DR PHILIPPA KAYE: It is an extremely intimate act that a third of couples perform… but few admit it. As a doctor, I think we MUST talk about it so women can stay safe and injury free.

It’s a topic that many people will feel uncomfortable reading about: anal sex.

Some reading this might think this is extreme or, to put it delicately, extremely specific.

But is not. The National Sexual Attitudes Survey in Britain recently reported that almost 30 per cent of people aged 16 to 24 engage in heterosexual anal sex.

And this did not surprise me. As a GP with a special interest in women’s health, I often talk about the topic with patients of a wide range of ages.

It often occurs when things have not gone as planned.

Common problems include anal fissures, which are small cracks in the anus that can be extraordinarily painful and bleed.

In the worst case, women may be left with continence problems due to damage to the muscles that help us “hold on.”

And then there are sexually transmitted infections (STIs): sadly, younger women have told me about couples who insist that condoms are not needed for anal sex, as there is no risk of pregnancy.

But, of course, the risk of contracting everything from the easier-to-treat gonorrhea to the more complicated and incurable genital herpes and even, although rare, HIV, which still exists.

My biggest concern, however, is that there are many women who do not seek help and advice if they suffer from anal problems, due to shame.

I’m not alone: ​​a recent editorial in the British Medical Journal discussed the importance of doctors having open conversations about anal sex to meet women’s needs.

However, it is important to note that I am in no way suggesting that if you want to have anal sex, don’t do it. Quite the opposite.

My message is that you can safely enjoy anal sex if you want.

And, with that in mind, here’s my simple guide to steps you can take to make it less painful and lower your risk of injury…

Be prepared, start slow and don’t forget the lubricant.

Anal sex can mean anything from external contact to penetrative anal sex with a finger, sex toy, or penis. Whichever way you want to do it, follow these steps.

Preparation: There are many ways that people prepare for anal sex, but it is not always necessary.

Although the rectum is the place where stool is stored just before going to the bathroom, it is not continually full unless you are constipated (keeping your intestine healthy with plenty of fiber and exercise is the best way to prevent this, but if it is a problem You may actually need to talk to your pharmacist.)

I’ve seen some guides online that suggest we should prepare for anal sex by using laxatives and douching, using a small squeeze device that fills the rectum with water to clean the area. But these things are really not necessary.

In fact, anal douching can irritate the lining of the rectum and is associated with increased risks of contracting an STI.

I totally understand that some people prefer to douche before anal sex, but if you’re going to do this, you should leave it at least an hour after douching to try to give yourself time to recover from any irritation.

Others choose to first use a toy to check for feces, but this is not mandatory either.

Start slowly: To avoid injuries it is important to start little by little. You may decide to do this by using sex toys or dilators of increasing size to achieve this gradually.

You can do this ahead of time; Some people suggest incorporating it into your daily routine, in the shower.

But if you are using sex toys like butt plugs, make sure you use a toy with a flange so it can’t be sucked on the inside and can be easily removed.

3. Use a condom and lubricant

Although there is no risk of pregnancy with anal sex, you should always use a condom.

This is because condoms prevent both the transmission and spread of sexually transmitted infections.

I also tell patients to use an appropriate lubricant since the anus cannot produce the same amount of lubrication as the vagina.

It is best to use a silicone or water-based lubricant, as oil-based lubricants are not compatible with condoms.

If you have vaginal and anal sex, you should always use a new condom after anal sex and before vaginal sex. This helps prevent the transfer of bacteria from the rectum to the vagina, which can cause problems, including bacterial and fungal infections.

But if you feel pain or if anal sex causes bleeding, you should stop and have any concerns evaluated by your doctor.

Please don’t be ashamed of how it looks.

Anal bleaching (cosmetic treatments that aim to lighten the appearance of anal skin) apparently gained popularity after Kim Kardashian’s sister Kourtney admitted to doing it.

But there is absolutely no reason to think this is necessary.

It is natural and normal for the skin around the anus and between the buttocks to be darker than the rest of the skin.

This is because the activities we do daily increase friction in the area, such as walking or even sweating, and friction increases pigmentation.

I totally get it, some people feel like it gives them more confidence.

If your partner is pressuring you to clear your anus, it may be time to consider explaining that it’s natural or putting some distance between you.

Even though it’s in the name, it’s not bleach: bleach can seriously damage skin and cause chemical burns.

The creams and lotions used are no different than chemical peels for the face, but are applied to the anus.

This lightens the skin by breaking down the skin pigment, melanin, and reducing the number of cells that produce it.

Lasers can also be used to remove pigmentation and lighten the skin.

Some products can cause a burning sensation and, if used incorrectly, can lead to skin damage and infections.

There are also risks that if the product is applied in the wrong place or used too much, it could affect the skin of your genitals.

In some cases, it can enter the anus and cause scar tissue and stricture, which is the narrowing of the anal canal, the development of which can cause pain when going to the bathroom.

Even if the treatment works, the difference may be minimal and only a few shades lighter. You will also have to keep repeating the treatment since it is not permanent.

My advice? Avoid.

…and if you plan to go completely naked down there

This is not so much a social media trend as a fad that has been around for a few years.

Many people remove hair around the genitals, perineum, around the anus, and in the cleft between the buttocks using waxing or other forms of hair removal.

But whether it’s a Brazilian, Hollywood wax, or more permanent laser, the hair removed actually has a purpose.

The skin around the anus produces secretions that are trapped by the hair, which helps increase lubrication and decrease friction in the area.

Remember that every time you take a step there is friction due to the movement.

Additionally, these oily secretions support the good bacteria that make up the skin microbiome around the anus. Hair also helps remove moisture from sweat.

But really, my friends, save yourself the pain of waxing.

Everything you need to know about anal STIs

Anal sex, whether penetrative with a penis, finger, sex toy, or anal oral sex, may carry a risk of transmitting STIs.

But anal sex that involves penetration actually has a higher risk of transmitting STIs than other forms of sex.

This is because the thin lining of the anus can be damaged and trauma increases the risk of infection.

If you are sexually active, it is recommended that you visit a sexual health clinic for an exam at least once a year. — more often if you have symptoms.

At a screening you will be asked about the type of sex you are having, such as oral, anal, and vaginal, so that appropriate samples can be taken.

Oral anal sex can not only transmit sexually transmitted diseases but also other bacteria such as E. coli, which can cause gastroenteritis.

STIs include bacterial infections such as chlamydia, gonorrhea and syphilis, viral infections such as genital herpes and genital warts, as well as hepatitis, HIV and parasitic infections including pubic lice, also known as lice.

Discharge from the anus, rectal bleeding, itching, pain, and discomfort when sitting or going to the bathroom are symptoms of an STI. You may also notice lumps, blisters, or sores in the area.

Remember that it is possible to have an STI and not have any symptoms.

To make anal sex safer, use condoms and water- or silicone-based lubricant, and don’t forget to have regular sexual health checkups.

Depending on where you live in the UK, free self-test kits may be sent to your home, for example from www.sh.uk and HIV testing www.freetest.hiv