +
|last4=Trice
 +
|init4=C
 +
|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=485-486
 +
|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.)
  
−
Cortés-González ''et al.'' found no statistically significant differences in terms of overall sexual satisfaction (p=0.15), pain during intercourse (p=0.23), or enjoyment of intercourse (p=0.32).<ref name="cortes2009"/>
+
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> There were very few [[intact]] males in Iowa in 1988 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 and response==
+
O'Hara & O'Hara (1999) argue that [[foreskin]] is a natural gliding stimulator of the [[Vagina| vagina 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
−
O'Hara and O'Hara 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
+
  |last=O'Hara
−
  | last=O'Hara
+
  |init=K
−
  | first=K.
+
  |last2=O'Hara
−
  | coauthors=J. O'Hara
+
|init2=J
−
  | title=The effect of male circumcision on the sexual enjoyment of the female partner
+
  |title=The effect of male circumcision on the sexual enjoyment of the female partner
−
  | journal=BJU International
+
  |journal=BJU International
−
  | volume=83
+
  |volume=83
−
  | issue=Supplement 1
+
  |issue=Supplement 1
−
  | pages=79–84
+
  |pages=79-84
−
  | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091407/PDFSTART
+
  |url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091407/PDFSTART
−
  | quote=
+
  |quote=
−
  | pubmedID=10349418
+
  |pubmedID=10349418
−
  | pubmedCID=
+
  |pubmedCID=
−
  | DOI=10.1046/j.1464-410x.1999.0830s1079.x
+
  |DOI=10.1046/j.1464-410x.1999.0830s1079.x
−
  | date=January 1999
+
  |date=1999-01
−
  | accessdate=
+
  |accessdate=2020-04-27
−
}}</ref> A study by psychologists Bensley & Boyle (2003) reported that vaginal dryness can be a problem when the male partner is circumcised.<ref>{{REFjournal
+
}}</ref>  
−
| 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=http://www.nzma.org.nz/journal/116-1181/595/
 
−
| quote=
 
−
| pubmedID=14581975
 
−
| pubmedCID=
 
−
| DOI=
 
−
| date=September 2003
 
−
| accessdate=
 
−
}}</ref> Boyle & Bensley (2001) reported that the lack of a foreskin in the male partner produces symptoms similar to those of female arousal disorder.{{Verify source|date=October 2008}} The authors hypothesized that the gliding action possibly involved intercourse with an uncircumcised partner might help prevent the loss of vaginal lubrication.{{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 ''et al.'' studied 19 female partners of men scheduled for circumcision.  They reported a significant reduction in vaginal lubrication following circumcision, from 78% to 63%, but found no statistically significant differences in "general sexual satisfaction, pain during vaginal penetration, desire, [or] vaginal orgasm".<ref>{{REFjournal
+
Boyle & Bensley (2003) reported that the lack of a [[foreskin]] in the male partner produces symptoms similar to those of [[Vagina#Female_Sexual_Arousal_Disorder| female arousal disorder]].<ref name="bensley2003">{{REFjournal
−
  | last=Cortés-González JR, Arratia-Maqueo JA, Gómez-Guerra LS
+
  |last=Bensley
−
  | first=
+
  |first=Gillian A.
−
  | coauthors=
+
  |init=GA
−
  | title=[Does circumcision has an effect on female's perception of sexual satisfaction?]
+
|last2=Boyle
−
  | journal=Rev. Invest. Clin.
+
|first2=Gregory J.
−
  | volume=60
+
|init2=GJ
−
  | issue=3
+
|author2-link=Gregory J. Boyle
−
  | pages=227–30
+
  |title=Effects of male circumcision on female arousal and orgasm
−
  | url=
+
  |journal=New Zealand Medical Journal
−
  | quote=
+
  |volume=116
−
  | pubmedID=18807735
+
  |issue=1181
−
  | pubmedCID=
+
  |pages=595-596
−
  | DOI=
+
  |url=http://www.cirp.org/library/sex_function/bensley1/
−
  | date=2008
+
  |quote=
−
  | accessdate=
+
  |pubmedID=14581975
−
| language=Spanish; Castilian
+
  |pubmedCID=
−
}}</ref>
+
  |DOI=
 +
  |date=2003-09-12
 +
  |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" />
  
−
Kigozi ''et al.'' reported on a prospective study of 455 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 circumcised.<ref>{{REFjournal
+
A study by psychologists Bensley & Boyle (2003) reported that vaginal dryness can be a problem when the male partner is [[circumcised]].<ref name="bensley2003" />
−
| last=Kigozi G, Lukabwe I, Kagaayi J, ''et al.''
 
−
| first=
 
−
| coauthors=
 
−
| title=Sexual satisfaction of women partners of circumcised men in a randomized trial of male circumcision in Rakai, Uganda
 
−
| journal=BJU Int
 
−
| volume=104
 
−
| issue=11
 
−
| pages=1698–701
 
−
| url=
 
−
| quote=
 
−
| pubmedID=19522862
 
−
| pubmedCID=
 
−
| DOI=10.1111/j.1464-410X.2009.08683.x
 
−
| date=June 2009
 
−
| accessdate=
 
−
}}</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>  Wildman and Wildman (1976) surveyed 55 young women in Georgia, US, reporting that 47 (89%) of respondents preferred the circumcised penis (the remainder preferred the uncircumcised penis).<ref>{{REFjournal
+
==Effect of circumcision on heterosexual relations==
−
| 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 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?cmd=Retrieve&db=PubMed&list_uids=11798403&dopt=Abstract]</ref>{{Verify source|date=October 2008}}
 
  
−
== Summary of research findings (Wikipedia table) ==
+
As previously reported, the [[foreskin]] reduces the force required for penetration of the female partner's [[vagina]] by as much as ninety percent,<ref name="taves2002">{{REFjournal
 +
|last=Taves
 +
|init=D
 +
|author-link=
 +
|title=The intromission function of the foreskin
 +
|journal=Med Hypotheses
 +
|date=2002
 +
|volume=59
 +
|issue=2
 +
|pages=180
 +
|url=http://www.sciencedirect.com/science/article/pii/S0306987702002505
 +
|quote=
 +
|pubmedID=12208206
 +
|pubmedCID=
 +
|DOI=10.1016/s0306-9877(02)00250-5
 +
|accessdate=2020-01-04
 +
}}</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="warren-bigelow1994">{{REFjournal
 +
|last=Warren
 +
|first=John
 +
|init=J
 +
|author-link=John Warren
 +
|last2=Bigelow
 +
|first2=Jim
 +
|init2=J
 +
|author2-link=Jim Bigelow
 +
|title=The case against circumcision
 +
|journal=Brit J Sex Med
 +
|date=1994-09
 +
|volume=
 +
|issue=
 +
|pages=
 +
|url=http://www.cirp.org/library/general/warren2/
 +
|quote=
 +
|pubmedID=
 +
|pubmedCID=
 +
|DOI=
 +
|accessdate=2020-01-04
 +
}}</ref> so the lack of the foreskin in the [[circumcised]] partner renders the female experience less satisfactory.
  
−
{| class="wikitable"
+
In a first of its kind, O'Hara & O'Hara (1999) 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:
−
! scope="col" | Study
+
<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="ohara1998">{{REFjournal
−
! scope="col" | Design
+
|last=O'Hara
−
! scope="col" | Peer reviewed
+
|init=K
−
! scope="col" | Sample size
+
|author-link=
−
! scope="col" | Finding
+
|last2=O'Hara
−
! scope="col" | Significant¹
+
  |init2=J
−
|-
+
  |author2-link=
−
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Sexual drive
+
  |etal=no
−
|-
+
  |title=The effect of male circumcision on the sexual enjoyment of the female partner
−
! scope="row" | Collins (2002)<ref name="Collins2002"/>
+
  |journal=BJU Int
−
| Prospective; adult circumcision patients
+
|location=
−
| Yes || 15 || No difference found || No; p > 0.68
+
|date=1999
−
|-
+
  |volume=83 Suppl 1
−
! scope="row" | Senkul (2004)<ref name="senkul2004"/>
+
  |issue=
−
| Prospective; adult circumcision patients
+
  |pages=79-84
−
| Yes || 42 || No difference found || No; p = 0.32
+
  |url=https://onlinelibrary.wiley.com/doi/epdf/10.1046/j.1464-410x.1999.0830s1079.x
−
|-
+
  |quote=
−
! scope="row" | Kim and Pang (2006)<ref name="kimpang2006"/>
+
  |pubmedID=10349418
−
| Prospective; adult circumcision patients
+
  |pubmedCID=
−
| Yes || 373 || No difference found || Not stated
+
  |DOI=10.1046/j.1464-410x.1999.0830s1079.x
−
|-
+
  |accessdate=2019-10-22
−
! scope="row" | Senol (2008)<ref name="senol2008">{{REFjournal
 
−
  | last=Senol MG, Sen B, Karademir K, Sen H, Saraçoğlu M
 
−
  | first=
 
−
  | coauthors=
 
−
  | title=The effect of male circumcision on pudendal evoked potentials and sexual satisfaction
 
−
  | journal=Acta Neurol Belg
 
−
  | volume=108
 
−
  | issue=3
 
−
  | pages=90-3
 
−
  | url=
 
−
  | quote=
 
−
  | pubmedID=19115671
 
−
  | pubmedCID=
 
−
  | DOI=
 
−
| date=September 2008
 
−
  | accessdate=
 
 
}}</ref>
 
}}</ref>
−
| Prospective; adult circumcision patients
+
</blockquote>  
−
| Yes || 43 || No difference found || No; p = 0.11
+
 
−
|-
+
Solinis & Yiannaki (2007) concluded; "[t]here was a decrease in couple’s sexual life after [[circumcision]] indicating that [[adult circumcision]] adversely affects sexual function in many men or/and their partners, possibly because of complications of surgery and loss of nerve endings."<ref name="solinis-yiannaki2005">{{REFjournal
−
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Erectile function
+
|last=Solinis
−
|-
+
|first=
−
! scope="row" | Fink (2002)<ref name="fink2002"/>
+
|author-link=
−
| Cross-sectional; adult circumcision patients
+
|last2=Yiannaki
−
| Yes || 40 || Worse after circumcision || Yes; p = 0.01
+
|first2=
−
|-
+
|author2-link=
−
! scope="row" | Collins (2002)<ref name="Collins2002"/>
+
|etal=no
−
| Prospective; adult circumcision patients
+
|title=Does circumcision improve couple's sex life?
−
| Yes || 15 || No difference found || No; p > 0.96
+
|trans-title=
−
|-
+
  |language=
−
! scope="row" | Senkul (2004)<ref name="senkul2004"/>
+
  |journal=Journal of Men's Health and Gender
−
| Prospective; adult circumcision patients
+
  |location=
−
| Yes || 42 || No difference found || No; p = 0.89
+
  |date=2007-09
−
|-
+
  |volume=4
−
! scope="row" | Masood (2005)<ref name= "masood2005"/>
+
  |issue=3
−
| Not stated; adult circumcision patients
+
  |pages=361
−
| Yes || 88 || No difference found || No; p = 0.40
+
  |url=http://www.cirp.org/library/sex_function/solinis2007/
−
|-
+
  |quote=
−
! scope="row" | Shen (2004)<ref name="shen2004"/>
+
  |pubmedID=
−
| Not stated; adult circumcision patients
+
  |pubmedCID=
−
| Yes || 95 || Worse after circumcision || Yes; p = 0.001
+
  |DOI=
−
|-
+
  |accessdate=2020-01-04
−
! scope="row" | Laumann (1997)<ref name="Laumann1997"/>
 
−
| National probability study
 
−
| Yes || 1410 || Better in circumcised males || Yes; p < 0.10
 
−
|-
 
−
! scope="row" | Richters (2006)<ref name= "richters2006"/>
 
−
| Telephone survey
 
−
| Yes || 10,173 || Better in circumcised males || Yes; p=0.022
 
−
|-
 
−
! scope="row" | Kim 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 = 0.23
 
−
|-
 
−
| 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
 
−
|-
 
−
! scope="row" | Senkul (2004)<ref name="senkul2004"/>
 
−
| 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 = 0.02
 
−
|-
 
−
! scope="row" | Shen (2004)<ref name="shen2004"/>
 
−
| Not stated; adult circumcision patients
 
−
| Yes || 95 || Greater time to ejaculate after circumcision || Yes; p=0.04
 
−
|-
 
−
! scope="row" | Laumann (1997)<ref name="Laumann1997"/>
 
−
| National probability study
 
−
| Yes || 1410 || Circumcised men less likely to ejaculate prematurely || Yes; p < 0.10
 
−
|-
 
−
! scope="row" | Waldinger (2005)<ref name="Waldinger2005"/>
 
−
| Multinational, stopwatch assessment
 
−
| Yes || 500 || No difference found || No
 
−
|-
 
−
! scope="row" | Richters (2006)<ref name= "richters2006"/>
 
−
| Telephone survey
 
−
| Yes || 10,173 || Circumcised men more likely to ejaculate prematurely || No; p = 0.11
 
−
|-
 
−
! scope="row" | Senol (2008)<ref name="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 = 0.001
 
−
|-
 
−
| colspan="7" style="bgcolor: #f2f2f2; font-weight: bold;" | Penile sensation
 
−
|-
 
−
! scope="row" | Fink (2002)<ref name="fink2002"/>
 
−
| Cross-sectional, adult circumcision patients
 
−
| Yes || 40 || Worse after circumcision || No; p = 0.08
 
−
|-
 
−
! 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 name= "Dennniston2004">{{REFjournal
 
−
  | last=Denniston
 
−
  | first=G.C.
 
−
  | coauthors=Hill G.
 
−
  | title=Circumcision in adults: effect on sexual function
 
−
| journal=Urology
 
−
  | volume=64
 
−
  | issue=6
 
−
  | pages=1267
 
−
  | url=http://www.cirp.org/library/sex_function/denniston3/http://www.cirp.org/library/sex_function/denniston3/
 
−
  | quote=
 
−
  | pubmedID=15596221
 
−
  | pubmedCID=
 
−
  | DOI=10.1016/j.urology.2004.03.059
 
−
| date=2006
 
−
  | accessdate=
 
 
}}</ref>
 
}}</ref>
−
| Not stated; survey of males circumcised in adulthood
 
−
| No || 38 || Better after circumcision in 34%, worse in 58% || Not stated
 
−
|-
 
−
! 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
 
−
|-
 
−
! 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 2008
 
−
}}</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 ==
+
Frisch et al. (2013) surveyed a very large group of men and women in [[Denmark]]. They concluded:
−
# If stated, author's analysis is used. Otherwise, significance is considered to be p <= 0.05.
+
<blockquote>
−
# c = circumcised; uc = uncircumcised.
+
"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>{{FrischM LindholmM GroenbaekM 2011}}</ref>
−
 
+
</blockquote>
−
<!-- commented out due to not being used in the article:
 
−
* Denniston GC, Hill G (2004) [http://www.cirp.org/library/sex_function/denniston3/ Circumcision in adults: effect on sexual function]. ''Urology'', '''64'''(6);1267.
 
−
-->
 
  
 
{{SEEALSO}}
 
{{SEEALSO}}
−
 
+
* [[Circumcision]]
 +
* [[Dyspareunia]]
 
* [[Foreskin]]
 
* [[Foreskin]]
 +
* [[Foreskin sensitivity]]
 
* [[Erection]]
 
* [[Erection]]
−
* [[Circumcision]]
+
* [[Gliding action]]
 +
* [[Masturbation]]
 +
* [[Penis]]
 +
* [[Premature ejaculation]]
 
* [[Ridged band]]
 
* [[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/
 +
|title=Foreskin Sexual Function/Circumcision Sexual Dysfunction
 +
|last=
 +
|first=
 +
|publisher=circumcision Information Reference Library
 +
|website=Foreskin Sexual Function/Circumcision Sexual Dysfunction
 +
|date=2013-07-30
 +
|accessdate=2019-09-28
 +
}}
 +
* {{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}}
 
{{REF}}
  
 +
 +
[[Category:Education]]
 +
[[Category:Parental information]]
 
[[Category:Circumcision]]
 
[[Category:Circumcision]]
 +
[[Category:Circumcision complication]]
 +
[[Category:Sexuality]]
  
 +
[[Category:From Intactipedia]]
 
[[Category:From IntactWiki]]
 
[[Category:From IntactWiki]]
 +
 +
[[de:Sexuelle Auswirkungen der Beschneidung]]

Latest revision as of 16:18, 22 October 2024

The 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 ejaculation, sexual satisfaction, sexual sensation and penile sensitivity. Studies 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. Cold & Taylor (1999) stated:

The prepuce is primary, erogenous tissue necessary for normal sexual function.[1]

History

In the beginning

The human foreskin was once thought to have little or no sexual function. Sex researcher Alfred C. Kinsey (1948) placed no importance on the presence or absence of the foreskin.[2]

Masters & Johnson (1966) in their book, Human Sexual Response,[3] 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:

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.

With regard to the glans penis, Masters & Johnson stated:

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.[3]

Therefore, it appears that Masters & Johnson (1966) performed little or no testing on the foreskins of their few intact subjects and provided no useful information.[4]

The 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 (1956) investigated the innervation of the prepuce and found it to be highly innervated.[5] Winkleman (1959) later identified the prepuce as "specific erogenous tissue".[6]

William Keith C. Morgan, M.D.[a 1] (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:

Now let us consider whether the operation is in any way harmful or contraindicated. The function of 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 to foreign stimuli which dull these special receptors. 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 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 sock that has been previously rolled up.[7]

Morgan (1967) addressed the issue again in the Medical Journal of Australia:

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.[8]

Falliers (1970) commented in a critical letter to the Journal of the American Mmedical Association:

The sensory pleasure induced by tactile stimulation of the foreskin is almost totally lost after its surgical removal. The surface of the exposed glans, 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.[9]

And so began the investigation of the sexual effects of male circumcision.

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.[10] 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).[11]

Glans sensitivity

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."[12]

An examination of 7 circumcised and 6 intact males found no difference in keratinization of the glans penis.[13]

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."[4]

Foreskin sensitivity

Some recent researchers assert that the foreskin is sexually sensitive highly-innervated erogenous tissue.[5][6] [14][1] The foreskin has a large population of Meissner's corpuscles.[15] [16] 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 at the end of the foreskin.[14] Taylor (1996) observed that the ridged band had more Meissner's corpuscles — a kind of nerve ending that is concentrated in areas of greatest sensitivity — than the areas of the foreskin with smooth mucus membranes and a rich blood supply to serve the neurological tissue. Taylor (2000) 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 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.[17] This gliding action was also described by Lakshmanan (1980).[18]

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."[19] 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.[4]

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.[20]

García-Mesa et al. (2021) reported that the mechanical motion of the foreskin generates pleasurable sexual sensation.[15]

Erectile function

Reports detailing the effect of circumcision on erectile dysfunction have been mixed. Studies have variously found a statistically significant increase,[11][21] or decrease,[22] [23] in erectile dysfunction among circumcised men, while other studies have shown little to no effect.[24][25][26]

Fink et al. (2002), in an American study of 123 men, found that medically necessitated circumcision resulted in worsened erectile function (p=0.01).[11]

Kim & Pang (2007) reported no significant difference in erection.[26]

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).[23]

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 nerves seems to decrease PE.

Waldinger et al. (2005) 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.[27] 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]."[4]

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.[25]

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.[24]

In a telephone survey of 10,173 Australian men, 22% of 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.[22]

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.[26]

In a study of men circumcised for benign disease, Masood et al. (2005) 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.[10]

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.[28]

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 (2007) reported that masturbatory pleasure decreased in 48% of the respondents and increased in 8%. Masturbatory difficulty increased in 63% but was easier in 37%. They concluded that there was a decrease in masturbatory pleasure after circumcision.[26]

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.[23] 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."[29]

Fink et al. (2002) did not find a change in sexual activity with adult circumcision (p=0.22).[11]

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,[26] Collins et al.,[25] and Senkul et al.[24]

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."[26]

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.[10]

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.[21]

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.[24]

Collins et al. reported on a study of 15 adult circumcision patients. No statistically significant difference in BMSFI scores was observed.[25]

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.[11]

Uberoi et al. (2022) surveyed reports from circumcised men on social media. The authors reported:

The qualitative review of social media posts clearly demonstrates that some men are experiencing a complex constellation of negative psychological, physical, and sexual associations that lead to significant emotional distress directed both internally and externally.[30]

Female preferences and response

Wildman & Wildman (1976) surveyed 55 young women in Georgia, US, reporting that 47 (89%) of respondents preferred the circumcised penis (the remainder preferred the intact penis).[31] (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.)

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.[32] There were very few intact males in Iowa in 1988 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.)

O'Hara & O'Hara (1999) argue that foreskin is a natural gliding stimulator of the vagina 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.[33]

Boyle & Bensley (2003) reported that the lack of a foreskin in the male partner produces symptoms similar to those of female arousal disorder.[34] The authors hypothesized that the gliding action possibly involved intercourse with an intact partner might help prevent the loss of vaginal lubrication.[34] They stated that the respondents were self-selected, and that larger sample sizes are needed.[34]

A study by psychologists Bensley & Boyle (2003) reported that vaginal dryness can be a problem when the male partner is circumcised.[34]

Effect of circumcision on heterosexual relations

As previously reported, the foreskin reduces the force required for penetration of the female partner's vagina by as much as ninety percent,[35], so the lack of the foreskin makes penetration more difficult. The gliding action of the foreskin reduces friction and abrasion, while conserving vaginal lubrication,[36] 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 (1999) 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:

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.[37]

Solinis & Yiannaki (2007) concluded; "[t]here was a decrease in couple’s sexual life after circumcision indicating that adult circumcision adversely affects sexual function in many men or/and their partners, possibly because of complications of surgery and loss of nerve endings."[38]

Frisch et al. (2013) surveyed a very large group of men and women in Denmark. They concluded:

"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."[39]

See also

External links

Abbreviations

  1. ↑ REFweb Doctor of Medicine, Wikipedia. Retrieved 14 June 2021. In the United Kingdom, Ireland and some Commonwealth countries, the abbreviation MD is common.

References

  1. ↑ a b REFjournal Cold CJ, Taylor JR. The prepuce. BJU Int. January 1999; 83, Suppl. 1: 34-44. PMID. DOI. Retrieved 8 July 2021.
  2. ↑ REFbook Kinsey AC, Pemeroy AC (1948): Sexual Behavior in the Human Male. A. C. Saunders. Retrieved 21 December 2019.
  3. ↑ a b REFbook Masters WL, Johnson VE (1966): Human sexual response. Toronto, New York: Bantam. ISBN 0-553-20429-7. Retrieved 21 December 2019.
  4. ↑ a b c d REFjournal Sorrells ML, Snyder JL, Reiss MD, Eden C, Milos MF, Wilcox N, Van Howe RS. Fine‐touch pressure thresholds in the adult penis. BJUI. 19 March 2007; 99(4): 864-9. PMID. DOI. Retrieved 10 January 2021.
  5. ↑ a b REFjournal Winkelmann RK. The cutaneous innervation of human newborn prepuce. Journal of Investigative Dermatology. January 1956; 26(1): 53-67. PMID. Retrieved 21 December 2019.
  6. ↑ a b REFjournal Winkelmann RK. The erogenous zones: their nerve supply and significance. Mayo Clin Proc. 21 January 1959; 34(3): 39-47. PMID. Retrieved 4 June 2021.
  7. ↑ REFjournal Morgan WKC. The rape of the phallus. JAMA. 1965; 193: 123-4. PMID. DOI. Retrieved 21 December 2019.
  8. ↑ REFjournal Morgan WKC. Penile Plunder. Med J Aust. 27 May 1967; 1(21): 1102-3. PMID. Retrieved 21 December 2019.
  9. ↑ REFjournal Falliers. Circumcision (letter). JAMA. 21 December 1970; 214(12): 2194. Retrieved 21 December 2019.
  10. ↑ a b c REFjournal Masood S, Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff M.K. Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly?. Urol Internationalalis. 2005; 75(1): 62-66. PMID. DOI.
  11. ↑ a b c d e REFjournal Fink KS, Carson CC, DeVillis RF. Adult circumcision outcomes study: effect on erectile function, penile sensitivity, sexual activity and satisfaction. J Urol. May 2002; 167(5): 2113-2116. PMID. DOI.
  12. ↑ REFjournal Yang CC, Bradley WE. Neuroanatomy of the penile portion of the human dorsal nerve of the penis. British Journal Urology. July 1998; 82(1): 109-113. PMID. DOI.
  13. ↑ REFjournal Szabo R, Short RV. How does male circumcision protect against HIV infection?. BMJ. June 2000; 320(7249): 1592-1594. PMID. PMC. DOI. Retrieved 9 July 2006.
  14. ↑ a b REFjournal Taylor JR, Lockwood AP, Taylor AJ. The prepuce: specialized mucosa of the penis and its loss to circumcision. Br J Urol. 1996; 77: 291-5. PMID. DOI. Retrieved 23 September 2019.
  15. ↑ a b REFjournal García-Mesa, Yolanda, García-Piqueras, Jorge, Cobo, Ramón, Martín-Cruces, José, Suazo, Iván, García-Suárez, Olivia, Feito, Jorge. Sensory innervation of the human male prepuce: Meissner's corpuscles predominate. Journal of Anatomy. October 2021; 239(4): 892-902. PMID. PMC. DOI. Retrieved 15 November 2021.
  16. ↑ REFweb Garret, Connor (17 February 2024). What Do The Eyelids, Lips, Fingertips & The Intact Penis Have in Common?, Intact America. Retrieved 22 October 2024.
  17. ↑ REFjournal Taylor JR. Back and forth (letter). Pediatric news. October 2000; 34(10): 50.
  18. ↑ REFjournal Lakshmanan S, Parkash S. Human prepuce: some aspects of structure and function. Indian journal of surgery. 1980; 44: 134-137. Retrieved 19 December 2019.
  19. ↑ REFjournal Boyle GJ, Bensley GA. Adverse Sexual and Psychological Effects of Male Infant Circumcision. Psychological reports. July 2001; 88(3, Part 2): 1105-1106. PMID.
  20. ↑ REFjournal Schober JM, Meyer-Bahlburg HF, Dolezal C. Self-ratings of genital anatomy, sexual sensitivity and function in men using the 'Self-Assessment of Genital Anatomy and Sexual Function, Male' questionnaire. BJU Int. September 2009; 103(8): 1096-103. PMID. DOI.
  21. ↑ a b REFjournal Shen Z, Chen S, Zhu C, Wan Q, Chen Z. Erectile function evaluation after adult circumcision. Zhonghua Nan Ke Xue. January 2004; 10(1): 18-19. PMID.
  22. ↑ a b REFjournal Richters J, Patel HR, Himpson RC, Palmer JH, Mufti GR, Sheriff MK. Circumcision in Australia: prevalence and effects on sexual health. International Journal of Sexually Transmissible Diseases and AIDS. 2006; 17(8): 547-554. PMID. DOI.
  23. ↑ a b c REFjournal Laumann EO, Masi CM, Zuckerman EW. Circumcision in the United States: prevalence, prophylactic effects, and sexual practice. JAMA. 2 April 1997; 277(13): 1052-1057. PMID. DOI. Retrieved 8 August 2021.
  24. ↑ a b c d REFjournal Senkul T, Iseri C, Sen B, Karademir K, Saracoglu F, Erden D. Circumcision in Adults: Effect on Sexual Function. Urology. 2004; 63(1): 155-158. PMID. DOI.
  25. ↑ a b c d REFjournal Collins S, Upshaw J, Rutchik S, Ohannessian C, Ortenberg J, Albertsen P. Effects of circumcision on male sexual function: debunking a myth?. Journal of Urology. 2002; 167(5): 2111-2112. PMID. DOI. Retrieved 18 February 2020.
  26. ↑ a b c d e f REFjournal Kim DS, Pang MG. The effect of male circumcision on sexuality PDF. BJU Int. March 2007; 99(3): 619-622. PMID. DOI. Retrieved 4 November 2023.
  27. ↑ REFjournal Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M. Circumcision in the United States: prevalence, prophylactic effects, and sexual practice. Journal of Sexual Medicine. 2005; 2(4): 492-497. PMID. DOI.
  28. ↑ REFjournal Cortés-González JR, Arratia-Maqueo JA, Martínez-Montelongo R, Gómez-Guerra LS. [Does circumcision affect male's perception of sexual satisfaction?]. Arch Esp Urol. November 2009; 62(9): 733-6. PMID. DOI. Retrieved 19 August 2024.
  29. ↑ Study Is Adding to Doubts About Circumcision By SUSAN GILBERT Published: April 2, 1997. New York Times. [1]
  30. ↑ REFjournal Uberoi M, Abdulcadir J, Ohi DA, Santiago JE, et al. 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. Int J Impot Res. 23 October 2022; PMID. DOI. Retrieved 19 February 2023.
  31. ↑ REFjournal Wildman RW, Wildman RW 2nd, Brown A, Trice C. Note on males' and females' preferences for opposite-sex body parts, bust sizes, and bust-revealing clothing. Psychological Reports. 1976; 38(2): 485-486. PMID.
  32. ↑ Williamson ML, Williamson PS. Women's Preferences for Penile Circumcision in Sexual Partners. J Sex Educ Ther 1988; 14: 8
  33. ↑ REFjournal O'Hara K, O'Hara J. The effect of male circumcision on the sexual enjoyment of the female partner. BJU International. January 1999; 83(Supplement 1): 79-84. PMID. DOI. Retrieved 27 April 2020.
  34. ↑ a b c d REFjournal Bensley GA, Boyle GJ. Effects of male circumcision on female arousal and orgasm. New Zealand Medical Journal. 12 September 2003; 116(1181): 595-596. PMID. Retrieved 27 April 2020.
  35. ↑ REFjournal Taves D. The intromission function of the foreskin. Med Hypotheses. 2002; 59(2): 180. PMID. DOI. Retrieved 4 January 2020.
  36. ↑ REFjournal Warren J, Bigelow J. The case against circumcision. Brit J Sex Med. September 1994; Retrieved 4 January 2020.
  37. ↑ REFjournal O'Hara K, O'Hara J. The effect of male circumcision on the sexual enjoyment of the female partner. BJU Int. 1999; 83 Suppl 1: 79-84. PMID. DOI. Retrieved 22 October 2019.
  38. ↑ REFjournal Solinis, Yiannaki. Does circumcision improve couple's sex life?. Journal of Men's Health and Gender. September 2007; 4(3): 361. Retrieved 4 January 2020.
  39. ↑ REFjournal Frisch M, Lindholm M, Grønbæk M. Male circumcision and sexual function in men and women: a survey-based, cross-sectional study in Denmark. Int J Epidemiol. 14 June 2011; 40(5): 1367-81. PMID. DOI. Retrieved 26 September 2021.
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