Anal Prepping is bad for you?

[sincitymix]

http://www.towleroad.com/2019/05/douching-before-sex/

 

Yikes! everything is bad for you now a days.

[manTOman]

This is from the linked article:

"They say men who douche were more likely to report a higher number of sexual partners and engage in group sex. However, based on their research, this alone fails to account for the higher incidence of STIs, which they conclude is linked to the actual practice of douching.’"

 

Does this makes sense to anyone?

[+ MasssageGuy]

This is from the linked article:

"They say men who douche were more likely to report a higher number of sexual partners and engage in group sex. However, based on their research, this alone fails to account for the higher incidence of STIs, which they conclude is linked to the actual practice of douching.’"

 

Does this makes sense to anyone?

No it does not make any sense. It is the same "logic" that the anti-vaccine folks use to tout that vaccines cause autism.

[+ keroscenefire]

But I think this makes sense: "The mucus lining in the rectum, which is there to protect against infection, may be injured by [douching]." We already know that HIV and other infections enter the body through micro-tears that often occur through anal sex in the rectal tissue. If douching washes away some of the mucus lining then you're more likely to get micro tears through sex and therefore infection.

 

This is almost especially true for HIV itself which attacks the very immune cells that the body is sending to those micro-tears after injury. Getting rid of the natural mucus lining (and not using enough lube as well) means you're more likely to cause those micro-tears during sex and put yourself at higher risk.

 

The study mentioned in the article is also a "meta-study" meaning it actually studies the results of previous studies. These meta-studies tend to be pretty legit because they are not just giving you the results of one group of men being but in this case 24 groups of men and according to their analysis, douching does put you at higher risk for STIs. It's not just a one-off study whose results could be skewed by many factors, but rather a more solid collection of data from a variety of sources that shows a strong overall trend.

 

In many ways, this study is almost the opposite of the single, one-off study (since discredited) that did show a connection between vaccines and autism. Instead of seeing the dozens of studies that showed no connection, people latched onto the study that did.

[LivingnLA]

Douching is bad for the rectum for multiple reasons. Mostly because it reduces or removes protective mucus. Dries out tissues and more. Rectal tissues are delicate. If done carefully and only with warm water, douching can be okay occasionally. Say you're planning to be powerfucked for hours or doing some fisting, then it's okay if you're careful. Douching is not safe for daily sexual activity. There are much better habits if you want to bottom regularly.

 

It's much better to significantly increase the fiber in your diet, which is also great for your overall health. Regularize your bowel movements and give yourself enough time to have your bowel movement without rushing. Lastly, don't forget to hydrate.

 

If after all of that, you still don't feel secure, 2, 3, or 4 glycerin suppositories will take care of it. Take 1 and wait about an hour. Have a bowel movement. Take the second, wait an hour, and have another bowel movement. Take a third. After three, many people would be well cleaned out quite a way into the small intestine.

 

Fun fact, douching is also bad for vaginal health. But that's something many on this forum don't need to worry about.

[bendable2019]

At least douche your opening and the bushy pothole edges ?

[manTOman]

Aren't glycerin suppositories worse for you than douching?

[Guest]

This is from the linked article:

"They say men who douche were more likely to report a higher number of sexual partners and engage in group sex. However, based on their research, this alone fails to account for the higher incidence of STIs, which they conclude is linked to the actual practice of douching.’"

 

Does this makes sense to anyone?

Well, the article only links to the abstract, not the full article, so I can't say for sure in this case, and it is a meta-analysis of retrospective studies, so that has to be taken into account. However, even in a retrospective, or case-control study, one can (and should) control for known risk factors such as number of sexual partners. If the increased STI's were noted even when known (and obvious) risk factors were accounted for, then one can infer an association between douching and increased STI's. Even if the association is correct, however, this does not allow one to assume causation. The only way to infer causation is to do randomized clinical trial: take a group of sexually active gay men, and randomly assign them to either always douche or never douche before sex, and see what happens.

[+ MasssageGuy]

Even if the association is correct, however, this does not allow one to assume causation. The only way to infer causation is to do randomized clinical trial: take a group of sexually active gay men, and randomly assign them to either always douche or never douche before sex, and see what happens.

Absolutely the correct way to run a test!

[+ FrankR]

But I think this makes sense: "The mucus lining in the rectum, which is there to protect against infection, may be injured by [douching]." We already know that HIV and other infections enter the body through micro-tears that often occur through anal sex in the rectal tissue.

This makes sense, but consider that not douching may result in residual fecal matter remaining in the rectum. This residual fecal matter, when combined with the friction of anal sex, could also damage the mucus lining...

[LivingnLA]

Aren't glycerin suppositories worse for you than douching?

 

Everything in life has risks. Glycerin when inserted into the rectum is hyperosmotic. It attracts water into the intestine by irritating the epithelium. Staying hydrated and maintaining electrolytic balance are important. So too is a high fiber diet. Most Americans do not get enough fiber in their diets. For many people, if they ate enough fiber and were well hydrated, their bowel movement would keep them clean enough for anal sex. Though, as always, ass to mouth activity is always risky.

 

If glycerin suppositories are used very frequently, there is a risk that it may disrupt bowel function enough to cause dependency on glycerin for proper bowel movement.

 

Douching, on the other hand, has been linked to increased risk for HepB, HIV, and transmission of other STIs during anal sex. It may be correlated or causal, the research isn't fully there yet, but it's a strong enough link for me to decide in my own personal life not to douche and recommend against it when I'm asked about it.

 

There is some research and product development into an anal douche that would be safer for the rectum and also reduce STD/STI transmission, but that is years away from viability. For now, frequent douching is too risky in my opinion based on the research I've read.

 

https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-95

In multivariable analysis, adjusting for age, gender, region, condom and lubricant use, substance use, and HIV-status, douchers had a 74% increased odds of reporting STI in the past year as compared to non-douchers [adjusted odds ratio (AOR) = 1.74; 95% CI 1.01-3.00].

 

https://link.springer.com/article/10.1007/s10508-013-0203-0

 

https://academic.oup.com/jid/article-abstract/146/1/7/992842?redirectedFrom=fulltext

 

https://link.springer.com/article/10.1007/s10461-007-9301-0

Edited May 17, 2019 by LivingnLA

[LivingnLA]

Absolutely the correct way to run a test!

 

It's always good to have more research. See the links I included above for some examples of research that's out there on douching, anal sex, and STD/STI transmission.

[+ Charlie]

The only way to infer causation is to do randomized clinical trial: take a group of sexually active gay men, and randomly assign them to either always douche or never douche before sex, and see what happens.

Umm....how does one verify that they did or did not douche before their activities? Self-reporting?

[LivingnLA]

Umm....how does one verify that they did or did not douche before their activities? Self-reporting?

 

Pretty much.

[bendable2019]

Jury is out. No douching anymore. Messy anal for now on ?

 

Hahaha yeah peanut butter and mud cakes ?????

[SirBillybob]

I am thinking a prospective research design, whether randomized or douche option- selective, would be tricky because each subject douching would need to be pair-matched with a nondouching participant on several variables unequivocally predictive of STI.

 

Douche methods and AI style alone are already variant.

 

In addition, STI is a broad categorical variable. The incidence of an arbitrary quantity of non-specific STI over an arbitrary time frame may not reveal much.

 

Also, since history (duration) of douche practices seems to be related to rectal lining vulnerability, matched pairing would be limited in this respect.

[+ keroscenefire]

Well, the article only links to the abstract, not the full article, so I can't say for sure in this case, and it is a meta-analysis of retrospective studies, so that has to be taken into account. However, even in a retrospective, or case-control study, one can (and should) control for known risk factors such as number of sexual partners. If the increased STI's were noted even when known (and obvious) risk factors were accounted for, then one can infer an association between douching and increased STI's. Even if the association is correct, however, this does not allow one to assume causation. The only way to infer causation is to do randomized clinical trial: take a group of sexually active gay men, and randomly assign them to either always douche or never douche before sex, and see what happens.

 

Such a study would likely never pass an institutional review board especially if your hypothesis is that douching is harmful to health. You can't knowingly ask someone to do something that could cause them a life-threatening illness. That is why you do these meta-analysis studies because you can get around the ethical issues that a double-blind study like this would present. So instead you try to pull several studies and their data and do statistical analysis to find out of there is an association between rectal douching and STIs and that association is significant even when you put in other potential factors in the statistical modeling.

 

This study was published in the British Medical Journal, a peer-reviewed journal that takes less than a quarter of its submissions (https://sti.bmj.com/pages/about/). I'm pretty confident that if the data was crap, it wouldn't have been published. The data is good and suggests that douching increases your risk of getting STIs.

[Guest]

Such a study would likely never pass an institutional review board especially if your hypothesis is that douching is harmful to health...

 

We will never know the answer if we don't do prospective, randomized clinical trials. Hypothesis is not fact. Perhaps the most famous study in which the results of the prospective study were opposite those of the case-control studies is the Women's Health Initiative. Prior to the WHI, multiple case-control studies all showed the same result: women who took estrogens after menopause had fewer heart attacks and strokes, and they definitely lived longer. The studies did control, to the extent they knew, all known risk factors for cardiovascular disease: smoking, exercise levels, diet, etc. It took a prospective study to prove that estrogens did NOT improve longevity, heart attacks, or strokes (even had a slightly higher rate of heart attack and stroke). So there was some unknown factor that resulted in the women taking estrogen having fewer events in the case-control studies: perhaps more doctor visits, health awareness, Tai Chi, or who knows.

It's very difficult for most people, often even doctors, to understand: finding an association does NOT imply causation. Estrogen use was associated with a lower heart attack risk, but the lower heart attack risk does not seem to be due to the estrogen use. The easiest example that people can relate to is carrying matches. Carrying matches is definitely associated with a many-fold increased risk of getting lung cancer. However, carrying matches does not cause lung cancer.

[LivingnLA]

finding an association does NOT imply causation.

 

It doesn't not imply causation either. That's the challenge with this kind of research. It is unethical to knowingly create trials where one or more groups of humans are exposed to possibly life threatening illnesses.

 

The first link I provided above is one of the better papers I've seen and their findings are compelling to me. As I have often said, each of us is responsible for our own lives and choices. Responsible humans should do their own research and reach their own conclusions to make up their own minds about how they want to live and the risks they wish to take in life.

[Guest]

It doesn't not imply causation either. That's the challenge with this kind of research. It is unethical to knowingly create trials where one or more groups of humans are exposed to possibly life threatening illnesses.

 

The first link I provided above is one of the better papers I've seen and their findings are compelling to me...

 

Sorry, but testing a hypothesis is NOT considered unethical. If it were, the WHI study would never have taken place. Believe me, there were strong associations showing estrogen use with a reduction in heart disease and stroke, and it was considered standard of care before the study came out to prescribe all women estrogen at menopause unless there was an obvious contra-indication. Just because you find the association of douche use and STI's compelling to you personally does not make this an established scientific fact. Of course, if patients were to be enrolled in such a study, they should be informed of the purpose of the study: preliminary data show an association of douche use with STI's, so we are testing the hypothesis regarding whether or not douche use increases the risk of certain STI's. There are other reasonable explanations for the association. Perhaps people who douche more tend to be more constipated, eat fewer vegetables, use fewer or different types of condoms, etc.

I remember a time when prescribing estrogen replacement at menopause was almost a Commandment: Thou shalt prescribe estrogen at menopause. If we close our minds before testing a hypothesis, we'll never be sure of the truth.

[SirBillybob]

Still, the idea of a "controlled" prospective study is challenging.

 

Randomized has been mentioned, but chaps interested in participating would already have been predisposed to douche or not douche based on preferential behavioral patterns. Douchers might grudgingingly agree to freestyle if scooped (against pre-established behaviour) into the residual-poop group but would possibly alter their receptive anal intercourse style.

 

Also, when I started to try douching I did not like it and found it made no difference according to my needs and tolerances, so randomly imposing douching is fraught with complexity.

 

Also, a point of clarification about double-blind. Assholes have eyes, so there would be no possibility of maintaining ignorance about the independent variable ... unless an anal douche is developed in suppository form with one a placebo version (here you may detect I am taking this to the ridiculous).

 

The only possible visual impairment when I am getting royally shtooped is when my eyes roll back in my head or I am proverbially fucked blind.

 

This discussion reminds me of the 1980's era when a mysterious syndrome emerged among queers and IVDU. Being gay was associated with thIs killer illness. Unique among gay men was a high preponderance of anal exposure to jizz.

 

The 'retrospective' trends were enough to have me pause and alter my sexual behaviour. Others perhaps were sticklers about the disease manifestations and related presumed factors meeting all of the necessary and sufficient assumptions about causal directionality. Logically, I did not think that getting sick and dying made you a queer taking it up the arse. In contrast, without the need of a prospective design, I logically thought that being a queer taking it up the ass causally predicted morbidity and mortality.

 

There may be 'just enough' evidence now about douching. Additionally, douching (or not) is non-stigmatized and either of them cannot be easily appropriated against us by the douche-y religious right in any way. Not douching also deflates pharma profit margins.

[LivingnLA]

Sorry, but testing a hypothesis is NOT considered unethical. If it were, the WHI study would never have taken place. Believe me, there were strong associations showing estrogen use with a reduction in heart disease and stroke, and it was considered standard of care before the study came out to prescribe all women estrogen at menopause unless there was an obvious contra-indication. Just because you find the association of douche use and STI's compelling to you personally does not make this an established scientific fact. Of course, if patients were to be enrolled in such a study, they should be informed of the purpose of the study: preliminary data show an association of douche use with STI's, so we are testing the hypothesis regarding whether or not douche use increases the risk of certain STI's. There are other reasonable explanations for the association. Perhaps people who douche more tend to be more constipated, eat fewer vegetables, use fewer or different types of condoms, etc.

I remember a time when prescribing estrogen replacement at menopause was almost a Commandment: Thou shalt prescribe estrogen at menopause. If we close our minds before testing a hypothesis, we'll never be sure of the truth.

 

So long as it's fully informed consent by the study participants and they know the current research that shows an association of douching with higher STI infection rates, I can see an ethical study being done. But, they must be fully informed of the risks.

 

Another factor to consider, the WHI (Women's Health Initiative ) was and is about long-term tracking of women's health, their health decisions, and the impact of those decisions. I agree it's been immensely valuable in countering a whole range of assumptions and long held practices. I'm all for something like this in the MSM community to explore a whole range of topics.

Edited May 18, 2019 by LivingnLA

[+ keroscenefire]

Cohort and longitudinal studies are very common in medical research. Researchers acknowledge the limitations of such studies but recognize that they are the only ethical way to get information about health outcomes over time. One such longitudinal cohort study is the Framingham Heart Study that basically provides the scientific basis in the medical field for understanding how factors such as cigarette smoking, obesity, genetics, exercise, etc. play into risk factors for heart disease. This study has been going on for more than 70 years and has been used as the basis for more than 1,000 medical papers.

 

It is true that randomized, controlled studies are the "gold standard" in medical research and must be used when you are trying to test new medications and treatments. But we are long past the time when it was considered ok to randomly give people syphilis just to see what happens.

 

That's why this meta-analysis study of douching is pretty solid in my opinion. It takes data from 24 other studies (going all the way back to 1970) and looks at trends over time using statistical analysis that even takes into account other risk factors. If a doctor of a gay man was asked by his patient, "Does douching increase my risk of STIs?" The only ethical answer would be, yes. Just as the same doctor would use the Framingham Heart Study to tell the patient that smoking or eating fatty food, or not exercising is bad for your heart. We all get to choose what risks we want to take or not, but the evidence here is clear that douching very likely increases your risk for STIs and we do not need a randomized, controlled study for medical professionals to make that call.

Edited May 18, 2019 by keroscenefire

[LivingnLA]

"Is douching my anus bad for my health?" The only ethical answer would be, no.

We all get to choose what risks we want to take or not, but the evidence here is clear that douching very likely increases your risk for STIs and we do not need a randomized, controlled study for medical professionals to make that call.

 

@keroscenefire, I'm confused, why is the ethical answer no when you go on to say "the evidence here is clear that douching very likely increases your risk for STIs?"

[+ keroscenefire]

@keroscenefire, I'm confused, why is the ethical answer no when you go on to say "the evidence here is clear that douching very likely increases your risk for STIs?"

 

Just typing too fast...I fixed it.