Two Studies Look at Circumcision's Effect on Sex
Tue May 7, 1:27 PM ET

By Alison McCook

NEW YORK (Reuters Health) - In some of the first efforts to study the effect of male circumcision on sexual function, two new papers present opposite findings, providing evidence to support both sides of the debate surrounding the procedure.

In one study, University of North Carolina researchers led by Dr. Kenneth Fink showed that adult men who underwent circumcision reported a decrease in both erectile functioning and penile sensitivity after the procedure.

In the other study, based on results from a much smaller group of patients, Dr. Sean Collins of Louisiana State University and his team found that newly circumcised adult men reported no difference in sexual functioning after the procedure.

Fink and his team also noted that, despite reporting a decrease in their sexual pleasure, 62% of men said they were satisfied with the results of the procedure. In both studies, most of the men underwent the procedure for the treatment of a medical condition, such as phimosis, a condition in which the foreskin cannot be pulled back over the head of the penis.

Around 77% of American-born men in the US are circumcised, although that number appears to be declining rapidly in some regions of the country. In one Washington state study, only 37% of baby boys born between 1987 and 1996 were circumcised in the hospital.

In recent years, a debate has risen over the merits of the procedure, with one side citing the decreased rate of infections and sexually transmitted diseases among circumcised men, and the other stressing the pain and stress inflicted on a baby during circumcision, as well as the complications that can arise from the procedure.

The current policy of the American Academy of Pediatrics is that the potential medical benefits of male circumcision are not substantial enough to recommend that all boys become circumcised.

Despite anecdotal evidence that circumcised penises are less sensitive than uncircumcised penises, no studies have examined the effect of adult male circumcision on sexual functioning and pleasure--that is, until the appearance of these two studies, both published in the May issue of the Journal of Urology.

In the study conducted by Fink and his team, the authors asked 123 men who were already circumcised as adults to compare their sexual functioning and pleasure from before and after the procedure. The study by Collins and his colleagues was based on surveys of 15 men conducted both before and 12 weeks after the procedure.

Commenting on the Collins study to Reuters Health, Fink explained that talking to patients both before and after the procedure is a better way to measure changes, but that 15 patients is simply too small a group to detect anything other than large differences.

Fink added that both studies are flawed in that they examine sexual functioning changes in adults undergoing circumcision who, in most cases, opt for the procedure to correct medical problems. Consequently, Fink explained that a man's report of his sexual enjoyment and functioning could be influenced by the medical condition that prompted circumcision.

Based on this reasoning, Fink said, one would expect study participants to report an increase in sexual functioning after the procedure, which could be attributed to an improvement in the medical condition. However, a decrease in sexual functioning, as reported in Fink's study, shows there is likely some other factor influencing the change, he said.

As an explanation for why the men in his study reported high satisfaction despite a decrease in sexual functioning, Fink said that some were happy to have lower sensitivity, which enabled them to postpone orgasm, and better please their partners.

Fink noted that a man's report of sexual satisfaction depends on a number of factors.

"It means different things to different men," he said. "Overall, it looked like it was worth it to them to have the procedure."

Fink stressed that studies of circumcised adults cannot be directly applied to newborns, but that parents may wish to consider these findings when deciding whether to circumcise their children.

SOURCE: Journal of Urology 2002;167:2111-2116.