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There is nothing wrong with engaging in anal sex, but whether it is right for you is something only you can decide. Since the anus is not capable of producing its own lubrication as the vagina can and the tissue of the anus is very fragile, it is important that additional water-soluble lubrication a variety of brands are available at drugstores be used during anal sex. Without lubrication, there may be pain, discomfort and tearing of the tissue in the anus. During anal intercourseas with any other type, comfort and relaxation are important for a pleasurable experience. Couples analer sex engage in anal intercourse need to know that it is one of the ways that HIV can be spread sexually. This is because the lining of the anus is prone to tearing if there is not enough lubrication.

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Learn More. The aim of this study was to assess the prevalence and associations between anal intercourse and fecal incontinence.

Fecal incontinence was defined as the loss of liquid, solid, or mucus stool occurring at least monthly on a validated questionnaire. A gender-specific sexual behavior questionnaire assessed any anal intercourse via an audio computer-assisted personal interview. Co-variables included: age, race, education, poverty income ratio, body mass index, chronic illnesses, analer sex, loose stool consistency Bristol Stool Scale types 6 or 7and reproductive variables in women.

Prevalence estimates and prevalence odds ratios PORs were analyzed in adjusted multivariable models using appropriate sampling weights. Overall, 4, adults aged 20—69 years 2, women and 2, men completed sexual behavior questionnaires and responded to fecal incontinence questions. Anal intercourse was higher among women Fecal incontinence rates were higher among women 9. After multivariable adjustment for other factors associated with fecal incontinence, anal intercourse remained a predictor of fecal incontinence among women POR: 1.

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The analer sex support the assessment of anal intercourse as a factor contributing to fecal incontinence in adults, especially among men. Anal intercourse is a common practice among both heterosexual and homosexual couples where at least one of the partners is male. Men engaged in anal intercourse may have lower manometry pressures than men not engaged in anal intercourse; however, few studies have examined fecal incontinence FI symptoms and anal intercourse 56.

Although specific sexual practices of women with FI are undescribed, women with FI are as likely to be sexually active as women without FI but their sexual function scores are lower 78.

Studies evaluating the impact of FI treatment on sexual function are limited to descriptions in small populations following sphincteroplasty, with most studies reporting improved function and less embarrassment with sexual activity following treatment for FI 9 — The primary aim of this study was to determine if anal intercourse is associated with reports of FI, defined as the accidental loss of liquid, solid, or mucus stool occurring at least monthly.

Secondary aims were i to characterize the prevalence of anal intercourse in a nationally representative sample of analer sex US adults aged 20—69 years and ii to assess the relationship of anal intercourse with other known factors associated with FI, such as age, comorbid diseases, depression, and stool consistency.

We hypothesized that both women and men who engaged in anal intercourse would have higher rates of FI. The National Health and Nutrition Examination Surveys NHANES are cross-sectional surveys of a nationally representative sample of analer sex non-institutionalized population sampled using a complex, stratified, multi-stage, probability cluster de.

The National Center for Health Statistics NCHS ethics review board approved the survey protocols, and all participants provided written informed consent. Questions specific to anal intercourse were administered to men and women aged 18—69 years. Women who were pregnant were excluded from the analysis. Questions about bowel symptoms were ascertained in the mobile examination center interview room using a computer-assisted personal interview system.

Questions about sexual analer sex were ascertained in a private mobile examination center interview room using an audio computer-assisted personal interview system. Our final analytic sample included 4, adults aged 20—69 years who answered questions about anal intercourse and FI Figure 1. The FISI has subjects ranked according to the frequency of incontinence into four separate of gas, mucus, liquid, and solid stool, ranging from 1 to 20, with higher scores indicating greater severity Hard stool was defined as a Type 1 separate hard lumps, like nuts or Type 2 rating sausage like, but lumpy.

No questions queried the frequency of anal intercourse.

Chronic lower respiratory tract disease included self-reported emphysema, chronic bronchitis, or asthma; coronary heart disease included coronary artery disease, angina, or a myocardial infarction. All estimates, standard errors, and association measures were derived using the sampling weights provided by the NCHS.

These weights take into unequal probabilities of selection resulting from the sample de, non-response, and planned over-sampling of specific racial and ethnic groups in the US population. Comparisons for those with and without FI have been published elsewhere We used appropriate sample weighting for two-sample t -tests for testing differences in means. From the sexual behavior questionnaires, 4, participants aged 20—69 years had data regarding anal intercourse.

After exclusions for those analer sex did not answer FI or sexual behavior questions, 2, men and 2, women had complete data and comprised the final analytic sample in the multivariable models.

Anal intercourse was reported more frequently among younger women aged 20—49 years with at least a high school education as well as women reporting symptoms of moderate-to-severe depression. Men reporting anal intercourse were more likely to have at least a high school education. Overall, FI prevalence was 8.

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FI rates were higher among women 9. For both genders, FISI scores were low and did not differ among those with or without a history of anal intercourse. FISI scores were not higher in men or women After multivariable adjustment including other known FI clinical risk factors Table 2anal intercourse remained ificantly associated with prevalent FI among both men and women.

The adjusted odds of FI were higher in men reporting anal intercourse OR: 2. Men who confirmed anal intercourse at least once in their lifetime reported a higher prevalence of FI Anal intercourse associations with at least monthly fecal incontinence in multivariable models for men and women, NHANES — From a US population-based survey that involved private interviews with an audio-enabled computer-assisted questionnaire, women reported higher prevalence than men for anal intercourse 37 vs.


Despite higher overall prevalence of anal intercourse in women, men reporting anal intercourse had a higher prevalence of FI than women After controlling for other known factors for FI in adults, anal intercourse was associated with an increased odds of having FI in both men and women. Better recognition of factors that may contribute to FI may open dialogue and improve discussion of two taboo topics in the healthcare setting: individual sexual practices and accidental bowel leakage Despite public concern, little work has examined anal intercourse as a possible risk factor for FI in the scientific community.

Studies have mainly focused on the relationship between anorectal structure and function and anal intercourse among men with mixed. Analer sex anal resting pressure has been noted among men who engaged in anal intercourse 56.

However, studies have had inconsistent regarding lower maximum squeeze pressures and the complaint of FI in men who practice anal intercourse 56. These studies had small s of men who had anal intercourse, 40 and 14—respectively. Data on the effects of anal intercourse on anorectal structure and function among women are lacking. Biologic plausibility exists for anal intercourse as a risk factor for FI. The internal anal sphincter contributes to the majority of the anal resting pressure.

Anal intercourse could dilate and eventually stretch the internal and external anal sphincters leading to damage of these structures, as demonstrated by the lower resting pressure. This lower pressure and possible damage to the internal and external anal sphincters could lead to FI via muscle atrophy and sensory deficits.

Smaller clinical cohort studies have found than women with and without FI have lower anal pressures than men 18 We did not see differences in the FISI scores among those with and without the self-report of anal intercourse. FI severity, as measured by the FISI scores, only measures the frequency of stool loss and the type of leakage including flatus, mucus, liquid, or solid stool. FISI scores do not take into fecal urgency or the conditions when FI occurs, such as passive analer sex or urgency leakage.

Anal intercourse may affect urgency or passive FI more than the type of leakage that occurs.

In addition, anal intercourse may only have a small impact on fecal continence so that it lowers the threshold for occurrence without worsening severity. In addition, we were analer sex to quantify the frequency of anal intercourse in this population and it is possible that the majority of individuals rarely practice anal intercourse, which would have decreased the impact on FI severity. More data are needed to further test this hypothesis. The strengths of this study include the population-based study de as well as a large sample size. Prior studies have been limited by gender and we were able to include both genders in this study.

Finally, validated questions were used for both FI and stool consistency, which have been shown to be valid and reliable in the assessment of bowel symptoms.

There are several limitations in this work. There are no validated questions for anal intercourse and we were unable to assess the frequency of anal intercourse among women. In addition, the definition utilized in this study for male anal intercourse is imperfect and limited to the questions asked in this NHANES cycle.

A sensitivity analysis including only the 69 men who responded positively to both questions, revealed similar. Although the definition of anal intercourse for men in this study may overestimate the of men engaged in anal intercourse, studies have shown that men who report sex with men frequently report at least some experience with anal intercourse We could not distinguish between consensual anal intercourse and non-consensual anal intercourse in this cohort. Both men and women may be reluctant to divulge anal intercourse practices.

We have ly found that women are more likely to respond positively to a written questionnaire than oral history taking with regard to FI; although the questions were administered in private, we do not know the concordance between oral and written history taking for anal intercourse When using cross-sectional data sets, such as NHANES, we are not able to prove causality between the outcome of interest FI and the exposure variables.

We also did not adjust our analyses for multiple testing and all the potential confounding variables of the analer sex between anal incontinence and FI may not have been queried in a broad study of health factors such as NHANES. Lastly, stool consistency assessment was only asked for the usual or most common type and may not represent the more analer sex changes in stool consistency that may occur with FI episodes.

These provide initial epidemiologic evidence supporting a link between anal intercourse and FI among both men and women.