Does circumcision affect sex life? 4 practice questions

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Circumcision has been practiced for thousands of years.

Historians believe that it already existed 15,000 years ago in Egyptian society and has reached our days, with about one in every three men circumcised in the world.

Circumcised men – that is, those who have had the foreskin cut off the penis, leaving the glans uncovered – are mostly Muslims. In Islam, circumcision is practiced as a ritual on newborns, just as it is in Judaism.

In second place are men born in the United States – 80.5%, according to data from 2016. In that country, circumcision has been considered a beneficial medical intervention for decades.

Most circumcisions are performed immediately after birth. Uncircumcised men may need to have the intervention later for health reasons.

Here are the science answers to four questions about circumcision.

1. What is the biological function of the foreskin and what happens when it is cut?

The foreskin is the part of the skin of the penis that covers the glans.

Unlike the rest of the skin on the penis, which is attached to the organ, the foreskin is loose. Under normal conditions, the foreskin should be able to recede until it completely uncovers the glans, both in the flaccid state and during erection.

The inner surface of the foreskin is a lubricated mucosa, similar to the inside of the mouth or vagina among women.

“Its function is to cover the organ and serve as a lining”, according to urologist Ana María Autrán, from the American Confederation of Urology.

Experts also believe that the foreskin may have some immune function.

Men can do without the foreskin, but the glans is a very sensitive area of ​​the penis. When the foreskin is removed for health reasons in childhood, adolescence or adulthood, the glans, which was previously protected, is now in direct contact with the air and clothes.

Therefore, in the first weeks, the patient feels discomfort caused by the contact of the glans with the tissues. And you may also experience pain during erections. But, over time, the skin of the glans becomes more rigid and loses some of its sensitivity.

Surgery is usually performed in two ways: the traditional way, cutting the foreskin with a scalpel, or with a surgical stapler. Only local anesthesia can be applied, although, many times, the patient is sedated before the intervention in such a sensitive region of the body.

2. When is it necessary to undergo circumcision?

Leaving religious motives aside and focusing on health reasons, there are different opinions about it.

On the one hand, there is the majority position in the United States that it is preferable to have babies circumcised when they are born. According to the American Academy of Pediatrics (AAP), “the health benefits of male circumcision in the newborn outweigh the risks.”

Among these benefits, the organization mentions the prevention of urinary tract infections, penile cancer and the spread of some sexually transmitted diseases, including HIV/AIDS.

“Male circumcision performed during the neonatal period has considerably lower complication rates than when performed later in life,” according to the AAP.

On the other hand, the organization claims that there are not enough elements to ask that circumcision be a routine intervention for all babies. “It is a decision that must be taken by the parents, always assisted by a doctor”, explains the pediatrician Ilan Shapiro, member of the AAP, to BBC News Mundo, the Spanish language service of the BBC.

The Royal Dutch Medical Association, for example, takes the opposite view. She states that babies should not undergo circumcision because “there is no convincing evidence that circumcision is useful or necessary in terms of prevention or hygiene.” Therefore, it “is not justifiable except for medical/therapeutic reasons”.

“Contrary to popular belief, circumcision carries the risk of medical and psychological complications. The most common complications are bleeding, infections, stenosis of the canal (the narrowing of the urethra) and panic attacks”, argues the organization.

The main medical reasons that can lead to circumcision are phimosis, paraphimosis and balanoposthitis.

Phimosis occurs when the foreskin is so narrow at its end that it does not allow its normal sliding until it completely frees the glans. When detected at a young age, it can be cured with creams so that surgery is not necessary.

Paraphimosis occurs when the foreskin slides completely off, but then does not return to its original position.

Balanoposthitis is inflammation of the glans, almost always caused by lack of hygiene. To avoid it, since childhood, boys should remove the foreskin and clean the region well with soap and water to remove smegma – a thick, whitish secretion – that is produced below the foreskin.

These complications can appear at any stage of life, from childhood to old age.

3. Does circumcision have an impact on sex life and sensitivity?

According to Shapiro, this is a difficult question to answer. Statistically, there are few cases of men who manage to compare their sex life before and after circumcision and, therefore, there are no conclusive studies in this regard.

While the penis adapts to its new shape after circumcision, the patient suffers increased sensitivity in the glans, which can cause discomfort, according to Autrán.

Subsequently, the skin of the glans, which was protected by the lubricated foreskin, changes when it is in direct contact with the air. “It starts to dry out, and as the skin hardens, that sensitivity changes,” explains Shapiro.

He adds that the foreskin is also a region full of nerves that are lost when it is removed.

Some patients come to the office asking the doctor to have them circumcised for cosmetic reasons. They understand that your penis will look better without the protective covering.

This type of intervention is also carried out, but some myths must be dispelled: the penis will not increase in size, will not become longer, nor will it have greater power during sex. And the ejaculation will be the same as before.

A warning from specialists is that patients do not have sexual intercourse for four or five weeks after surgery, to avoid pain and healing complications.

4. Does circumcision help prevent HIV and other sexually transmitted diseases?

One of the benefits touted by circumcision advocates is that it helps prevent sexually transmitted diseases (STDs) such as HIV/AIDS.

The UN itself, in its program to fight HIV, carries out mass circumcision campaigns in countries in eastern and southern Africa that have high levels of incidence of the virus.

It has already been shown that removing the foreskin reduces the rate of HIV transmission, but only in heterosexual men and in regions of high transmission.

“The relationship between circumcision and HIV transmission is unclear to say the least, which is illustrated by the fact that the United States has a high incidence of STDs and HIV infections with a high percentage of routine circumcisions,” states the Dutch association. “In the Netherlands, the exact opposite is true: a low incidence of HIV/AIDS, combined with a relatively low number of circumcisions.”

In men who have sex with other men and are active, the protection of circumcision against HIV is partial, while, among passive men, no differences were observed.

Other STDs, such as gonorrhea, syphilis, chlamydia, herpes, the human papilloma virus and genital ulcers, were studied by medicine because it was believed that circumcision would prevent their contagion. But there is no evidence to support this claim.

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