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Anal sex may increase risk for incontinence
Engaging in anal intercourse was found to be associated with an increased risk for fecal incontinence, especially among men who have sex with men, according to an analysis of national survey data.
“The study did not provide data on the frequency of the practice of anal intercourse and the impact of incontinence, but it did show a relationship between the practice of anal intercourse and fecal incontinence — more so among men than women,” Alayne D. Markland, DO, MSc, associate professor in the division of gerontology, geriatrics and palliative care, University of Alabama at Birmingham School of Medicine, said in a press release. “What we don’t know is whether someone who has anal intercourse one or two times is at the same increased risk for fecal incontinence as someone who has anal intercourse regularly.”
Markland and colleagues analyzed 2009-2010 data from the National Health and Nutrition Examination Surveys, which are cross-sectional surveys of a nationally representative sample of non-institutionalized adults aged 20 to 69 years. The final analysis included data on 2,070 women and 2,100 men who answered validated questionnaires about sexual behavior and fecal incontinence. Other covariables analyzed included age, race, education, poverty income ratio, BMI, chronic illnesses, depression, loose stool consistency and reproductive variables in women.
More women than men reported engaging in anal intercourse (37.3% vs. 4.5%; P < .001). Both women and men who reported engaging in anal intercourse had higher rates of fecal incontinence compared with those who did not report engaging in anal intercourse (women, 9.9% vs. 7.4%; P = .05; men, 11.6% vs. 5.3%; P = .03).
The association between fecal incontinence and anal intercourse persisted in multivariate analysis among both women (prevalence OR = 1.5; 95% CI, 1-2) and men (prevalence OR = 2.8; 95% CI, 1.6-5).
“When using cross-sectional data sets, such as NHANES, we are not able to prove causality between the outcome of interest [fecal incontinence] and the exposure variables,” the researchers wrote. Although its strengths include a population-based design, large sample size, inclusion of both genders and validated questionnaires for fecal incontinence and stool consistency, the study is limited by its lack of validated questions for anal intercourse and an “imperfect” definition for male anal intercourse. “In addition, other sexual practices that involve the rectum, such as ‘fisting’ were not measured, and could impact the results of this current analysis,” they wrote.
“One thing I think this study does show is that it is important that both the patient and clinical provider need to be aware of the potential risks associated with anal incontinence and be willing to discuss what those risks may be,” Markov said in the press release. – by Adam Leitenberger
Disclosure: The researchers report no relevant financial disclosures.