Women’s sexual health: open about "forbidden"you should know this (18+)

The popularity of anal sex has increased in recent years, and with it the problems of women’s health. Their discussion should not be hindered by false modesty – both on the part of the patient and on the part of the doctor.

According to experts, this can and should be discussed, since the consequences of this type of relationship are quite serious for some women – bleeding, incontinence, STIs (sexually transmitted infections). Physicians should bring this topic up with their patients and be open about emerging issues, argue two NHS surgeons, Tabitha Ghana and Leslie Hunt, co-authors of the British Medical Journal article.

Surgeons argue that it is doctors’ reluctance to discuss the risks associated with anal sex with patients that has led women to suffer from the practice. They have let down an entire generation of women who are completely unaware of the potential problems.

The authors of the article argue that British women are suffering from trauma and other problems as a result of the growing popularity of anal sex among heterosexual couples. Among the most common are infections, incontinence, bleeding, and pain experienced during intercourse. Edition The Guardian quotes:

“Anal sex is considered a risky sexual behavior due to its association with alcohol, drug use and multiple sexual partners. But in popular culture, it has moved from the world of pornography to accessible content – films, shows, series, as an example – “Sex and the City” and “Fleabag”. Perhaps this contributed to a similar trend, making it “spicy and daring””.

The medical report notes that women in this situation are at greater risk than men:

“Women who have anal sex have an increased rate of fecal incontinence and anal sphincter injury. Women are at a higher risk of urinary incontinence than men due to their different anatomy and the effects of hormones, pregnancy and childbirth on the pelvic floor. Women have weaker anal sphincters and lower anal pressure than men, so the damage caused by this type of penetration is more severe. The pain and bleeding that women report after anal sex is indicative of trauma, and risks may be increased if sexual intercourse is forced.”

Data from the UK National Survey of Sexual Relationships showed that the proportion of young people aged 16 to 24 who engage in heterosexual anal intercourse has risen from 12.5% ​​to 28.5% in recent decades. In the US, 30% to 45% of both sexes have experienced this. Ghana, a Yorkshire-based colorectal surgeon, and Hunt, a Sheffield surgeon, warn readers: “This is no longer considered extreme behavior, but is increasingly being portrayed as a valuable and enjoyable experience.”

But the problem, they note, is that many doctors, especially general practitioners and hospitals, are extremely reluctant to talk to women about the risks involved. Perhaps because they do not want to show their condemnation or homophobia:

“However, with such a high proportion of young women currently engaging in anal sex, failure to discuss it when they show anorectal symptoms exposes women to missed diagnoses, useless treatments, and further harm from lack of medical advice. Information from NHS patients on the risks of anal sex is incomplete as it only mentions STIs and “does not mention the anal trauma, urinary incontinence, or psychological effects of coercion reported by young women in this regard.”

Claudia Estcourt, Professor of Sexual Health and HIV and Fellow of the British Association for Sexual Health and HIV (BASHH), echoes the two surgeons’ call for an open dialogue with patients:

“BASHH strongly supports the call for a thorough, unbiased investigation of anal sex in the context of women with anal symptoms. Are specific commitments in a women’s health strategy enough to really “reset the scale”? Sexual health services regularly ask women about the types of sex they have so that a comprehensive assessment of the likely cause of the symptoms, investigations and treatment needed can be made. We believe that explaining why we ask these questions, asking them sensitively, without judgment, and giving patients time to respond, is key to providing the best possible care. We have extensive experience in assessing women with possible sexual anal injury, whether as a result of consensual or non-consensual sex, and recommend that women with concerns contact their local sexual health clinic or sexual assault service, as appropriate.”

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