I’m Zachary Zane, a sex writer, author, and ethical Boyslut (a fancy way of saying I sleep with a lot of people, and I’m very, very open about it). Over the years, I’ve had my fair share of sexual experiences, dating and sleeping with hundreds of people of all genders and orientations. In doing so, I’ve learned a thing or two about navigating issues in the bedroom (and a bunch of other places, TBH). I’m here to answer your most pressing sex questions with thorough, actionable advice that isn’t just “communicate with your partner” because you know that already. Ask me anything—literally, anything—and I will gladly Sexplain It.
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Dear Sexplain It,
More From Men’s Health
Is it possible that my foreskin is too tight for my erect penis? During sex, it’s hard to pull back my foreskin, and I feel this intense, painful pressure on my penis. Is this normal? If it’s not, what do I do?
—Tight Foreskin
Dear Tight Foreskin,
As a general rule, if you’re feeling pain during sex—and not because someone is smacking your behind with a paddle—then you should see a doctor. But, since you asked so kindly, I reached out to two urologists to see what might be going on with your penis.
Jamin Brahmbhatt, M.D. of Orlando Health and Michael Ingber, M.D. of Garden State Urology, both suspect you have a condition known as ‘phimosis,’ the medical term for tight foreskin. While the data vary, phimosis is not that uncommon in adult men. A systematic review in Urology estimates that about 3% of uncircumcised cisgender men over 18 have phimosis.
Phimosis can be due to various factors. “It might be a congenital condition, or can develop later in life due to repeated infections, scarring, or inflammation,” Brahmbhatt says.
There are several approaches to addressing tight foreskin, which may differ depending on the cause of your phimosis. (This is why you should still go see a doctor about your issue!) If the cause of the problem is dermatological disease, you may be prescribed a topical steroid, according to Ingber. “Approximately three in every 1,000 men have something called balanitis xerotica obliterans, or BXO,” he says. Another name for this is lichen sclerosus. “Sometimes, a small biopsy is required, and if you have this condition, we can treat it with a high-potency steroid cream, which will soften the skin over time and prevent scarring and pain.”
However, if the cause is congenital (meaning you’ve had it since birth), you may need a surgical option such as a dorsal slit—a surgical procedure that modifies the foreskin without removing it. Lastly, there’s circumcision, which involves the complete removal of the foreskin. (In adults, this is done under anesthesia, Brahmbhatt notes.)
In the meantime, using lube during sex can help with discomfort, Ingber says. It’s also important to make sure the foreskin gets replaced over the tip of the penis after sexual activity, since you don’t want your foreskin cutting off circulation to the head of your penis. “This can result in something called paraphimosis, which is a surgical emergency as it may cut off the blood supply to the tip of the penis,” Ingber says. And not to scare you, but Ingber adds, “some literature suggests that phimosis can be pre-cancerous if not treated appropriately.”
So really, go see a damn urologist.
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