Sexual Study of 105 Women Rating the Importance of 8 Penile Aspects

                                                                                         

 Changes sought after by average men today. Not related to study.

Women (n = 105) were asked to evaluate photos of surgically repaired genital malformations. They did not know that half the photosets showed “normal”, circumcised genitals.

For every photoset in the questionnaire, women had to indicate on a 4-point scale ranging from total disagreement (1) to full agreement (4) how much they agreed with the statement: “This is a normal (-looking) penis.”

Importance of Penile Aspects

In the questionnaire, women were also asked how important they consider eight different aspects of a penis on a 5-point scale ranging from very unimportant (1) to very important (5). The penile aspects were penile length, penile girth, position and shape of meatus, shape of glans, appearance of scrotum, shape of penile skin, appearance of pubic hair, and general cosmetic appearance. These penile aspects were chosen based on the Penile Perception Score (PPS) [12] and the work of Mureau et al. [13] and Winter [14].

We were not sure whether the exposure to multiple photos of HASRGs would affect the way women looked at genitals, with a possible influence on their evaluation of particular aspects of the appearance. Consequently, one half of the women (n = 55) evaluated the importance of the penile aspects before rating photosets of HASRGs and the other half (n = 50) after rating photosets of HASRGs.

Sexuality of Women

Furthermore, the questionnaire included questions on women's own sexuality (e.g. numbers of sexual partners). A short Sexual Interest Scale (on the basis of the work of Bucher et al. [15] ) was calculated by the averaged sum of two items, women's level of sexual desire and women's frequency of masturbation for the last 3 months. Both items were scored as follows: 0 = never, 1 = less than once a month; 2 = once a month; 3 = twice or three times a month; 4 = once a week; 5 = twice or three times a week; and 6 = every or nearly every day.

Socioeconomic Status (SES)

SES for adults was calculated on the basis of their education and occupation, and SES for adolescents was calculated on the basis of maternal education and paternal occupation. Education and occupation were scored on a 6-point scale. SES scores (range: 2–12 points) were subdivided into three social classes: lower (2–5 points); middle (6–9 points), and upper (10–12 points). This measure has proven to be a reliable and valid indicator of SES [16].

Procedure

The study was approved by the ethical committee of the Canton of Zurich, which is responsible for approval of all research studies. All selected women received an information letter about the study. Those who were interested were asked to return a signed consent form. Women younger than 18 years old had to provide a consent form signed by their parents to participate. After a few months, a reminder was sent to all nonresponders.

Adolescents were interviewed at school and adults at the hospital. After answering the questionnaires, participants had the opportunity to talk to a psychologist.

Statistical Analysis

Data were analyzed with SPSS (version 16) for Windows (SPSS Inc., Chicago, IL, USA). A P < 0.05 was considered significant. Two-sided tests were performed for all calculations. Effect sizes (Cohen's d) were calculated to show the clinical relevance of group differences [17]. Mann–Whitney U-tests were performed for comparisons of the ratings of penile aspects that were made before and after the evaluation of photosets. Wilcoxon tests were computed regarding the appraisal of photosets.

Two multiple regression analyses were computed. After square-root transformation, both dependent variables were normally distributed (Kolmogorov–Smirnov test). Dependent variables were “normality of penile look of HASRGs” and “normality of penile look of circumcised genitals.” According to their significance in bivariate correlations with the dependent variable and based on a priori assumptions, the following predictors were chosen: age, number of sexual partners, sexual interest, importance of penile length, importance of position and shape of the meatus, and importance of general cosmetic appearance.

Results                    

Characteristics of the Study Sample

Table 1 shows the demographic and sexual characteristics of the final study sample consisting of 105 women in three different age groups with a mean age of 28.37 years (SD = 9.65). Regarding their sexual experiences, only 18 of 33 women (54.5%) in the youngest age group (16–20 years) reported that they had experience of sexual intercourse. In contrast, all participants of the two older age groups (25–30 years and 40–45 years) had experience of sexual intercourse.

Table 1. Demographic characteristics and sexual characteristics of women (n = 105)

SD = standard deviation.
Age (years)                    Quantity
16–20	33	31.4%
25–30	44	41.9%
40–45	28	26.7%
Mean (SD)	28.37	9.65
Median (range)	27.0	16–45
Socioeconomic status (n)
Lower	7	6.6%
Middle	51	48.6%
Upper	47	44.8%
Relationship status (n)
Living in a relationship	65	61.9%
Single	40	38.1%
Number of sexual partners
Mean (SD)	7.22	7.75
Median (range)	4.5	0–40
Sexual interest scale
Mean (SD)	3.44	1.29
Median (range)	3.50	0.00–6.00

Importance of Several Penile Aspects

As displayed in Table 2, on average, “general cosmetic appearance” was rated as the most relevant aspect of penile appearance, “penile length” was ranked sixth, and the item “position and shape of meatus” was ranked last.

Table 2. Rating of eight aspects of penile appearance by women

Importance of eight penile aspects	Rating before evaluation of photosets (n = 55)				Rating after evaluation of photosets (n = 50)
	Order	Mean	SD    -{*}-	Order	Mean	SD	P†	Cohen's d
*P < 0.05, **P < 0.01. †U-tests according to Mann–Whitney. Bold indicates significant results. 1 = very unimportant; 2 = unimportant; 3 = neither important nor unimportant; 4 = important; 5 = very important. Effect sizes according to Cohen: 0.20 small effect size; 0.50 medium effect size; > 0.80 large effect size. SD = standard deviation. by MedPage Today, LLC. 345 Hudson Street 16th Floor New York, NY 10014
Importance of penile length	6	3.19	0.75	6	3.54	0.87	0.02*	−0.43
Importance of penile girth	3	3.41	0.74	7	3.46	0.82	0.74	−0.06
Importance of position and shape of meatus (where is pointing)	8	2.37	0.88	8	2.63	1.12	0.29	−0.26
Importance of shape of glans	5	3.28	0.90	3	3.71	0.90	0.005**	−0.48
Importance of appearance of scrotum	7	3.02	1.00	4	3.69	0.85	0.001**	−0.72
Importance of penile skin	3	3.41	1.00	2	3.89	0.89	0.02*	−0.51
Importance of appearance of pubic hair	2	3.43	1.16	5	3.60	1.20	0.38	−0.14
Importance of general cosmetic appearance