Q: I am uncircumcised, and the opening at the end of my foreskin is not large enough for the head of my penis to pass through. This means my foreskin doesn’t pull back when I get an erection. The Internet says this is a condition called “phimosis,” and a lot of medical websites recommend circumcision. I’m not super-excited by that idea. I don’t have any pain or difficulty with sex or urination, and I’ve never had any health problems related to being uncircumcised. The foreskin isn’t stuck or fused to the glans — the hole is just small. Is there a safe, nonsurgical way to enlarge the opening in the foreskin?
Dick Hole Panic
A: “Tell Dick Hole Panic not to panic,” said Stephen H. King, MD, a urologist in Washington State and my new go-to guy for all questions dick. “Phimosis occurs in an uncircumcised penis when a circular ring of the foreskin becomes scarred, often from prior infection, inflammation or trauma. This scar prevents the normally elastic tissue of the foreskin from fully retracting to expose the head of the penis.”
Roughly one in 100 men have phimosis, said Dr. King, “and depending on the degree of narrowing, complications of phimosis can vary widely. These can include difficulty with cleaning/hygiene, infection, pain with erection, bleeding from skin cracking, and paraphimosis.” Paraphimosis sounds like something you want to avoid: “It occurs when a narrow foreskin is pulled back to expose the head of the penis but then can’t be pulled back over the head, which then constricts blood flow to the glans,” said Dr. King. Paraphimosis can cut off blood flow to the head of the penis, which can cause the head of your cock to become gangrenous and die, which is why anyone suffering from it should head to an emergency room immediately. Here’s something else to worry about: “Although extremely rare, penile cancer can arise, usually in older patients with recurrent infections/inflammation.”
You’re probably panicking now, DHP — hell, hearing about paraphimosis has me panicking, and I’m circumcised. But the doctor said your case doesn’t sound serious: You aren’t experiencing any pain, your dick seems to work fine, you haven’t suffered from a series of infections. You don’t need to do anything about your phimosis for now, said Dr. King, but if you’re worried about complications arising in the future, or if you want your sex partners to see the head of your dick someday, there are nonsurgical remedies.
“‘Preputial gymnastics’ is one way to resolve phimosis,” said Dr. King. “It sounds like an Olympic event, but it involves gently pulling the foreskin back to expose the tip of the glans to the point where the ring of scar is exposed.” In other words, pull your foreskin back until you can’t pull it back anymore, and you’ll be looking at the scar tissue. “Hold this position for one minute and repeat three to four times a day,” Dr. King continued. “In combination with topical application of a steroid cream twice daily, typically betamethasone 0.05 percent (needs a prescription), more than 90 percent of cases will dramatically improve or resolve within four to six weeks.”
And if you’re one of the 10 percent of phimosis sufferers whose case doesn’t improve through preputial gymnastics?
“Then he should break out the Manischewitz for his impending bris,” said Dr. King.
Q: I have rarely ever been able to have an orgasm during intercourse. The few times it happened, I was stimulating my clit. But I think my body is used to clitoral orgasms without a penis thrusting inside my vagina. Recently, I started mixing pot and sex. I’ve been a pot smoker for years but never thought to have sex on pot before. It has always been just a social thing with friends. It is incredible! Marijuana relaxes my body and heightens my senses so that when my BF and I have sex, I come! When we have sex without smoking, the sex is still great, but I don’t orgasm like I do when I’m high. I feel like I need weed to orgasm the way I want to. Before I dated my BF, I smoked pot only once a month or so. Now I’m doing it once a week at least. My sex life is finally amazing AND fulfilling. Three questions: 1) Does this sound like a huge problem? 2) Should I be worried? 3) What do you suggest?
Blazing Orgasms Newly Gained
A: 1) It does sound like a problem — a problem that’s been solved. 2) Not if you live in Colorado or Washington State, BONG, where voters legalized pot use in last November’s election. 3) A vaporizer.
This week on the “Savage Lovecast,” I talk with author Emily Bazelon about sexting, bullying and suicide: thestranger.com/savage.