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Sexual effects of circumcision

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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
| last= | first= | coauthors= | title=Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision | journal=Pediatrics | volume=103 | issue=3 | pages=686-93 | url= | quote= | pubmedID=10049981 | pubmedCID= | DOI=10.1542/peds.103.3.686 | date=March 1999 | 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="AAFP"/> Conversely, a 2002 review by Boyle ''et al.'' stated that "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision, with an inevitable reduction in sexual sensation experienced by circumcised males." They concluded, "intercourse is less satisfying for both partners when the man is circumcised".<ref>{{REFweb
| quote=
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
| last=Masood | first=S. | coauthorslast2=Patel HR, |first2=H.R. |last3=Himpson RC, |first3=R.C. |last4=Palmer JH, |first4=J.H. |last5=Mufti GR, |first5=G.R. |last6=Sheriff MK |first6=M.K. | title=Penile sensitivity and sexual satisfaction after circumcision: are we informing men correctly? | journal=Urol Internationalalis | volume=75 | issue=1 | pages=62-6 | url=http://www.cirp.org/library/sex_function/masood1/ | quote= | pubmedID=16037710 | pubmedCID= | DOI=10.1159/000085930 | date=2005 | accessdate=
}}</ref> In a survey of men circumcised as adults for medical (93%) or elective (7%) reasons, Fink ''et al.'' found an association between adult circumcision and decreased penile sensitivity that "bordered on statistical significance" (p=0.08).<ref name="fink2002">{{REFjournal
| last=Fink | first=K.S. | coauthorsfirst2=C.C. |last2=Carson and |first3=R.F. |last3=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>
In a 2008 study, Krieger ''et al.'' stated that "Adult male circumcision was not associated with sexual dysfunction. Circumcised men reported increased penile sensitivity and enhanced ease of reaching orgasm."<ref name="Krieger2008">{{REFjournal
| last=Krieger | first=JNJ.N. | coauthorslast2=Mehta SD, |first2=S.D. |last3=Bailey RC, |first3=R.C. |last4=Agot |first4=K, . |last5=Ndinya-Achola JO, |first5=J.O. |last6=Parker |first6=C, . |last7=Moses |first7=S. | title=Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya | journal=The journal of sexual medicine | volume=Epub ahead of print | issue=11 | pages=2610–22 | url= | quote= | pubmedID=18761593 | pubmedCID= | DOI=10.1111/j.1743-6109.2008.00979.x | date=August 2008 | accessdate=
}}</ref> In a 2009 study, Cortés-González ''et al.'' reported a statistically significant improvement in "perception of sexual events" (p=0.04).<ref name="cortes2009">{{REFjournal
| last=Cortés-González JR, |first=J.R. |last2=Arratia-Maqueo JA, |first2=J.A. |last3=Martínez-Montelongo |first3=R, Gómez-Guerra LS. | firstlast4=Gómez-Guerra | coauthorsfirst4=L.S. | 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>
|note=
}}</ref> Sorrells ''et al.'' criticised this early study for being poorly documented and not subject to peer review.<ref name="sorrells">{{REFjournal
| last=Sorrells | first=Morris L. | coauthorsauthor-link=Morris L. Sorrells |first2=James L. |last2=Snyder, |first3=Mark D. |last3=Reiss, |first4=Christopher |last4=Eden, |first5=Marilyn F. |last5=Milos, |author5-link=Marilyn Fayre Milos |first6=Norma |last6=Wilcox and |first7=Robert S. |last8=Van Howe |author8-link=Robert Van Howe | title=Fine-touch pressure thresholds in the adult penis | journal=BJU International | volume=99 | issue=4 | pages=864-869 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508429/PDFSTART | quote= | pubmedID=17378847 | pubmedCID= | DOI=10.1111/j.1464-410X.2006.06685.x | date=March 2007 | accessdate=
}}</ref> In January 2007, The American Academy of Family Physicians (AAFP) stated "The effect of circumcision on penile sensation or sexual satisfaction is unknown. Because the epithelium of a circumcised glans becomes cornified, and because some feel nerve over-stimulation leads to desensitization, many believe that the glans of a circumcised penis is less sensitive. Opinions differ about how this decreased sensitivity, which may result in prolonged time to orgasm, affects sexual satisfaction. An investigation of the exteroceptive and light tactile discrimination of the glans of circumcised and uncircumcised men found no difference on comparison. No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction."
<ref name="AAFP">{{REFweb
Yang ''et al.'' (1998) concluded in their study into the innervation of the penile shaft and glans penis that: "The distinct pattern of innervation of the glans emphasizes the role of the glans as a sensory structure."<ref name="yang1998">{{REFjournal
| last=Yang | first=CCC.C. | coauthorslast2=Bradley WE |first2=W.E. | 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
| last=Szabo | first=Robert | coauthorsfirst2=Roger V. |last2=Short | title=How does male circumcision protect against HIV infection? | journal=BMJ | volume=320 | issue=7249 | pages=1592-1594 | url=http://bmj.bmjjournals.com/cgi/reprint/320/7249/1592 | quote= | pubmedID=10845974 | pubmedCID=1127372 | DOI=10.1136/bmj.320.7249.1592 | date=June 2000 | accessdate=2006-07-09
}}</ref> Bleustein ''et al.'' (2003) tested the sensitivity of the glans penis, and found no difference between circumcised and uncircumcised men.<ref name="bleustein2003">{{REFconference
| place=Chicago, Illinois
| accessdate=2019-09-29
}}</ref> Bleustein ''et al.'' (2005) divided 125 patients (62 uncircumcised men and 63 neonatally circumcised men) into groups based on their sexual dysfunction using the [[Sexological_testing#IIEF_.28International_Index_of_Erectile_Function.29|IIEF]](International Index of Erectile Function). Twenty-nine were placed in the functional group, and 96 in the dysfunctional group. Quantitative somatosensory testing (including vibration, pressure, spatial perception, and warm and cold thermal thresholds) was used on the dorsal midline glans of the penis. In the dysfunctional group, circumcised men (49 +/- 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. | coauthorslast2=Fogarty JD, |first2=J.D. |last3=Eckholdt |first3=H, . |last4=Arezzo JC, |first4=J.C. |last5=Melman |first5=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>
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
| last=Waskett | first=Jake H. | coauthorsauthor-link=Jake H. Waskett |first2=Brian J. |last2=Morris |author2-link=Brian J. Morris | title=Fine touch pressure thresholds in the adult penis | journal=BJU International | volume=99 | issue=6 | pages=1551–1552 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/118508593/HTMLSTARThttp://www3.interscience.wiley.com/cgi-bin/fulltext/118508593/HTMLSTART | quote= | pubmedID=17537227 | pubmedCID= | DOI=10.1111/j.1464-410X.2007.06970_6.x | date=May 2007 | accessdate=
}}</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
| last=Young | first=Hugh | coauthorsauthor-link=Hugh Young | 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
| last=Payne | first=Kimberley | coauthorslast2=Thaler, |first2=Lea; |last3=Kukkonen, |first3=Tuuli; |last4=Carrier, |first4=Serge; and [[ |last5=Binik |first5=Yitzchak |author5-link=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>
Some recent researchers have asserted that the [[foreskin]] may be sexually responsive.<ref>{{REFjournal
| last=Winkelmann | first=R.K. | coauthors= | title=The cutaneous innervation of human newborn prepuce | journal=Journal of investigative dermatology | volume=26 | issue=1 | pages=53-67 | url=http://www.cirp.org/library/anatomy/winkelmann2/ | quote= | pubmedID=13295637 | pubmedCID= | DOI= | date=January 1956 | accessdate=
}}</ref><ref>{{REFjournal
| last=Winkelmann | first=R.K. | coauthors= | title=The erogenous zones: their nerve supply and significance | journal=Proceedings of the staff meetings of the mayo clinic | volume=34 | issue=2 | pages=39-47 | url=http://www.cirp.org/library/anatomy/winkelmann/ | quote= | pubmedID=13645790 | pubmedCID= | DOI= | date=January 1959 | accessdate=
}}</ref><ref name="taylor">{{REFjournal
| last=Taylor | first=J.R. | coauthorsauthor-link=John R. Taylor |first2=A.P. |last2=Lockwood and |first3=A.J. |last3=Taylor | title=The prepuce: Specialized mucosa of the penis and its loss to circumcision | journal=British journal of urology | volume=77 | issue=2 | pages=291-295 | url=http://www.cirp.org/library/anatomy/taylor/ | quote= | pubmedID=8800902 | pubmedCID= | DOI=10.1046/j.1464-410X.1996.85023.x | date=February 1996 | accessdate=
}}</ref><ref name="taylorcold1999">{{REFjournal
| last=Taylor | first=J.R. | coauthorsauthor-link=John R. Taylor |first2=C.J. |last2=Cold | title=The prepuce | journal=British journal of urology | volume=83 | issue=Supplement 1 | pages=34–44 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091418/PDFSTART | quote= | pubmedID= | pubmedCID= | DOI= | date=February 1999 | accessdate=
}}</ref> Opponents of circumcision have cited these studies, which report on the sensitivity or innervation of the foreskin, claiming a sexual role based upon the presence of nerve-endings in the foreskin sensitive to light touch, stroking and fluttering sensations.
Circumcision removes the [[Ridged band|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
| last=Taylor | first=J.R. | coauthorsauthor-link=John R. Taylor | title=Back and forth (letter) | journal=Pediatric news | volume=34 | issue=10 | pages=50 | url=http://www.cirp.org/library/anatomy/taylor2/ | quote= | pubmedID= | pubmedCID= | DOI= | date=October 2000 | accessdate=
}}</ref> This gliding action was also described by Lakshmanan (1980).<ref>{{REFjournal
| last=Lakshmanan | first=S. | coauthorsfirst2=S. |last2=Parkash | title=Human prepuce: some aspects of structure and function | journal=Indian journal of surgery | volume=44 | issue= | pages=134–137 | url=http://www.cirp.org/library/anatomy/lakshmanan/ | quote= | pubmedID= | pubmedCID= | DOI= | date=1980 | accessdate=
}}</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
| last=Schober JM, |first=J.M. |last2=Meyer-Bahlburg HF, Dolezal C | firstfirst2=H.F. |last3=Dolezal | coauthorsfirst3=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=April 2009 | accessdate=
}}</ref>
Boyle ''et al.'' (2002) argued that circumcision and frenectomy remove tissues with "heightened erogenous sensitivity," stating "the genitally intact male has thousands of fine touch receptors and other highly erogenous nerve endings&mdash;many of which are lost to circumcision."<ref name="boyle2002">{{REFjournal
| last=Boyle | first=Gregory J. | coauthorsfirst2=Gillian A. |last2=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."
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 | first=Z. | coauthorslast2=Chen |first2=S, . |last3=Zhu |first3=C, . |last4=Wan |first4=Q, . |last5=Chen |first5=Z. | title=Erectile function evaluation after adult circumcision | journal=Zhonghua Nan Ke Xue | volume=10 | issue=1 | pages=18-9 | url= | quote= | pubmedID=14979200 | pubmedCID= | DOI= | date=January 2004 | accessdate=
}}</ref> or decrease,<ref name="cortes2009"/><ref name= "richters2006">{{REFjournal
| last=Richters | first=J. | coauthorslast2=Patel HR, |first2=H.R. |last3=Himpson RC, |first3=R.C. |last4=Palmer JH, |first4=J.H. |last5=Mufti GR, |first5=G.R. |last6=Sheriff MK |first6=M.K. | title=Circumcision in Australia: prevalence and effects on sexual health | journal=International Journal of Sexually Transmissible Diseases and AIDS | volume=17 | issue=8 | pages=547–554 | url=http://www.cirp.org/library/general/richters1/ | quote= | pubmedID=16925903 | pubmedCID= | DOI=10.1258/095646206778145730 | date=2006 | accessdate=
}}</ref><ref name="Laumann1997"/> in erectile dysfunction among circumcised men, while other studies have shown little to no effect.<ref name="masood2005"/><ref name="krieger2008">{{REFjournal
| last=Krieger JN, |first=J.N. |last2=Mehta SD, |first2=S.D. |last3=Bailey RC, ''et al.'' | firstfirst3=R.C. | coauthorsetal=yes | title=Adult Male Circumcision: Effects on Sexual Function and Sexual Satisfaction in Kisumu, Kenya | journal=The journal of sexual medicine | volume=5 | issue=11 | pages=2610-22 | url= | quote= | pubmedID=18761593 | pubmedCID= | DOI=10.1111/j.1743-6109.2008.00979.x | date=August 2008 | accessdate=
}}</ref><ref name="senkul2004"/><ref name="Collins2002">{{REFjournal
| last=Collins | first=S. | coauthorslast2=Upshaw |first2=J, . |last3=Rutchik |first3=S, . |last4=Ohannessian |first4=C, . |last5=Ortenberg |first5=J, . |last6=Albertsen |first6=P. | title=Effects of circumcision on male sexual function: debunking a myth? | journal=Journal of Urology | volume=167 | issue=5 | pages=2111–2112 | url=http://www.circs.org/library/collins/ | quote= | pubmedID=11956452 | pubmedCID= | DOI=10.1016/S0022-5347(05)65097-5 | date=2002 | accessdate=
}}</ref><ref name="kigozi2007">{{REFjournal
| last=Kigozi | first=G. | coauthorslast2=Watya |first2=S, . |last3=Polis CB, |first3=C.B. |last4=Buwembo |first4=D, . |last5=Kiggundu |first5=V, . |last6=Wawer MJ, |first6=M.J. |last7=Serwadda |first7=D, . |last8=Nalugoda |first8=F, . |last9=Kiwanuka |first9=N, . |last10=Bacon MC, |first10=M.C. |last11=Ssempijja |first11=V, . |last12=Makumbi |first12=F, . |last13=Gray RH |first13=R.H. |etal=yes | title=The effect of male circumcision on sexual satisfaction and function, results from a randomized trial of male circumcision for human immunodeficiency virus prevention, Rakai, Uganda | journal=[[British Journal of Urology|BJU International]] | volume=101 | issue=1 | pages=65-70 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119420541/PDFSTART | quote= | pubmedID=18086100 | pubmedCID= | DOI=10.1111/j.1464-410X.2007.07369.x | date=January 2007 | accessdate=
}}</ref><ref name="kimpang2006"/>
Kim and Pang reported no significant difference in erection.<ref name="kimpang2006">{{REFjournal
| last=DaiSik | first=Kim | coauthorsfirst2=Myung-Geol |last2=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>
Waldinger ''et al.'' recruited 500 men (98 circumcised and 261 not-circumcised) from five countries: the [[Netherlands]], [[United Kingdom]], [[Spain]], [[Turkey]], and the [[United States]] and studied their ejaculation times during [[sexual intercourse]]. They found that the circumcised men in the study took on average 6.7 minutes to ejaculate, compared with 6.0 minutes for the uncircumcised men. This difference was not statistically significant. The comparison excluded Turkey, which was significantly different from the other countries studied.<ref name="Waldinger2005">{{REFjournal
| last=Waldinger | first=M.D. | coauthorslast2=Quinn |first2=P, . |last3=Dilleen |first3=M, . |last4=Mundayat |first4=R, . |last5=Schweitzer DH, |first5=D.H. |last6=Boolell |first6=M. | title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice | journal=Journal of Sexual Medicine | volume=2 | 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.'' said "Turkish men, the vast majority of whom are circumcised, had the shortest IELT [Intravaginal ejaculation latency time]."<ref name="sorrells"/>
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
| last=Senkul | first=T. | coauthorsfirst2=C. |last2=Iseri, |first3=B. |last3=Sen, |first4=K. |last4=Karademir, |first5=F. |last5=Saracoglu and |first6=D. |last6=Erden | title=Circumcision in Adults: Effect on Sexual Function | journal=Urology | volume=63 | issue=1 | pages=155–8 | url=http://www.circs.org/library/senkul/ | quote= | pubmedID=14751371 | pubmedCID= | DOI=10.1016/j.urology.2003.08.035 | date=2004 | accessdate=
}}</ref>
Laumann ''et al.'' reported that circumcised men in their survey displayed a greater rates of experience of various sexual practices, including oral sex, anal sex, and masturbation.<ref name="Laumann1997">{{REFjournal
| last=Laumann | first=E.O. | coauthorsfirst2=C.M. |last2=Masi and |first3=E.W. |last3=Zuckerman | title=Circumcision in the United States: prevalence, prophylactic effects, and sexual practice | journal=[[Journal of the American Medical Association|JAMA]] | volume=277 | issue=13 | pages=1052–7 | url=http://www.circs.org/library/laumann/ | quote= | pubmedID=9091693 | pubmedCID= | DOI=10.1001/jama.277.13.1052 | date=1997 | accessdate=
}}</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
==Female preferences and response==
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 | first=K. | coauthorsfirst2=J. |last2=O'Hara | title=The effect of male circumcision on the sexual enjoyment of the female partner | journal=BJU International | volume=83 | issue=Supplement 1 | pages=79–84 | url=http://www3.interscience.wiley.com/cgi-bin/fulltext/119091407/PDFSTART | quote= | pubmedID=10349418 | pubmedCID= | DOI=10.1046/j.1464-410x.1999.0830s1079.x | date=January 1999 | accessdate=
}}</ref> A study by psychologists Bensley & Boyle (2003) reported that vaginal dryness can be a problem when the male partner is circumcised.<ref>{{REFjournal
| last=Bensley | first=Gillian A. | coauthorsfirst2=Gregory J. |last2=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
| last=Cortés-González JR, |first=J.R. |last2=Arratia-Maqueo JA, Gómez-Guerra LS | firstfirst2=J.A. |last3=Gómez-Guerra | coauthorsfirst3=L.S. | title=[Does circumcision has an effect on female's perception of sexual satisfaction?] | journal=Rev. Invest. Clin. | volume=60 | issue=3 | pages=227–30 | url= | quote= | pubmedID=18807735 | pubmedCID= | DOI= | date=2008 | accessdate=
| language=Spanish; Castilian
}}</ref>
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
| last=Kigozi |first=G, . |last2=Lukabwe |first2=I, . |last3=Kagaayi J, ''et al.'' | firstfirst3=J. | coauthorsetal=yes | 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
| last=Wildman RW, |first=R.W. |last2=Wildman RW, |first2=R.W. |last3=Brown |first3=A, Trice C. | firstlast4=Trice | coauthorsfirst4=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=485-6 | 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}}
|-
! scope="row" | Senol (2008)<ref name="senol2008">{{REFjournal
| last=Senol MG, |first=M.G. |last2=Sen |first2=B, . |last3=Karademir |first3=K, . |last4=Sen |first4=H, Saraçoğlu M. | firstlast5=Saraçoğlu | coauthorsfirst5=M. | 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>
| Prospective; adult circumcision patients
|-
! scope="row" | Denniston (2004), cited by Denniston (2004)<ref name= "Dennniston2004">{{REFjournal
| last=Denniston | first=G.C. | coauthorsauthor-link=George C. Denniston |last2=Hill |first2=G. |author2-link=George Hill | 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>
| Not stated; survey of males circumcised in adulthood
|-
! scope="row" | Yang (2008)<ref name="yang2008">{{REFjournal
| last=Yang | first=DMD.M. | coauthorslast2=Lin |first2=H, . |last3=Zhang |first3=B, . |last4=Guo |first4=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
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