The rise in popularity of anal sex among heterosexual couples is causing health problems in particular for women, according to two doctors.
NHS surgeons Tabitha Gana and Lesley Hunt say women are suffering injuries and other health risks without being aware of these problems.
In an article for the British Medical Journal, they say the consequences of anal intercourse for women can include incontinence, sexually transmitted infections, and pain and bleeding.
Doctors wrote that this may be the result of women suffering bodily trauma while having anal sex.
Gana and Hunt stated that people are engaging in the practice without knowing the potential risks, as doctors are reluctant to discuss the issue.
They said that anal intercourse may affect women differently than men, as the former have a different body anatomy that may make them more prone to health outcomes.
“Increased rates of fecal incontinence and anal sphincter injuries have been reported in women who have anal sex,” the report says.
He continued: “Women are at greater risk of incontinence than men because of their different anatomy and the effects of hormones, pregnancy and childbirth on the pelvic floor.
“Women have less robust anal sphincters and lower anal canal pressures than men, and so the damage from anal penetration is more consequential.
“Pain and bleeding reported by women after anal sex are indicative of trauma, and the risks may be increased if anal sex is coerced.”
But, the authors wrote, doctors are more reluctant to talk to women about anal sex for fear of being judgmental or homophobic.
Data from the National Survey of Sexual Attitudes show that the number of young people (aged 16 to 24) who have heterosexual anal sex has more than doubled, from 12.5% to 28.5% in last decades
Given the risks, whether you’ve already tried it or anal sex is something you’re thinking about exploring, it’s vital to know how to engage in it safely.
Rebecca Dakin, sex expert and author of 101 Sex Tips, says there are things you should keep in mind when having anal sex.
She says the holy grail is lube: “The key is relaxation through lots of foreplay, lots of lube and a sensitive lover who will take their time.”
Adult sex educator Chris Pinto adds: “The key to enjoying anal sex is relaxation and LOTS of lubrication. ‘Going dry’ will be unpleasant and painful for everyone involved.’
She recommends getting in the mood with your fingers and tongue before any penetration, which not only feels good, but helps prepare your body for the act itself.
“There are also many other ways to prepare for anal sex,” continues Chris.
“Sharing a warm bath along with some candles can help release tension in the pelvic area. You can even take the opportunity to explore early while you bathe, with the water as a kind of lubricant.
How to have safe anal sex
You should use a condom to protect yourself from the spread of infections and diseases.
Other tips from WebMD include:
- Cleanse well before having sex. An enema, or anal douche, can flush you out. Be sure to ask your doctor before giving yourself an enema to make sure you are doing it safely.
- If you use your hands, make sure your nails are short and clean before having anal sex.
- After having anal sex, change condoms before having oral or vaginal sex.
- Use plenty of lubricant to reduce the risk of tissue tears. With latex condoms, always use a water-based lubricant.
- Relax before you can reduce the risk of tears. A warm bath can help.
- Stop if painful.
- If you bleed afterward, or notice sores or lumps around or discharge from the anus, see your doctor as soon as possible.
- If you are at high risk for HIV, your doctor may prescribe a daily medication called pre-exposure prophylaxis (PrEP) to reduce your chances of getting it. You still need to wear a condom to protect yourself from other STDs.
- Get an HPV vaccine.
- Be open and honest with your partner. Communication is key to a safe and enjoyable experience.
- Afterwards, clean with water and mild soap to avoid infection. You can also apply a water-based cream to help with the pain.
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