Ask Marilyn – 19-year-old Considers Circumcision

The penis advice columnDear Marilyn:

My parents didn’t have me circumcised because they thought the choice should be mine. I felt a little self-conscious when I was in grade school because I was the only boy with a foreskin in my class. When I was in 7th grade, our science teacher told us circumcision was done so boys would be cleaner and healthier. After that, I felt inferior. Now that I’m 19, I’ve been considering circumcision for myself, but a couple of friends have warned me against it. My doctor told me it’s a simple surgery and a personal choice. That’s all he said. Can you tell me why I should or shouldn’t be circumcised?

­– Uncut in Milwaukee

Dear Uncut:

American doctors have been circumcising babies for several generations, so most  doctors practicing these days don’t have a foreskin. They learned little or nothing about the structures, functions, development, and care of the normal foreskin. Instead, they were taught it should be cut off.

Even though, at 19, you are legally able to consent to circumcision, it’s clear that your doctor has not given you the proper information for that consent to be truly “informed.”

Here’s what you should know:

  • A penis without a foreskin doesn’t work as nature intended for its owner or his sexual partner.
  • Amputating the foreskin eliminates the penis’ “command and control” nerve center, the normal skin system that allows for comfortable erections and the gliding mechanism necessary for sensory pleasure, foreplay, and normal intromission (entry during intercourse).
  • Circumcision amputates the tens of thousands of specialized, erogenous nerve endings that signal to the man where he is in relation to the orgasmic threshold.
  • It denudes and exposes the glans (head of the penis), causing it to become dry, calloused, and desensitized. Circumcised men talk about becoming impotent during their 50s or 60s while intact males tell me the urge doesn’t come around as often but their sensitivity hasn’t diminished.
  • Circumcision makes the penis smaller, too.

Your seventh-grade science teacher was wrong! Circumcision does not make the penis cleaner, reduce the risk of penile or cervical cancer, or prevent urinary tract infections, STDs, or HIV/AIDS.

Remember: Once the foreskin is cut off it can never be replaced. Though many men are now stretching the remnant foreskin to re-cover the glans and regaining the gliding mechanism and some sensitivity, the nerve endings in the foreskin are lost forever.

Your parents protected your body and your rights when you were a child. Now, it’s up to you to protect yourself, if you want to maintain the wholeness of your body and the fullness of your sexual experience.


Ask Marilyn – Stop the Steroid Cream!

The penis advice columnDear Marilyn:

I read your response to Katherine in Canada in which you said the doctor was wrong to prescribe a steroid to retract a boy’s foreskin when it was likely that the boy had a yeast infection. The question is timely because I’m facing a similar situation with my fourteen-year-old son, whose foreskin has not yet retracted.

Several weeks ago, my son began to feel a burning sensation when he peed and he wasn’t able to urinate much. We went to his pediatrician. We thought it was a UTI, but the pediatrician noticed an irritation on the tip of his penis, so she prescribed a topical antibiotic and an oral antibiotic. Neither worked, so we were referred to a pediatric urologist.

The urologist said that the fact that he couldn’t retract the foreskin could be the root of the issue. Then, without warning, she pulled his foreskin off his glans. I didn’t know what she was doing until I heard my son scream. I couldn’t believe it! Doctors tell you that it’s going to pinch when they give you a shot, and this was much worse.

The urologist prescribed a steroid for my son to use on his foreskin, and since using it he has been able to pull his foreskin further back and clean better. His pain and the urge to urinate has subsided a little bit.

One of the doctors also suggested that because my son was experiencing constipation, his full bowels were pushing on the walls of his bladder and that may have caused some of the discomfort, too.

My question after reading your response to Katherine in Canada is whether or not my son should continue to use the steroid. He’s still not 100% better. What can I do?

— Leslie, Connecticut

Dear Leslie:

I’m happy to know that you kept your son intact. It won’t be long until he understands you’ve given him a wonderful gift. In the meantime, there’s an easy solution to your son’s irritation. A reddened foreskin is usually caused by yeast overgrowth; some soaps, shampoos, bubble baths, or chlorine in pools or hot tubs can disturb the balance between the normal bacteria and yeast that live on our bodies. Antibiotics also can kill healthy bacteria as well as harmful bacteria, so it is counterproductive for a doctor to prescribe antibiotics to heal a reddened foreskin, unless there are other indications an antibiotic is needed.

You can treat yeast yourself by restoring the body’s healthy bacteria. I recommend you purchase a liquid probiotic (acidophilus culture works well) and have your son apply it six times a day. He can pour a tablespoon or so of the liquid into the palm of his hand, hold it for a moment to warm the solution, and then dip his foreskin into the solution and use his fingertips to rub the liquid onto the affected area. He doesn’t need to retract his foreskin because the bacteria will multiply and fill whatever empty tissue there is. You should notice an improvement in three days

You also asked about whether your son should continue to use a steroid cream. The doctor prescribed a steroid to prematurely retract the foreskin, which I’ve already said is not necessary when treating excess yeast. Your son should stop using the steroid cream and let nature take its course. His foreskin might tighten after steroid treatment stops, but the foreskin will loosen up with time . (Some men find their foreskins do not retract fully until their mid-twenties because men do not complete their sexual development until then.) Right now, as long as your son is urinating normally, he doesn’t need to fuss with his foreskin.

To prevent a yeast reoccurrence, don’t use cleansing products that harm good bacteria. If your son swims or uses hot tubs, have him apply non-petroleum jelly on his foreskin prior to going into chlorinated water. After swimming, he should shower to remove the chlorine from his body and then gently wipe away the protective cream from his foreskin.

I’m sorry you were misled by your doctors. As more and more boys are kept intact, health professionals need to learn to respect the foreskin and it treat it properly.

— Marilyn

Ask Marilyn – Circumcision Is a Bigger Risk Than Penile Cancer

The penis advice columnDear Marilyn:

My obstetrician tells me circumcision will prevent penile cancer in my son. Is that true?

Ann, Lansing, MI

Dear Ann:

Your obstetrician is wrong. Penile cancer occurs in circumcised males as well as intact males, but it is among the rarest of cancers. The American Cancer Society estimates that 2,070 new cases of penile cancer will be diagnosed in the United States in 2022 (compared to 287,850 new cases of breast cancer) and that 470 men will die from the disease (compared to 43,250 fatalities among breast cancer patients). Despite the higher incidence of breast cancer, no doctor recommends removing a baby girl’s breasts after birth.

Neither should doctors recommend amputating healthy tissues from a baby boy’s penis. Especially since the American Cancer Society itself questions the association between circumcision and penile cancer risk. The biggest risk it is most closely associated with genital hygiene and HPV infection. Proper genital hygiene and conscientious condom use offers far more protection for this disease.

Also, bear in mind that cancer of the penis is a rare disease of elderly men. Your son will be denied the protection and pleasure of his foreskin for many years until his age possibly puts him at risk. However, he will immediately face a risk from circumcision: more than 100 baby boys die each year from circumcisions.

There is no reason to risk circumcision of an infant for fear of cancer in the later years of life. As my mother used to say, “Never trouble trouble  ’til trouble troubles you.”


Ask Marilyn – The Doctor Is Wrong: Your Son’s Foreskin Is Not Too Tight

The penis advice columnDear Marilyn:

My son is 8 years old. His foreskin was red and sometimes it stings when he urinates, so I took him to our pediatrician. The doctor said his foreskin is too tight and recommended a steroid cream, suggesting we use it three times a day and that my son should try to gently pull his foreskin back. Once my son stopped using the cream, his foreskin closed down even tighter than it was before. We only use mild soap in the bath, but he does take swimming lessons once a week. I’m wondering what to do now to help my son.

—Katherine in Canada

 Dear Katherine:

Your son’s foreskin is doing its job, which is protecting the glans (the head of the penis) and urethral meatus (urinary opening) from irritants. When the foreskin tightens, the meatus often narrows, so urination can become painful or difficult.

Paradoxically, by recommending a steroid cream and urging your son to try to retract the foreskin, the pediatrician made your son’s condition worse. When steroid creams are used prematurely, it is not unusual for the foreskin to become tighter when the treatment ends. The foreskin probably is also reacting to the attempted retractions.

It appears that your son has developed a yeast infection, which likely caused his foreskin to turn red. Unfortunately, your pediatrician failed to realize that your son’s problem is not a tight foreskin, but rather a yeast infection that is irritating the foreskin.

Fortunately, it is relatively easy to treat a yeast infection with over-the-counter probiotics, such as liquid Acidophilus culture. Apply it on the foreskin six times a day. You or your son can pour a little culture into the palm of his hand and then he can dip the tip of his foreskin into the solution. He can use his fingertips to rub it around the afflicted area. The foreskin usually returns to normal in three to five days. (Note: There’s no need to retract his foreskin for this to work. The foreskin will retract naturally when it is time.)

We can’t tell if the yeast infection was caused by the mild soap you use in the bath or the chlorine in the pool where he swims. Therefore, use only warm water on his genitals and keep him out of pools while he is healing. Once his foreskin returns to health, watch to see if his foreskin reacts to the soap. If it does, don’t worry. You can keep his penis perfectly clean by washing it with warm water only.

Once his foreskin heals, your son can resume his swimming lessons if you take several precautions. He should apply non-petroleum jelly on his foreskin prior to going into chlorinated water. After swimming, he should shower to remove the chlorine from his body and then gently wipe away the protective cream from his foreskin. If he still reacts to the chlorine, limit his time in the water and the frequency of swimming.

Finally, please tell the pediatrician what you’ve learned so that the pediatrician will know better and can begin helping boys rather than causing additional problems.


Ask Marilyn – Let the Balloon Go!

The penis advice columnDear Marilyn: My son’s foreskin gets swollen when he urinates. Is this normal? Does something need to be done?

—Lauren, Los Angeles, CA

 Dear Lauren:

If the foreskin opening remains small, while the urine stream is considerable, the foreskin might balloon with urine from the back-pressure. This can be alarming to parents seeing it for the first time. If the boy is not in pain and his urine is free-flowing, there is nothing to worry about. This is simply an indication of the separation of the foreskin and glans and, with time, the foreskin opening will become lax and the ballooning will cease.

Unfortunately, many American health care professionals are unfamiliar with the natural penis, and they are quick to recommend circumcision when it is uncalled for. Any time a health professional suggests you cut your boy’s penis, think about what Sir James Spence wrote in 1950: “Nature is a possessive mistress, and whatever mistakes she makes about the structure of the less essential organs such as the brain and stomach, in which she is not much interested, you can be sure that she knows best about the genital organs.”

—Marilyn Milos, RN

Ask Marilyn – Circumcision: No Surgical Device Is Safe

The penis advice columnDear Marilyn: We are expecting a boy in May and plan to circumcise him. Friends tell me that there are many difference devices that can be used. Could you tell me which circumcision device is the safest?

—Cheryl F., New York, NY

Dear Cheryl: Circumcision devices are not safe for any baby. At birth, the foreskin and glans (head of the penis) are connected by a common membrane (the balanopreputial lamina, or synechia). The first step in any circumcision is to insert a probe between the two layers and tear them apart. At this point various clamps and cutting devices are used. All of these devices cause immense pain, put the child at risk of hemorrhaging, infection, and disfigurement of the genitals.

The commonly used Gomco Clamp crushes thousands of nerve endings, various specialized muscles, and many blood vessels in the foreskin with thousands of pounds  of pressure.. This intense pressure essentially welds everything together. Even with all that pressure, blood still seeps into the tissue once the clamp is removed, causing a dark ring at the scar site, evidence that a Gomco clamp was used. The clamp comes in many sizes and doctors often use the wrong size, leading to complications.

Circumcision DevicesDoctors who use the Plasti-Bell circumcision device insert it between the glans and the foreskin. Once in place, the doctor pulls the foreskin over the plastic tube and ties a string around the foreskin. He pulls the string as tight as he can to crush the tissue and ties a knot to hold it in place on the plastic tube. Then he slices off the foreskin. The foreskin under the string dies over the next few days, and then it and the Plasti-Bell fall off. At times, the device gets stuck and this causes new problems that must be dealt with medically. The Plasti-Bell has the highest infection rate following circumcision because of harmful bacteria on the string and decaying flesh.

The Mogen Clamp is most often used by ritual circumcisers called mohels. Glans (head of the penis) amputation occurs more frequently with this device. The Mogen Company, now out of business, was sued often. Sadly, there are replicas still being made and still hurting babies.

In short, there is no safe device. The safest way is don’t circumcise! Let him grow up and decide what parts of his own body he does or doesn’t want. He’ll be glad you did!

—Marilyn Milos