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Mar 17, 2023

Circumcised vs. Uncircumcised: What to Know

Is one "better" than the other? Being circumcised ("cut") means that the

Is one "better" than the other?

Being circumcised ("cut") means that the foreskin of a penis has been surgically removed, while being uncircumcised ("uncut") means that the foreskin is retained.

Historically in the United States, around 64% of male babies have undergone circumcision for preventive health reasons and/or cultural or religious reasons. Even so, the rate of male circumcision has been on the decline in recent years as some people—including some health experts—question whether the procedure is medically necessary.

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According to the United Nations Programme on HIV/AIDS (UNAIDS), around 30% of all males across the world—representing a total of roughly 670 million people—are circumcised.

This article looks at the various reasons why parents choose for their babies to be circumcised or uncircumcised. It also describes the pros and cons of male circumcision as well as the various medical concerns that may arise if you have a cut or uncut penis.

For the purpose of this article, "male" refers to people born with penises without regard to the gender or genders they identify with. The gender terms used in this article are the same used in the referenced source.

People often have strong opinions when faced with the issue of male circumcision.

On the one hand, some people consider it "unhealthy" not to undergo circumcision and regard an uncut penis as "unattractive." On the other hand, some regard the procedure as "outdated" and even "barbaric" or suggest that circumcision will undermine the sexual function of the penis.

None of these assumptions are inherently true. If anything, the heated debate can make it all the more difficult to discuss why both may be reasonable options.

In the United States, male circumcision is typically performed soon after birth but can also be performed later in life. The procedure is typically performed in a hospital but, for religious or cultural reasons, may be performed on newborns in a nonmedical setting.

Male circumcision involves the removal of the foreskin, the double layer of skin that covers the head (glans) of the penis. It is a relatively simple procedure in which the newborn's foreskin is stretched with forceps and the skin is snipped away with either scissors or a special cutting tool.

To avoid pain, a local anesthetic or a topical pain-numbing cream may be used. While not everyone uses an anesthetic for neonatal (newborn) circumcision, both the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC) recommend it to reduce pain.

Healing generally takes around a week, although it can take longer for adults.

There are many reasons a parent may choose to pursue or avoid circumcision for their child. It is ultimately an elective procedure that is not medically indicated unless the foreskin poses health concerns.

Among the reasons parents may opt to have their child circumcised include:

Among the reasons parents may opt to leave a child uncircumcised include:

Some people argue that male circumcision can negatively impact the sensitivity and sexual function of the penis and that the possible risks outweigh any perceived benefits.

In the past, the AAP largely agreed with the position, stating in the 1970s that there was "no medical indication for routine circumcision of the newborn." Since then, an increased understanding of disease transmission has led to a revision of the AAP stance.

In its most recent (2012) technical report and policy statement, the AAP found that the "health benefits of circumcision in newborn boys outweigh the risks." But, the AAP also concluded the benefits are not great enough to recommend circumcision for all newborns.

To this end, there are certain factors that may help inform whether circumcision or noncircumcision is the "right" option for you or your child.

With an uncircumcised penis, the foreskin will cover the glans like a hood whenever the penis is soft (flaccid). The foreskin is typically retractable and can be pulled back during urination to prevent splashing. During an erection, the foreskin will automatically retract and expose the head of the penis.

After circumcision, the removal of the foreskin will leave the glans permanently exposed. This can make urination easier and prevent the buildup of skin cells and oils known as smegma, which has a soft, cheesy consistency and unpleasant odor. The texture of the skin may also change.

A foreskin can cause sexual stimulation by rubbing against the head of the penis. The sensation can be further increased by mucous membranes that produce slippery mucus.

Removing the foreskin can alter these features, but it doesn't necessarily reduce sexual pleasure or the sensation of the penis itself.

While research has been conflicting (in part because penis sensitivity and pleasure are largely subjective), a comprehensive review of studies published in Sexual Medicine in 2020 concluded that male circumcision does not inherently reduce penis sensitivity.

Some studies reviewed suggested that circumcision might actually increase sensitivity by providing the glans with unobstructed contact with vaginal tissues during sexual intercourse.

The current body of evidence has also shown that male circumcision does not affect sexual function compared to uncircumcised males. With that said, there is evidence that circumcision may affect ejaculation (the emission of sperm and semen from the penis).

A 2021 review of studies published in the International Journal of Impotence Research suggests that circumcised men may be at greater risk of premature ejaculation (PE) than uncircumcised men.

The condition, in which orgasm and ejaculation occur right before or just after starting sex, is one of the most common sexual problems in males affecting up to 30% at some point in their life.

Even so, the evidence remains conflicted, with some studies suggesting a twofold increased risk of PE in circumcised men, while others show no difference in the risk at all.

There is no evidence that getting circumcised increases the risk of infertility (the inability to achieve pregnancy).

In fact, circumcision may reduce the risk of certain infections that can damage the male reproductive tract and lead to infertility. This includes HPV, a sexually transmitted infection (STI) that some researchers believe is linked to idiopathic (unexplained) male infertility.

Studies suggest that the risk of HPV is 4 times greater in uncircumcised males compared to uncircumcised males. Chronic HPV infection may, in turn, cause urethral inflammation that can potentially reduce the quality of sperm.

Parents who opt to leave a child uncircumcised will usually teach them how to clean under the foreskin. In the end, having an uncircumcised penis does not mean that you are any less hygienic than someone who is circumcised.

With that said, having a foreskin may increase your risk of certain infections if cleanliness is not maintained. This is because the skin under the foreskin is warm and moist, providing the ideal environment for bacteria or fungus (particularly is smegma allowed to accumulate).

A bacterial or fungal infection under the foreskin can lead to a number of inflammatory conditions, such as:

If a bacterial infection spreads into the urethra, it can lead to a urinary tract infection (UTI).

While some people may suggest that one is "better" or "worse" than the other, circumcised and uncircumcised penises are both vulnerable to medical conditions, some of which may be serious.

Medical conditions may arise after circumcision surgery. Postsurgical complications are rare and most often occur when the procedure is performed by a poorly trained nonmedical practitioner.

Possible complications include:

There are a number of conditions that uncircumcised males are vulnerable to. In addition to an increased risk of infection, a foreskin will sometimes not retract as it's supposed to, leading to aggravating and potentially serious conditions known as:

A foreskin can also increase the risk of getting certain sexually transmitted infections, albeit in slightly different ways, including:

Some studies suggest that having a foreskin may also increase the risk of penile cancer, a disease linked to chronic HPV infection. Even so, the evidence remains inconclusive, and removing a foreskin during adulthood is unlikely to reduce the risk.

Although circumcision is most commonly performed in newborns, there are occasions when it is medically indicated in adults, such as for phimosis or paraphimosis. Others may opt to be circumcised if it causes pain during sex or if faced with recurrent balanitis or UTIs.

Others still may schedule revision surgery to correct a botched circumcision or decide to pursue circumcision for cosmetic, religious, or relationship reasons.

Whatever the reason, the procedure is largely the same as it is in babies, albeit with a few alterations, as follows:

As long as there are no immediate complications, most people can return home on the day of the surgery. Recovery time can take anywhere from two to three weeks.

Neither circumcision nor the lack of circumcision is "bad" or "good." Each poses certain health benefits and risks.

Uncircumcised penises are vulnerable to infection and conditions like balanitis, phimosis, and paraphimosis. Having a foreskin may also increase the risk of getting sexually transmitted infections like HIV, HPV, and genital herpes.

While circumcision is relatively safe, there may be a risk of infection and other post-op complications. With that said, circumcision is generally not associated with the loss of sensitivity, sexual function, or fertility.

Despite the potential benefits, the decision to have your baby—or yourself—circumcised is an individual one. There is no "right" or "wrong" choice.

Having a circumcised or uncircumcised penis has no inherent impact on your ability to achieve or sustain erections. With that said, a condition called phimosis—in which the foreskin does not retract over the head of the penis as it's meant to—can cause painful erections and interfere with your ability to maintain erections.

People will tell you different things about how their penis feels before and after circumcision. Some report greater sensitivity, while others report less or no change in sensitivity. The answers tend to be subjective. But, on its own, circumcision is not associated with a loss of sensitivity or sexual pleasure.

Being circumcised or uncircumcised is neither "good" nor "bad." The decision may be based on religious or cultural concerns or the perceived health benefits or risks. With that said, having an uncircumcised penis does not mean you are either "unhygienic" or at inherent risk of disease. The decision to have or not have a circumcision is ultimately a personal one.

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By James Myhre & Dennis Sifris, MDDennis Sifris, MD, is an HIV specialist and Medical Director of LifeSense Disease Management. James Myhre is an American journalist and HIV educator.