Doctors’ reluctance to talk about anal sex is putting young women off, researchers warn

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Doctors’ reluctance to discuss the potential harms of anal sex is letting a generation of young women down, researchers have warned.

Many doctors worry they might appear judgmental or homophobic, but by avoiding the topic they may be failing patients who are unaware of the risks, a study has found.

Surgeons Tabitha Gana and Lesley Hunt argue that not talking about it “exposes women to missed diagnoses, futile treatments and further harm from a lack of medical advice”.

Writing in the British Medical Journal, they say health professionals, particularly those in general practice, gastroenterology and colorectal surgery, “have a duty to recognize changes in society around anal sex in young women, and to face these changes with an open, neutral attitude and non-judgmental conversations to ensure that all women have the information they need to make informed decisions about sex.”

Data from the National Survey of Sexual Attitudes and Lifestyle shows that participation in heterosexual anal intercourse among 16-24-year-olds in Britain rose from 12.5% ​​to 28.5% over the past few decades.

Up to 25% of women who experience anal sex report being pressured into it at least once.

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It’s also associated with specific health problems, surgeons say.

For example, increased rates of fecal incontinence and anal sphincter injuries have been reported in women who have anal sex.

Women are also at greater risk of incontinence than men, due to their different anatomy.

“Pain and bleeding reported by women after anal sex are indicative of trauma, and the risks may be increased if anal sex is coerced,” the authors said.

Effective management of anorectal disorders requires understanding the underlying risk factors and, they say, taking a good history is key.

However, doctors may avoid such discussions, influenced by societal taboos.

Furthermore, NHS patient information on anal sex only considers sexually transmitted diseases, without mentioning the anal trauma, incontinence or psychological consequences of coercion that young women report in relation to this activity.

“It may not just be avoidance or stigma that prevents health professionals from talking to young women about the risks of anal sex,” the authors said.

“There is a genuine concern that the message could be seen as critical or even misconstrued as homophobic.

“However, by avoiding these discussions, we may be failing a generation of young women, who are unaware of the risks.”

They added: “With better information, women who want anal sex could more effectively protect themselves from potential harm, and those who reluctantly accept anal sex to meet societal expectations or please their partners, they can feel more empowered to say no.”

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