Many of us would have seen those bright yellow billboards across the cities of Australia with confronting and sometimes contoversial messages including ‘want longer lasting sex?’, ‘want more sex?’ and more recently ‘oral strip: to last longer making love‘.

This latest advertising campaign appears to be an amalgamation of previous campaigns, and claims to help with both premature ejaculation and erectile dysfunction. According to the webiste of company behind the advertising, Advanced Medical Institute (AMI), “The new Oral strip technology for treatment developed by AMI is the World’s first for the treatment of Premature Ejaculation and Erectile Dysfunction (sexual dysfunction) in man.”

Can AMI actually deliver on those claims? Recent history would suggest that potential customers should take caution. In 2003 the ACCC prosecuted AMI over previous campaigns, and the NSW Office of Fair Trading has investigated numerous complaints against AMI over alleged unconscionable contracts and undeliverable guarantees. The late Ian ‘Turps’ Turpie, once an ambassador for the company’s nasal spray, also admitted that it didn’t cure his impotence.

Rather that putting their faith in oral strips and nasal sprays, perhaps Australian men should be asking a confronting question of their own: Could their circumcision be a contributing factor in premature ejaculation and other sexual dysfunction issues? And if circumcision is a factor, is there anything that can be done by circumcised men to reverse the damage?

The first thing to note is that is that circumcision significantly alters the form of the penis. Most estimates on how much skin is lost range between 10 to 15 square inches. In addition, what is lost is not just skin, but a complex set of structures including the frenulum, ridged band, frenal band, mucosal skin and other specialised nerves and structures. As most engineers will tell you, you can’t alter form without altering function, so with so many structures lost to circumcision, there is no doubt that the function of the penis is severly altered.

The most significant function of the foreskin, and the most relevant to premature ejaculation, is what is known as the ‘gliding’ or ‘rolling’ action. Without a foreskin, during sexual activity the foreskin will not ‘roll’ over the glans (head) of the penis in the way that it does on an intact penis. This results in an unnatural friction on the glans and can trigger ejaculation.

While premature ejaculation can be an issue for younger men, the opposite problem is more frequent in older men. A Danish study released in June 2011 concluded that male circumcision was “associated with frequent orgasm difficulties in Danish men and with a range of frequent sexual difficulties in women, notably orgasm difficulties, dyspareunia and a sense of incomplete sexual needs fulfilment.”

So if circumcision is a possible cause of these problems, is their anything that circumcised men can do? While there is nothing that can bring back all of the complex structures that are lost to circumcision, many Australian men are undertaking foreskin restoration to undo some of the damage. The restoration process is a non-surgical method which grows additional skin from what remains of the foreskin. There are many tools and methods, but each method involves tensioning the remaining skin which encourages the growth of new skin, to eventually cover the glans of the penis, recovering much of the function and appearance of an intact man.

The result is that many of the younger men who have undertaken foreskin restoration will say that the re-grown skin reduces the direct stimulation of their glans and allows them to last longer. For those with the opposite problem, the coverage regains the sensitivity of the glans, which had previously been de-sensitised from decades of friction against clothing.

Advanced Medical Institute has recently moved to also target females, by claiming that they can help with a range of sexual dysfunction issues for Australian females. The negative effects of male circumcision on female partners has already been documented in a study by Australian authors published in the Journal of the New Zealand Medical Association and in the website sex as nature intended it. Again it is mainly the lack of the gliding or rolling action in a circumcised penis that is to blame, causing too much friction. Female partners of restored men will often say that there has been an improvement in both comfort and pleasure.

The impact of circumcision on sexual function will always be a topic of debate. But for circumcised men, when comparing the options of using an oral strip or nasal spray with minimal amounts of an active ingredient, or restoring part of the penis that should naturally have been there, I know which option I think would be more likely to get results.