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ResearchBlogging.orgThe best way to prevent sexually transmitted infections is the proper use of condoms. That being said, it’s not the only way to prevent STI’s. Abstinence is one way, but it involves an amputation of sorts—the removal of a critical human behavior. Another amputation (of sorts) that prevents STIs is circumcision. Male circumcision has been found in several good studies to reduce the rate of HIV transmission, and now a study out of Uganda shows a significant decrease in rates of genital herpes infections (HSV-2), human papilloma virus (HPV) infection (the strains that cause penile, cervical, and anal cancer), but no decrease in syphilis infection.

This study complements the our knowledge on the benefits of circumcision to prevent disease. The authors emphasize that circumcision alone is not sufficient, but may be a useful adjunct to prevent serious STIs. In fact, STI’s tend to travel together, and ulcerative diseases such as herpes increase transmission of HIV.

Now people get a little touchy about male circumcision. Despite the lack of data to show negative effects, there is a reasonable question to be asked as to whether the removal of the foreskin, whatever benefit may accrue, is worth any loss of sexual pleasure that may result. This is a tough outcome to study. Most males are circumcised as infants and know no different. However, a small study was published in the Journal of Urology a few years back that asked an interesting question: if you circumcise an adult male, what differences will he report? In the study published, they found that men reported decreased erectile function, decreased penile sensitivity, but increased satisfaction.

The study has its limitations of course, but what it did not find was a group of terribly unhappy men.

The science is quite clear; circumcision effectively prevents the transmission of a number of important diseases, and used in congress with condoms has a great potential to reduce the plagues killing millions of people yearly. What has yet to be answered is whether the human cost of circumcision, whatever that may be, justifies its use.

References

Aaron A.R. Tobian, M.D., Ph.D., David Serwadda, M.Med., M.P.H., Thomas C. Quinn, M.D., M.Sc., Godfrey Kigozi, M.B., Ch.B., M.P.H., Patti E. Gravitt, Ph.D., Oliver Laeyendecker, M.S., M.B.A., Blake Charvat, M.Sc., Victor Ssempijja, B.Stat., Melissa Riedese (2009). Male Circumcision for the Prevention of HSV-2 and HPV Infections and Syphilis The New England Journal of Medicine, 360 (13), 1298-1309

FINK, K., CARSON, C., & DEVELLIS, R. (2002). Adult Circumcision Outcomes Study: Effect on Erectile Function, Penile Sensitivity, Sexual Activity and Satisfaction The Journal of Urology, 167 (5), 2113-2116 DOI: 10.1016/S0022-5347(05)65098-7

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  • A smiling man wearing glasses and a white lab coat with "Peter A. Lipson, MD Internal Medicine" and "Michigan Healthcare Professionals" embroidered on it, standing against a plain light background.

    Peter A. Lipson, MD is a practicing internist in Southeast Michigan.  After graduating from Rush Medical College in Chicago, he completed his Internal Medicine residency at Northwestern Memorial Hospital, and taught medical residents for many years.

    As he has watched the effects of the information revolution on medicine, he became alarmed at the explosion of pseudoscience and it’s effects on his patients and on the population at large. He works daily to help patients and his community tease out truth from fact using critical thinking and skepticism.

    Disclaimer: The views in all of of Dr. Lipson's writing are his alone.  They do not represent in any way his practice, hospital, employers, or anyone else.

    Any medical information is general and should not be applied to specific personal medical decisions.  Any medical questions should be directed to your personal physician.  Dr. Lipson will not answer any specific medical questions, and any emails and comments should be assumed public.

    Dr. Lipson receives no compensation for his writing.

    Dr. Lipson's posts for Science-Based Medicine are archived here.

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Posted by Peter Lipson

Peter A. Lipson, MD is a practicing internist in Southeast Michigan.  After graduating from Rush Medical College in Chicago, he completed his Internal Medicine residency at Northwestern Memorial Hospital, and taught medical residents for many years. As he has watched the effects of the information revolution on medicine, he became alarmed at the explosion of pseudoscience and it’s effects on his patients and on the population at large. He works daily to help patients and his community tease out truth from fact using critical thinking and skepticism. Disclaimer: The views in all of of Dr. Lipson's writing are his alone.  They do not represent in any way his practice, hospital, employers, or anyone else. Any medical information is general and should not be applied to specific personal medical decisions.  Any medical questions should be directed to your personal physician.  Dr. Lipson will not answer any specific medical questions, and any emails and comments should be assumed public. Dr. Lipson receives no compensation for his writing. Dr. Lipson's posts for Science-Based Medicine are archived here.

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