Examining the association between male circumcision and sexual function

Abstract

Objective:Despite biological advantages of male circumcision in reducing HIV/sexually transmitted infection acquisition, concern is often expressed that it may reduce sexual enjoyment and function. We examine the association between circumcision and sexual function among sexually active men in Britain using data from Britain's third National Survey of Sexual Attitudes and Lifestyles (Natsal-3). Natsal-3 asked about circumcision and included a validated measure of sexual function, the Natsal-SF, which takes into account not only sexual difficulties but also the relationship context and overall level of satisfaction.Methods:A stratified probability survey of 6293 men and 8869 women aged 16–74 years, resident in Britain, undertaken 2010–2012, using computer-assisted face-to-face interviewing with computer-assisted self-interview for the more sensitive questions. Logistic regression was used to calculate odds ratios (ORs) to examine the association between reporting male circumcision and aspects of sexual function among sexually active men (n = 4816).Results:The prevalence of male circumcision in Britain was 20.7% [95% confidence interval (CI): 19.3–21.8]. There was no association between male circumcision and, being in the lowest quintile of scores for the Natsal-SF, an indicator of poorer sexual function (adjusted OR: 0.95, 95% CI: 0.76–1.18). Circumcised men were as likely as uncircumcised men to report the specific sexual difficulties asked about in Natsal-3, except that a larger proportion of circumcised men reported erectile difficulties. This association was of borderline statistical significance after adjusting for age and relationship status (adjusted OR: 1.27, 95% CI: 0.99–1.63).Conclusion:Data from a large, nationally representative British survey suggest that circumcision is not associated with men's overall sexual function at a population level.

Medical Male Circumcision Is Associated with Improvements in Pain During Intercourse and Sexual Satisfaction in Kenya

“…In Uganda, Kigozi et al 12 used RCT data to compare sexual function and satisfaction in circumcised men (n = 2,210) and uncircumcised controls (n = 2,246) 15 to 49 years old. They found very low rates of sexual dysfunctions and dissatisfaction in men overall (<2%), whereas rates of sexual dysfunction found in the Kenyan RCT were higher (24.7% overall at baseline, 95% CI = 23.0–26.5) and generally comparable to rates found in our study and in most other countries 24, 25, 33, 34, 35, 36, 37. Differences between Kenya and Uganda in cultural views about sexuality and survey tools used in each study might have contributed to the comparably low rates of sexual dysfunction and dissatisfaction reported by Kigozi et al.…”

CDC's Male Circumcision Recommendations Represent a Key Public Health Measure

“…Furthermore, the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3), a large national probability survey, which used a new, comprehensive, validated measure of sexual function, the Natsal-SF, presented findings for 6,293 men and 8,869 women aged 16–74 years, broadly representative of the British population. The survey concluded that MC is not associated with men's overall sexual function 31 . In addition, a recent survey of 1,000 adults by an Internet-based market research firm that is a member of the British Polling Council found 29% of un circumcised men wished they had been circumcised, compared with only 10% of circumcised men who wished they had not been circumcised (margin of error ±4%) 34 .…”

Critical evaluation of arguments opposing male circumcision: A systematic review

“…The most recent of these found pain during intercourse was 64% more common in uncircumcised males, and that that erectile dysfunction was significantly less common in circumcised men . A UK study of 6293 men and 8869 women added further support . A case‐control study in Kenya found that circumcised men reported less pain during sexual intercourse than uncircumcised control men during 2 years of follow‐up .…”