Typically when we talk about male sexual anatomy and health, we talk about parts of the body that all men have.  Here, however, we’re going to stray slightly from that path---by discussing a body part that all men are born with, but that many no longer possess:  the foreskin.  The foreskin is a “hot” issue (pun intended!) in the community on a number of levels.  Hot, first, because there is some debate both in the medical community and in the community at large about the benefits and deficits of the foreskin.  And hot, second, because many men find the foreskin to be a very erotic part of the male anatomy.  So discussion of the foreskin seems relevant for all of us---whether you have one or not!

What is the foreskin?  The foreskin is a thin sheath or tube of skin that extends over the head of the penis.  This skin is very rich in nerve endings and is extremely sensitive.  In many men with an intact foreskin, it is loose enough to be manipulated, rolled, stretched, and/or massaged.  The presence or absence of a foreskin, or as most of us say being “cut” or “uncut,” does have some affects on both health and sexual pleasure for men.  Most men in the US do not have a foreskin because at birth or early in childhood they undergo a medical procedure called circumcision that removes the foreskin.  An estimated 2/3 of US men are circumcised.  For some, circumcision is part of a culture or religion (for example, the Jewish community traditionally circumcises its infant boys).  For many others, however, circumcision is a fact of life because it has become an American cultural norm.   Circumcision is somewhat less common in many communities of color in the US and is definitely practiced far less outside the United States.  It is also worth noting that over time norms about circumcision have started to evolve and so families who choose not to circumcise their sons are becoming more common.

Many doctors once believed that circumcision was necessary for both the physical and mental health of young men.  (In fact at one point in our history it was the supposed cure for “masturbatory insanity”!).  It has also been recommended by many physicians over the years to improve cleanliness, decrease STD’s, and avoid cancer.  Critics of circumcision, however, have argued that these concerns are not valid and, furthermore, that circumcision is a cruel and unnecessary procedure.  Whatever your thoughts on circumcision and the foreskin, however, there are some interesting health tips to know about:

1.    HYGIENE:  One of the primary concerns raised by proponents of circumcision is that it is possible for dirt, bacteria, soap, and other foreign particles to get trapped under the foreskin.  This can lead to a range of concerns ranging from a build-up of smegma, a creamy substance that can develop under the foreskin, to balanitis, an infection that can cause inflammation in the head of the penis.  Many opponents of circumcision, however, rightly argue that these health issues can be relatively easily avoided if men are educated from a young age about proper hygiene.  Keeping the penis, and foreskin, clean is critical for both hygiene and health reasons.

2.    SENSITIVITY:  An intact foreskin often provides enhanced sexual sensitivity for an uncircumcised man.  And many men, cut or not, find uncut partners very appealing.  The foreskin can also be sensitive in other ways.  Namely it can be easily irritated by harsh soaps or aggressive washing, scrubbing, or rubbing (including, perhaps, during sex play).  Taking care with how you (or your partners) handle the foreskin and choosing mild soaps and/or warm water can go a long way to prevent problems and keep you feeling great!

3.    TIGHTNESS:  For some men the foreskin is very tight around the penis…in some cases, uncomfortably so.  A condition known as phimosis results when the foreskin is so tight it cannot be easily retracted over the penis head…which can be both inconvenient and uncomfortable.  For these men, talking to a physician about ways to expand or stretch the foreskin can often help---and a small percentage of men may opt for circumcision in adolescence or adulthood to alleviate the issue.

4.    DISEASE RISK/PREVENTION:  Many studies have suggested that uncircumcised men are higher risk for STD’s and HIV.  There are a variety of reasons for why this risk might be heightened.  It could be because of the types of cells that line the foreskin, the fact that the skin on the head of uncircumcised men is more sensitive and perhaps more permeable to infection, or that the foreskin can trap virus or bacteria inside.  Many men may even have read or heard recommendations that circumcision, including as an adult, is an important HIV & STD prevention strategy.  This is a hotly debated issue…but here is what we think is most important to understand:  Indeed there may be some evidence that being uncut might increase risk for STDs during unprotected sex (specifically insertive anal & vaginal sex)…however, that is not necessarily a call to action for all men to run out and get circumcised.  In fact, a report published by the CDC in the summer of 2009 actually demonstrated that circumcision was NOT a significant factor in lowering HIV risk in men who have sex with men.  In addition, whether or not to have this procedure performed is a deeply personal decision and not one that should be undertaken lightly.  A more moderate approach for men concerned about HIV/STD risk would be to advise uncut men to practice safer sex during anal and/or vaginal sex OR to have sex only with a partner(s) who they know to be HIV/STD-free.

Whether you have a foreskin or not, or whether you desire one on your partner or not, knowing all you can about your own body and the body of your partner(s) is beneficial for everyone's health and pleasure.