Male Health

The news is heating up lately over one San Franciscan’s attempts to ban circumcision in his city.  Is circumcision so bad that it’s worth banning?  Studies support health benefits of circumcision, including reducing the risk of human papilloma virus in men and cancer of the cervix in their female partners and lessening the chance of urinary tract infections in boys.  Three large studies in Africa (Auvert, Gray and Bailey) all show that circumcision cuts by half the risk of transmission of HIV from a woman to a man.

Foreskin contains nerve endings lost during circumcision, but removing it can’t be seriously equated to clitorectomy, the practice in some cultures of removing a girl’s clitoris at birth.  The equivalent of clitoretomy in the male would be to remove the entire glans penis, which would obviously have profound consequences on sexual sensation.  The question is, does removing the foreskin inflict such harm to a young boy that it ought to be prohibited?  LIke all medical questions, the answer comes from weighing the risks against the benefits.

The majority of circumcised men would tell you that their penises work fine without the foreskin, and so the risk of circumcision, while there, is small.  The benefits, lessening the chance of infection and cancer, are real.  It seems to me that parents choosing to circumcise their newborn boys are balancing the benefits against the risks and making a sensible choice.  If the voters in San Francisco do get a chance to vote on a ban on circumcision, I hope that they preserve that choice for parents.

You can’t fault a man for thinking his penis a single use tool.  But it’s more like a Leatherman or a good Swiss Army knife.  One great use is as a barometer for gauging the health of a man’s heart and blood vessels.

The structure of the penis is basically a sponge with a tiny artery that supplies blood.  The sponge fills with blood, and the penis becomes erect.  (It’s actually a really impressive piece of engineering, with veins at the outer edge of the sponge that are pressed closed as the penis fills, trapping the blood and holding the erection.)  The artery supplying the sponge is very small, only about half the diameter of the coronary blood vessels supplying the heart.  If the arteries are getting clogged, the arteries in the penis go before the heart ones do, giving a man a two to five years heads-up that something bad is happening, not just to the penis, but that may be life-threatening.

Recently published guidelines recommend that if a man is experiencing problems with erections, that he be evaluated for high cholesterol and other artery clogging problems, and that if the labs are out of whack, he be treated aggressively with medication.

As important as the penis is, the heart’s kind of necessary.