Circumcision in men: recovery, risks and the research on sensitivity

Circumcision is surgery to remove the foreskin, and in Britain about one man in five has had it: Britain's third national sex survey, Natsal-3, put the figure at 20.7%. On the NHS it's only done for medical reasons.

What is circumcision?

Male circumcision is surgery to remove the skin that covers the head of the penis (the foreskin). The British Association of Urological Surgeons (BAUS) describes the result: the whole foreskin is removed, leaving the head of the penis completely exposed, and that's what a circumcised penis looks like.

Circumcised means a man has had this done, either as a child, sometimes for religious reasons, or later in life for a medical reason. The NHS says it's used to treat men and boys.

Why do men get circumcised?

On the NHS, circumcision is only available for medical reasons, and it's usually offered only when other treatments haven't worked or it's the only option. The NHS says it may be needed if you:

• keep getting a swollen, itchy or sore foreskin or head of the penis, or infections of the foreskin (balanitis)
• have a tight foreskin (phimosis) that's causing problems, such as painful erections or difficulty peeing
• can't pull back your foreskin
• have scarring or tightness that has led to problems with your foreskin, which can be caused by conditions such as lichen sclerosus
• have other problems with the way your penis has grown, such as a very curved penis

It may also be recommended as part of treatment for cancer of the penis, although this is rare. NHS inform in Scotland says a tight foreskin is the most common reason. Circumcision is also common in certain religions, for example in Jewish and Muslim communities, according to NHS inform.

Is circumcision necessary?

Not always. BAUS lists alternatives that may suit some men: topical treatment, including short-term use of a steroid cream, which for a tight foreskin may decrease inflammation and relieve some tightness, though symptoms often return once treatment stops; a dorsal slit, a cut at the tip of the foreskin; frenuloplasty, an operation on a tight frenulum; and preputioplasty, which widens the foreskin. BAUS adds that topical treatment isn't suitable or effective in all patients, and that circumcision is usually necessary if it fails.

What happens during a circumcision?

Circumcision is usually done in hospital, and you should be able to go home the same day. The NHS says it's usually done under general anaesthetic (you're asleep), but sometimes with a local anaesthetic, where you will not be able to feel anything in the area around your penis, or with an epidural, where you will not be able to feel anything from the waist down.

The procedure takes about 30 minutes and is the same for adults and children. The NHS describes three steps:

1. The surgeon makes a circular cut around your foreskin, just below the head of your penis.
2. The foreskin is removed.
3. Dissolvable stitches attach the skin to the shaft below the head of your penis. They should dissolve after 2 to 6 weeks.

If you've had a general anaesthetic, someone needs to take you home, and you shouldn't drive for at least 24 hours.

How long does circumcision take to heal?

It takes 4 to 6 weeks for the penis to heal after a circumcision, although sometimes it may take longer, according to the NHS. Swelling, bruising and some minor bleeding are normal for 1 to 2 weeks. BAUS says it can take up to six weeks before the penis looks the way it finally will.

The NHS says the head of the penis will usually be very sensitive after the operation. This can be uncomfortable but should ease after a few weeks. You may also feel tightness or discomfort when you get an erection, the NHS adds, which usually goes away within a few months as the scar tissue stretches, but sometimes it can cause bleeding.

The NHS advice while you recover:

• wear loose-fitting clothing and underwear
• take painkillers such as paracetamol or ibuprofen if you need them, following the leaflet
• wash the area carefully and pat it dry or let it air dry
• stay off work for a week
• don't swim, ride a bike, play sport or do any heavy lifting for at least 2 weeks
• don't have sex or masturbate for at least 4 weeks, or until the wound has fully healed

Does circumcision hurt?

You're usually asleep for the operation, and you'll be given painkillers for pain and swelling in the recovery room. BAUS says surgeons use local anaesthetic nerve blocks, whatever the type of anaesthetic, to give pain relief after the operation. Discomfort in the first weeks is normal, but the NHS says to get help if the pain is very bad or isn't getting better (see below).

What are the risks of circumcision?

Most people only have minor complications, such as bleeding, the NHS says. Sometimes another operation is needed, to stop bleeding, remove more skin because of swelling, or improve how the penis looks after it has healed, if you're concerned. Rarely, circumcision can narrow or damage the urethra, the tube that carries pee out of the bladder.

BAUS lists the after-effects and how often they happen:

• swelling of the penis, which usually lasts up to 7 to 14 days: all patients
• increased sensitivity of the head of the penis for up to two weeks: almost all patients
• "permanent altered or reduced sensation" in the head of the penis: almost all patients
• infection of the wound needing antibiotics or drainage: 1 in 50 to 1 in 100 (1 to 2%)
• bleeding from the wound, occasionally needing a further procedure: 1 in 50 to 1 in 100 (1 to 2%)
• dissatisfaction with how it looks: 1 in 50 to 1 in 250
• swelling of excess skin needing further surgery: 1 in 50 to 1 in 250
• anaesthetic or heart and circulation problems, possibly needing intensive care, including chest infection, a clot in the lungs, stroke, deep vein thrombosis, heart attack and death: 1 in 50 to 1 in 250 (your anaesthetist can estimate your own risk)

BAUS adds that the procedure has no effect on ejaculation or fertility. A 2021 review of 351 studies, covering more than 4 million people, found that complications needing treatment followed about 4 in every 100 circumcisions. There were twice as many after circumcisions done for a medical reason (7.47%) as after others (3.34%).

Does circumcision reduce sensitivity?

The NHS says circumcision usually leads to loss of sensitivity of the head of the penis, which may be noticeable during sex, but that it shouldn't have a major effect on your sex life in the long term. BAUS lists "permanent altered or reduced sensation" in the head of the penis among the after-effects, for almost all patients. Studies of sensitivity and of sex afterwards disagree.

The 2013 review of the higher-quality studies found no overall adverse effect on sensitivity, sexual function or satisfaction. Two other reviews could not support the idea of poorer sexual function, though one rates the evidence low quality and the other calls for more studies of medical circumcision and age at circumcision. Some surveys and a touch test found differences, as the table shows. The NHS also notes that without a foreskin, the skin of the penis won't move in the same way as before, and that these changes may make your experience of sex or masturbation different. BAUS says that most men adapt to these changes and enjoy a healthy sex life.

Circumcised vs uncircumcised men: what the main studies found

	Who took part and how.	What it found.	Limits.
Morris and Krieger, 2013 (systematic review)	36 studies with original data, covering 40,473 men	The higher-quality studies found no overall adverse effect on sensitivity, sexual sensation, function or satisfaction; 10 of the 13 low-quality studies reported impairment in one or more measures	Only 2 of the 36 studies were randomised trials
Tian and colleagues, 2013 (meta-analysis)	10 studies: 9,317 circumcised and 9,423 uncircumcised men	No significant differences in sexual desire, pain during sex, erection problems or orgasm difficulties	The authors call the evidence low quality, with large differences between studies
Shabanzadeh and colleagues, 2016 (systematic review)	38 studies, including 2 randomised trials	Poorer sexual function after circumcision was not supported; increased penile sensitivity was one of the differences found (grade A to B); after medical circumcision, problems reaching orgasm were more common, on weaker evidence (grade C), and erection problems were reported inconsistently (grade D)	More studies of medical circumcision and age at circumcision needed
Kigozi and colleagues, 2008 (randomised trial, Uganda)	4,456 HIV-negative men aged 15 to 49; half were circumcised straight away, half 2 years later	No adverse effect on sexual satisfaction or clinically significant function	Self-reported; problems were rare in both groups (under 2%)
Krieger and colleagues, 2008 (randomised trial, Kenya)	2,784 men aged 18 to 24 randomised in Kisumu, 100 of them left out of the analysis	Circumcision wasn't linked to sexual dysfunction; after 2 years, 64.0% of circumcised men said their penis was much more sensitive than before	Self-reported; young men taking part in an HIV prevention trial
Homfray and colleagues, 2015 (national survey, Britain)	Natsal-3, 2010 to 2012: 4,816 sexually active men aged 16 to 74	No link between circumcision and overall sexual function; erectile difficulties were reported a little more often, a borderline finding	Self-reported; didn't ask men their age at circumcision
Frisch and colleagues, 2011 (national survey, Denmark)	5,552 men and women (women reported on their spouse); about 5% of Danish men are circumcised	Circumcised men were more likely to report frequent orgasm difficulties (11% against 4%); women with a circumcised spouse more often reported frequent sexual difficulties overall (31% against 22%)	A one-off survey, self-reported
Bronselaer and colleagues, 2013 (online survey, led from Ghent, Belgium)	1,369 men (310 circumcised) recruited through leaflets and adverts	Circumcised men reported less sexual pleasure and lower orgasm intensity at the head of the penis, and more unusual sensations	Volunteers who chose to answer; self-assessment
Sorrells and colleagues, 2007 (touch test, led from the US)	Adult volunteers tested with fine filaments	The head of the circumcised penis was less sensitive to fine touch; the most sensitive area of the uncircumcised penis was on the foreskin	Light touch only; the abstract doesn't report how many men took part
Bossio and colleagues, 2016 (sensory testing, led from Canada)	62 men aged 18 to 37: 30 circumcised as babies, 32 not	No difference in sensitivity to touch, pain, warmth or heat pain at any site; the foreskin of uncircumcised men was more sensitive to touch than other sites, but not to the other tests	A small group of young men; the circumcised men were all circumcised as newborns

The reviews pooled earlier studies. The trials and surveys asked men (and in Denmark, women too) about their sex lives; the touch and sensory tests measured sensation directly. Figures are as each study reports them.

Why do the studies disagree?

They measured different things in different men. Some tested sensation on the skin with instruments; others asked men about their sex lives in trials or surveys. The researchers' own reports point to these differences:

• Study quality. In the 2013 review, the lower-quality studies were the ones that mostly found problems, and the reviewers note flaws in their design, selection, statistics or interpretation.
• Age at circumcision. In the Belgian survey, men circumcised in adolescence or later reported less pleasure at the head of the penis than men circumcised before puberty. The 2016 review found that a younger age at circumcision seemed to cause less sexual dysfunction.
• Who was studied. The two large trials enrolled African men taking part in HIV prevention studies, the sensory testing study had 62 men, and the surveys relied on volunteers or self-report. A 2014 review of the research, with a focus on North America, called for rigorous research on sexual function and penile sensitivity, and for objective outcomes.

For erections specifically, the British survey found erectile difficulties a little more often in circumcised men, a borderline result, while the higher-quality studies in the 2013 review found no adverse effect on erectile function. If erection problems keep happening, our guide to erectile dysfunction covers the common causes and what helps.

For more men's questions answered from the research, see our sex questions hub, including average penis size.

When to see a GP after circumcision

The NHS gives three levels of warning signs after a circumcision.

See a GP if:

• the stitches haven't dissolved after 6 weeks
• there's pus, discharge or a smell coming from the wound
• the wound re-opens
• you have new bruising or bleeding
• the tip of your penis looks narrower or your pee comes out slowly

Ask for an urgent GP appointment or get help from NHS 111 if:

• you have bleeding that doesn't stop
• the wound is red or feels warm (redness may be harder to see on black or brown skin)
• you have a high temperature, or feel hot, cold or shivery
• you're finding it very difficult to pee, or there's blood in your pee
• your penis is very painful, or the pain isn't getting better

Call 999 or go to A&E if you can't pee at all.

Foreskin problems

For a tight foreskin, the NHS says to see a GP if it's tight and swollen or painful, if there's bleeding, a thick discharge or an unpleasant smell, if peeing is painful or difficult, or if you're having painful erections. For symptoms of balanitis, such as a swollen, itchy, sore or red head of the penis, the NHS says adults can also go to a sexual health clinic for assessment, and that many clinics offer a walk-in service.

Call 999 or go to A&E if your foreskin is pulled back and can't go back to its original position over the end of the penis. This is called paraphimosis, and the NHS calls it a medical emergency.