Clinicians’ reluctance to discuss potential harms of anal sex may disappoint a generation of young women who are unaware of the risks, two British researchers say in opinion piece I am writing to Published today of BMJMore.
Not discussing the subject “will expose women to further harm from missed diagnoses, wasted treatment and lack of medical advice,” says Tabitha of Sheffield Teaching Hospitals NHS Foundation Trust and Northern General Hospital. Gana, MD, and Lesley Hunt, MD, write. , Sheffield, England.
In their opinion, health care professionals, particularly those in general practice, gastroenterology, and colorectal surgery, “are aware of societal changes surrounding young women’s anal sex and should be open and neutral to these changes.” We have a duty to respond in non-judgmental conversations that every woman has the information she needs to make informed choices about sex.”
Asking about anal sex is standard practice in genitourinary clinics, but less common in general practice and colorectal clinics, they point out.
no longer taboo
Anal sex is becoming more common among young heterosexual couples. It rose from about 13% to 29% year-on-year.
The same thing is happening in the United States, where studies show that between 30% and 44% of men and women report having had anal sex.
There are individual differences in motivation for anal sex. Young women cited pleasure, curiosity, pleasing a male partner, and coercion as factors. According to Gana and Hunt, up to 25% of women who have had anal sex report being pressured at least once.
However, anal sex is considered a risky sexual activity because of its association with alcohol, drug use, and multiple sex partners.
It’s also linked to certain health issues, Gana and Hunt note.These include faecal incontinence Anal sphincter injuries reported in women who have anal sex. Women are at higher risk than men when it comes to urinary incontinence due to different anatomy and the effects of hormones, pregnancy and childbirth on the pelvic floor.
“Women have a weaker anal sphincter and less pressure in the anal canal than men, so damage from anal penetration is more important,” Gana and Hunt point out.
“Women’s reported pain and bleeding after anal sex is indicative of trauma and may be at increased risk if anal sex is forced,” they added.
Knowledge of underlying risk factors and taking a good medical history are key to effective management of anorectal disorders, they say.
Gana and Hunt worry that clinicians will be reluctant to talk about anal sex, influenced by social taboos.
Currently, the NHS patient information on anal sex only considers sexually transmitted diseases and does not mention anal trauma, incontinence or the psychological consequences of being forced to have anal sex.
“Avoidance and stigma may not be the only barriers to care for healthcare workers. [from] Talk to young women about the dangers of anal sex. There is genuine concern that the message could be seen as critical or misinterpreted as homophobic,” wrote Gana and Hunt.
“But by avoiding these discussions, we may be disappointing a generation of young women who are unaware of the risks.
“With better information, women who want anal sex can more effectively protect themselves from possible harm. Women who consent to sex may feel more empowered to say no,” Gana and Hunt say.
There was no special funding for this study.Gana and Hunt You have not reported any related financial relationships.
BMJ. Published online on August 11, 2022. editorial
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