Circumcision is the surgical removal of the foreskin from the human penis. It is one of the most common procedures in the world, with roughly 38% of men globally being circumcised as of 2021. The procedure dates back thousands of years and has roots in religion, culture, and health. In recent decades, the practice has become controversial, with opponents arguing that circumcision can reduce sexual pleasure and sensitivity. This article will examine what research says about how circumcision affects penile sensitivity and sexual function.
Background on Circumcision Prevalence
Circumcision rates vary dramatically globally and between different groups. According to 2021 statistics:
- 69% of newborn boys in the United States are circumcised.
- 20% of men worldwide are circumcised, with the highest rates in the Middle East, Africa, and Muslim countries.
- Less than 20% of men in Europe, South America, and Asia are circumcised.
These vast differences come from cultural and religious norms. For instance, circumcision is near-universal in Jewish and Muslim communities. The procedure gained acceptance in countries like the US due to potential health benefits. However, other Western countries saw little reason to adopt the routine practice.
Functions of the Foreskin
To understand how circumcision might impact sensitivity, it helps to first review the anatomy and functions of the foreskin:
- The foreskin is a double-layered fold of skin and mucous membrane that covers the glans penis and urinary opening.
- It comprises up to 50% of the penile skin and forms a moist, protective barrier.
- The foreskin contains a dense concentration of nerve endings, blood vessels, and specialized erogenous tissue like the ridged band.
- It provides lubrication, facilitates intercourse, and protects the glans from chafing and drying out when flaccid.
With circumcision, most of these structures are removed, exposing the glans and meatus. Advocates argue this has no effect on function, while critics claim it can desensitize the penis.
Mechanisms for Reduced Sensitivity
There are several mechanisms by which circumcision could potentially decrease penile sensitivity:
Removal of Sensitive Nerve Endings
The foreskin itself, especially the ridged bands and frenulum, contain thousands of sensitive, erogenous nerve endings. These are necessarily damaged or removed by circumcision. A 1999 study found that the foreskin contains over 10,000 nerve endings, significantly more than the glans penis. These nerve networks are thought to play a role in sexual stimulation.
Increased Keratinization and Drying
Intact penises benefit from the moist environment created by the foreskin, keeping the glans soft, supple, and sensitive. After circumcision, the glans is exposed to air, clothing, and friction, causing it to undergo keratinization – a drying and thickening of the epithelial layer. This process desensitizes the glans by dulling nerve sensation.
Loss of Penile Mobility
The foreskin acts as a gliding mechanism during intercourse through its “rolling” action. This mobility eases penetration and provides additional stimulation. Circumcision eliminates this gliding mechanism, potentially reducing stimulation.
Increased Difficulty with Stimulation
For sexual activities like masturbation, the foreskin provides an extra layer of tissue that can stimulate the glans without direct handling. Removing this may necessitate more forceful masturbation post-circumcision.
Studies on Circumcision’s Impact on Sensitivity
While the anatomical effects of circumcision provide a mechanistic rationale for reduced sensitivity, the actual degree of impact remains debated. Here is what various studies have found:
Studies Suggesting Circumcision Reduces Sensitivity
- A 2013 Belgian study found that circumcised men reported decreased sexual pleasure and lower penile sensitivity, especially to fine-touch compared to intact men.
- A 2021 systematic review concluded that the most sensitive regions of the penis are removed by circumcision and that available evidence indicates decreased sensitivity post-circumcision.
- A 2007 study found that the five most sensitive penile areas had been removed in circumcision. It also found that the foreskin was more sensitive than the most sensitive area of the circumcised glans.
Studies Finding Minimal or No Reduction in Sensitivity
- A 2016 study measured penile sensitivity in 193 intact and 118 circumcised men using electromagnetic testing. It found no clinically significant difference in fine-touch or pain sensitivity between the two groups.
- A 2013 systematic review concluded that the “highest-quality studies suggest that medical male circumcision has no adverse effect on sexual function, sensitivity, sexual sensation, or satisfaction.”
- A 2020 study measured penile sensitivity using quantitative sensory testing in 62 infants before and after circumcision. It found no long-term change in sensitivity by the age of 24 months post-circumcision.
Studies Indicating Circumcision May Increase Sensitivity
Some research has found evidence that circumcision might even increase sensitivity:
- A 2017 study measured warmth detection and heat pain thresholds in the glans of 20 men before and after circumcision. It found improved sensitivity to warmth detection after circumcision.
- A 2005 study found adult male circumcision increased sexual enjoyment and sensation based on ratings from a self-reported survey.
Subjective Satisfaction and Problems with Intercourse
While good data on penile sensitivity are lacking, there is consistent evidence that circumcision has little impact on subjective sexual satisfaction:
- Most studies find no statistically significant difference between circumcised and intact men in ratings of sexual function, satisfaction with sex life, premature ejaculation, erectile dysfunction, etc.
- A 2013 systematic review concluded circumcision has no adverse effects on sexual function, sensation, or satisfaction.
However, some evidence points to an increased risk of certain issues affecting sexual performance and satisfaction after circumcision:
- A 2011 Danish study found circumcised men were ~3 times more likely to experience frequent orgasm difficulties than intact men.
- Surveys have found ~5% of circumcised men experience uncomfortable tightness or skin lacking during erections compared to <1% of intact men.
- One study observed more vaginal dryness during intercourse amongst couples where the man had been circumcised.
Factors that May Impact Degrees of Sensitivity Loss
Not every circumcision removes the same amount of erogenous tissue or impacts sensitivity equally. Here are some factors that play a role in determining potential sensitivity loss from circumcision:
Method and Amount of Foreskin Removed
- More tissue is removed by some methods like radical dorsal slit than by more minor cuts.
- Some cultures remove only the tip while others remove all or almost all of the foreskin.
Age at Circumcision
- Infant circumcision removes 20,000+ nerve endings before they fully develop.
- Adult circumcisions impact long-established neural pathways.
Degree of Exposure and Keratinization
- Tight circumcisions lead to more irritation and keratinization.
- Retaining some slack skin preserves more sensitivity.
Surgical Skill and Accidental Damage
- Botched procedures or damage to the frenulum can diminish sensitivity.
- Expert surgeons working carefully may mitigate sensitivity losses.
Do Men Perceive Decreased Sensitivity After Circumcision?
While research data are mixed, anecdotal self-reports suggest that some men do perceive a loss of sensitivity following circumcision:
- Surveys find 5-25% of circumcised men report inadequate penile sensitivity, a common complaint.
- Many men in online anti-circumcision communities attribute sexual problems to reduced sensitivity from infant circumcision.
- Lawsuits have been filed by some circumcised men against doctors for allegedly diminishing sexual function and sensitivity.
However, such self-reports are subjective and lack controls, making results ambiguous. Men circumcised in infancy also have no comparative experience of sex before vs after the procedure.
Potential Compensatory Factors
While circumcision initially reduces penile sensitivity, some evidence indicates that other sensory mechanisms may compensate:
- Increased exposure over time may desensitize the glans and pain receptors but upregulate light touch sensation.
- The brain may adapt to the new sensory inputs and increase pleasure signaling from the remaining sensors.
- Circumcised men may learn techniques or apply stimulus to the sensory areas they still possess.
Such nervous system adaptability makes pinpointing the degree of sensitivity loss from circumcision challenging.
Impact on Female Partners
Circumcision does not only affect male sensitivity, but some research indicates it potentially impacts sensations and satisfaction for female partners as well:
- Surveys have found that women were ~3 times more likely to experience orgasm difficulties with circumcised partners compared to intact partners.
- Studiesobserve more vaginal dryness during sex amongst women with circumcised partners.
- This could be due to reduced penile mobility and rougher skin texture decreasing lubrication and friction.
However, other studies show no difference in female sexual enjoyment, highlighting the need for more research on partner effects.
Conclusion
The literature presents conflicting evidence on whether circumcision reduces penile sensitivity and to what extent. While some well-designed studies have found decreased sensitivity, others using different methodologies show no effect. Much depends on the specific technique, amount of tissue removed, and how the brain adapts.
On balance, while adult circumcision may well carry some risk of diminished sexual sensitivity, moderate infant circumcision likely has modest sensory effects in most men and little impact on sexual satisfaction based on self-reports. But a subset of men circumcised tightly or who sustain surgical damage may experience more severe sensitivity losses negatively impacting function. There is also some evidence that female partners report sexual side effects like increased difficulty with arousal.
More high-quality research controlling carefully for variations in procedures and measuring sensitivity changes across specific penile sites will help clarify the nuanced picture. In the meantime, families weighing the cultural, religious, and minor potential health benefits of circumcision should consider unanswered questions around penile sensitivity impacts as part of a risk-benefit calculation. Like most facets of sexuality, sensitivity and satisfaction remain highly subjective and multifactorial.