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Doctors are failing to warn women patients about the potential harms of anal sex, two NHS surgeons have said in a report.
Dr Gana and Dr Hunt warned in a British Medical Journal article that doctors "may be failing a generation of young women" by not discussing the risks due to being "influenced by society’s taboos," and not wanting to be seen as judgmental or homophobic.
Participation in heterosexual anal intercourse has increased among 16 to 24-year-olds from 12.5 per cent to 28.5 per cent over the past few decades in Britain, according to the National Survey of Sexual Attitudes and Lifestyle, with 30-44 per cent of men and women in the US saying they have experienced it.
While anal intercourse is considered a "risky sexual behaviour because of its association with alcohol, drug use and multiple sex partners," Dr Tabitha Gana and Dr Lesley Hunt say its rise in popularity has been due to it being "moved from the world of pornography to mainstream media."
Portrayals in TV shows such as Sex and the City and Fleabag "unwittingly add to the pressure, as they seem to normalise anal sex in heterosexual relationships," and make it appear "racy and daring."
But the two surgeons have pointed out the health risks involved with anal intercourse which include incontinence, traumatic abrasions, sexually transmitted diseases (STIs) along with pain and bleeding.
"Women are at a higher risk of incontinence than men because of their different anatomy and the effects of hormones, pregnancy and childbirth on the pelvic floor," they explained.
"Women have less robust anal sphincters and lower anal canal pressures than men, and damage caused by anal penetration is, therefore, more consequential.
"The pain and bleeding women report after anal sex is indicative of trauma, and risks may be increased if anal sex is coerced," a stat in the article revealed that up to a quarter of women with experience of anal sex report say they have been pressured into it at least once.
They also noted that NHS guidance on anal sex is "lacking". Although STIs are referred to, there is "no mention of anal trauma, incontinence or the psychological aftermath of the coercion young women report in relation to this activity."
The lack of advice has resulted in a "plethora of non-medical or pseudomedical websites fill the health information void," which instead of giving advice could be contributing to societal pressure to try anal sex.
All-in-all, Dr Gana and Dr Hunt believe "health professionals have a duty to acknowledge changes in society around anal sex in young women."
There should be "open neutral and non-judgmental conversations" so that women have access to all the information they require to make informed choices.
"With better information, women who want anal sex would be able to protect themselves more effectively from possible harm, and those who agree to anal sex reluctantly to meet society’s expectations or please partners, may feel better empowered to say no."
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