New Circumcision and Sexual Satisfaction Study a Cut Above

98% of men reported sexual satisfaction and normal sexual function after circumcision

A study, published in the January issue of BJU International, sheds more light on the impact of circumcision on male sexual satisfaction and function. It also significantly raises the bar in terms of methodology and reduced rhetoric in a research area that is highly politicized and fraught with problems.

The study involved 4, 456 sexually experienced Ugandan men (aged 15 to 49) who were HIV negative. All men were scheduled to receive circumcision, however one group was circumcised as soon as the study began and a second group was circumcised 2 years later. Researchers looked at sexual desire, satisfaction and function in both groups at six, 12, and 24 months. Their findings included:

• 98.6 per cent of the circumcised men reported no problems in penetration, compared with 99.4 per cent of the control group.
• 99.4 per cent of the circumcised men reported no pain on intercourse, compared with 98.8 per cent of the control group.
• Sexual satisfaction was more or less constant in the circumcision group – 98.5 per cent on enrolment and 98.4 per cent after two years – but rose slightly from 98 per cent to 99.9 per cent in the control group. This difference was not felt to be clinically significant.
• At the six-month visit there was a small, but statistically significant, difference in problems with penetration and pain among the circumcised group, but this was temporary and was not reported at subsequent follow-up visits.

The authors point out that the gains in sexual function and satisfaction may be a result of the education and treatment received by participants during the study. If a participant disclosed a sexual problem they were referred for treatment.

While this study represents the largest randomized examination of this issue, and in my opinion the researchers do a much better job of acknowledging and minimizing their bias than in many other surveys of sexual satisfaction and circumcision, it is not without limitations.

As the authors themselves point out, both groups reported remarkably low sexual dissatisfaction and sexual dysfunction at the start of the study. Less than 2% of all participants in this Ugandan study reported dissatisfaction or dysfunction, compared to 7% in an earlier trial in Kenya. Figures in the U.S. of erectile dysfunction in the same age group (20-49) are around 6.5%.

They also point out that it was not possible to keep the circumcision status of participants from those administering the study, as such researcher bias is a possibility. Questions about satisfaction and function were asked in face to face interviews, and, as with all sex research, there is a distinct possibility that study participants’ responses were not completely honest.

Not mentioned by the authors is the fact that the number of participants who were circumcised and stayed with the study to the two year mark was very small. While the majority of participants came back at six and twelve months, less than half returned at the two year point. While we can’t know what this means exactly, it may point to this group as being less than representative.

In terms of the studies ability to say something general about sexual satisfaction, there were other methodological limitations. Sexual satisfaction was evaluated solely on the basis of satisfaction with intercourse. While it’s reasonable to focus on intercourse as an activity that is likely to be impacted by circumcision, this research fails to take into account any other sexual acts, thus limiting what we can say about the findings. They also failed to ask participants about how prominent a role intercourse played in their sex lives. So while they may be happy with the intercourse, it’s possible their overall satisfaction went up or down, depending on what they value most in their sex lives.

A final element of this study which I think is particularly exciting is the overall connection the researchers are making to sexual pleasure. Whether one agrees with their agenda or not they are realizing that sexual pleasure is a key part of sexual health promotion and intervention. The fact is that we need more talk about sexual pleasure in all sexual health discussions, whether its about STD prevention, sexual assault prevention, or promotion of healthy sexual behaviors. This study takes an important step in the right direction.

Read more – Sex and Circumcision

Related - Circumcision Info. from About Pediatrics; Circumcision Info. from About Pregnancy/Childbirth

_{Source:: Kigozi, G., Watya, S., Polis, C.B., et al. “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” BJU International Vol. 101, No. 1 (2008): 65-70.}

_{Photo credit: Blaise Hayward/Getty Images}