The study by Veale et al. [1] whether artificially reducing the depth of penetration of a penis during intercourse can impact female sexual satisfaction. The researchers used different sizes of silicone rings as a proxy for reducing penis length and report that reducing the depth of penetration led to a statistically significant 18% reduction of overall sexual pleasure following an average 15% reduction in length of the penis. They report that the longer the erect penis the less likely the rings were to have an impact on sexual pleasure.

The possible sites of activation during coitus have traditionally been limited to the clitoris and vagina. Recently, several erotogenic genito-pelvic sites with the possible stimuli that generate neural afferent sexual arousal inputs to the brain during foreplay, masturbation or coitus have been reviewed by Levin [2]. The influence of stimulation from various structures is likely to be multimodal, with different sensitivities of both peripheral and central neural structures impacting on the creation of orgasm for any woman.

Turning from the body part or object (such as a sex toy) that stimulates or penetrates the vagina, a recent publication has documented the specific vaginal stimulation and penetration techniques that women themselves report employing for sexual pleasure. Using nationally representative probability data from the second OMGYES pleasure report allowed the identification of four previously unnamed but distinct techniques that women use to make vaginal penetration more pleasurable: angling (87.5%), rocking (76.4%), shallowing (83.8%) and pairing (69.7%) [3]. The first of these, angling, is important because the angle or position of the hips of the woman can make a big difference to where the toy or penis rubs and what it feels like. The second, rocking, can be helpful with constant rubbing of the clitoris by the base of the partner's penis or by a sex toy during penetration and by the penis staying all the way inside the vagina rather than thrusting in and out. The third, shallowing, includes being touched just inside of the entrance of the vagina with the tip of the penis. Pairing includes forms of clitoral touch in combination with vaginal penetration to allow orgasm more often or to have more pleasurable sex than using penetration alone.

The report in the study by Veale et al. [1] that a minority of women found a reduction in the depth of penetration was more pleasurable is in keeping with the findings reported by Hensel et al. [3].

Focusing attention on the vagina, this is an elastic muscular tube of between 7 and 10 cm in length that will lengthen further with penetration by the penis or other object. The typical erect penis is between 14 and 16 cm in length [4]. Several factors can impact on total vaginal length including hysterectomy and pelvic reconstructive surgery, contributing to a shortening of 0.63 cm and 0.22 cm, respectively. Increasing age and menopause can shorten vaginal length by a lesser amount [5].

Likewise, the impact of concomitant disease on penile dimensions should be noted [6]. For men with a penis of shorter length and dimensions then those of a culturally similar population, the impact on sexual confidence and psychological wellbeing can be considerable. This may be primary or following penile shortening observed with Peyronie's disease, postpriapism and following certain types of prostate surgery. Some men have body dysmorphophobia and normal penile dimensions and this demands additional assessment. The authors statement that their results should not be misinterpreted as meaning that increasing penile length will increase sexual pleasure should be noted and respected. Counselling should advise against the inappropriate use of penile elongation surgery as the basis of increasing penile length to ensure improved sexual pleasure in the partner.

Regardless of aetiology, many men fear that they will be unable to penetrate their partner deeply enough to bring about sexual pleasure. Subsequent emotional distress (and sexual dysfunction including erectile dysfunction and rapid ejaculation) may be experienced by the man with significant impact on his partner. Any reduction in sexual pleasure in the partner that is experienced (or anticipated) because of the shorter penile length may accentuate sexual difficulties for the couple. For this reason, it is important that accurate information is readily available to men and their partners about normal penile (and vaginal) dimensions [4] as well as the multimodal impact of bringing about sexual pleasure for both partners.

Awareness of potential problems following penile or vaginal surgery for the partner and the opportunity to provide proactive education and advice regarding enhanced foreplay, adjunctive pleasure-enhancing techniques and the use of devices can all have a beneficial impact on sexual wellbeing and pleasure. The impact of penile shortening on sexual pleasure reported by Veale et al. [1] should form part of the informed consent process without raising unduly significant concern. The impact due to disease may be mitigated by the employment of these educational techniques and by provision of psychosexual support in advance of, alongside and after surgical procedures that may impact on penile length.

Veale 等人的研究。[ 1 ] 在性交时人为地降低阴茎的插入深度是否会影响女性的性满意度。研究人员使用不同尺寸的硅胶环作为减少阴茎长度的代理，并报告说，在阴茎长度平均减少 15% 后，减少插入深度导致整体性快感降低 18%，具有统计学意义。他们报告说，勃起的阴茎越长，环对性快感产生影响的可能性就越小。

传统上，性交期间可能的激活部位仅限于阴蒂和阴道。最近，Levin [ 2 ]审查了几个色情生殖器 - 骨盆部位，这些部位可能会在前戏、手淫或性交期间产生对大脑的神经传入性唤起输入。来自各种结构的刺激的影响可能是多模态的，外周和中枢神经结构的不同敏感性会影响任何女性产生性高潮。

从刺激或穿透阴道的身体部位或物体（例如性玩具）开始，最近的一份出版物记录了女性自己报告的特定阴道刺激和穿透技术，这些技术用于获得性快感。使用第二份 OMGYES 愉悦报告中具有全国代表性的概率数据，可以确定女性用来使阴道插入更愉悦的四种以前未命名但截然不同的技术：钓鱼 (87.5%)、摇摆 (76.4%)、浅浅 (83.8%) 和配对(69.7%) [ 3]。第一个，钓鱼，很重要，因为女性臀部的角度或位置会对玩具或阴茎摩擦的位置和感觉产生很大的影响。第二种方法是摇摆，在插入过程中通过伴侣的阴茎根部或性玩具不断摩擦阴蒂，并且阴茎一直留在阴道内而不是插入和伸出，这可能会有所帮助。第三，变浅，包括用阴茎尖端接触阴道入口的内部。配对包括阴蒂接触与阴道插入相结合的形式，与单独使用插入相比，可以更频繁地达到性高潮或进行更愉快的性行为。

Veale 等人的研究报告。[ 1 ] 少数女性发现减少渗透深度更令人愉悦，这与 Hensel 等人报告的发现一致。[ 3 ]。

将注意力集中在阴道上，这是一个 7 到 10 厘米长的弹性肌肉管，随着阴茎或其他物体的穿透，它会进一步延长。典型的勃起阴茎长度在 14 到 16 厘米之间 [ 4 ]。有几个因素会影响阴道总长度，包括子宫切除术和盆腔重建手术，分别导致缩短 0.63 厘米和 0.22 厘米。随着年龄的增长和更年期的增加，阴道长度会缩短较少 [ 5 ]。

同样，应注意伴随疾病对阴茎尺寸的影响 [ 6]]。对于阴茎长度和尺寸小于文化相似人群的男性来说，对性信心和心理健康的影响可能相当大。这可能是原发性或在佩罗尼氏病、阴茎异常勃起和某些类型的前列腺手术后观察到的阴茎缩短。有些男性有身体畸形恐惧症和正常的阴茎尺寸，这需要额外的评估。作者声明他们的结果不应该被误解为意味着增加阴茎长度会增加性快感应该得到注意和尊重。咨询人员应建议不要不当使用阴茎延长手术作为增加阴茎长度的基础，以确保改善伴侣的性快感。

不管病因如何，许多男人担心他们无法深入到他们的伴侣以带来性快感。男性可能会经历随后的情绪困扰（以及性功能障碍，包括勃起功能障碍和快速射精），并对他的伴侣产生重大影响。由于阴茎长度较短而导致伴侣体验（或预期）性快感的任何减少都可能加剧这对夫妇的性生活困难。出于这个原因，重要的是，男性及其伴侣可以随时获得关于正常阴茎（和阴道）尺寸 [ 4 ] 以及为双方带来性快感的多模式影响的准确信息。

对伴侣阴茎或阴道手术后潜在问题的认识，以及提供有关增强前戏、辅助性快感增强技术和使用设备的主动教育和建议的机会，都可以对性福祉和性快感产生有益影响。Veale 等人报告的阴茎缩短对性快感的影响。[ 1 ] 应成为知情同意过程的一部分，而不会引起过度的关注。通过采用这些教育技术以及在可能影响阴茎长度的外科手术之前、期间和之后提供性心理支持，可以减轻疾病造成的影响。