For many of us it’s part of our normal routine; we leave work on Friday, eat a clean sautéed spinach and grilled chicken dinner, pump up in the gym, shower, douche, and hit the scene. We include this second-to-last step with the expectation of meeting someone at the club, or finding someone on our plethora of apps, and taking them home. Of course, we want to be prepared – being dirty isn’t sexy, and peace of mind allows each consenting partner to fully enjoy the experience.
What is anal douching?
For gay men, the act of douching means introducing a liquid (usually water or saline) into the rectum in order to cleanse the passage prior to anal intercourse. This relatively small amount of liquid, usually approximately 6-8 oz, is held in the rectum by the user for one or two minutes, and then released into the toilet. This process is usually repeated several times until the water comes out clear, indicating a clean passage.
Some of you have incorporated douching into your everyday routine, using this cleansing method every time you anticipate a situation in which you might find yourself bottoming. Others only use this method every so often, or only with new sexual partners and hookups, while ceasing or reducing the frequency of use once in a relationship with someone you feel comfortable with. Finally, there are those of you who mostly or exclusively top, and therefore don’t personally use douches and enemas (although your boyfriend(s) or sexual partners likely do). Regardless of your personal frequency of use or experience, it is important to know the facts when it comes to health and enema usage.
What are the health implications of repeated enema usage? Is douching safe on a regular basis?
Naturally-occurring healthy mucus and bacteria
The human anus contains a natural mucous lining that helps to protect your body from potentially harmful bacteria in your stool. In addition to this lining, intestinal flora is naturally produced in your intestine and colon, which helps produce vitamins B-7, B-12, and K. When we are deprived of these vitamins we may experience hair loss, skin issues (due to the B-7 deficiency), ulcers, internal bleeding, and inconsistent bowel movements or constipation.
Excessive douching removes naturally-occurring necessities
According to the SFcityclinic, regular rectal douching reduces this healthy intestinal flora and mucous, and could also cause an electrolyte imbalance in your body. This “flushing out” effect douching has on eliminating much of the healthy intestinal flora contributes to poor gut health. Furthermore, evidence suggests that the reduction of the healthy intestinal mucous specifically increases one’s risk for acquiring a sexually transmitted infection such that the mucous acts as a protective barrier against harmful external bacteria. Therefore, it is especially risky to engage in bareback sex after anal douching
The reduction in this natural mucous membrane also has a “drying-out” effect on the lining inside the colon and rectum. This can result in an increased likelihood of abrasions, cuts, and internal bleeding during anal intercourse, also increasing the chances of contracting or transmitting diseases.
Reducing Health Risks & Safe Douching
We recognize the desire to be clean and the peace of mind rectal douching promotes. Therefore, rather than advocating against using this method of rectal cleansing, we suggest several approaches that promote safer douching.
1. Be clean: Given that repeated use of enemas, showerhead attachments, and other anal douches deteriorate the protective lining of parts of your rectum and colon, always use new or disinfected enemas when cleaning yourself out. Due to the fact that you are introducing liquids into a highly susceptible region, you want to reduce the amount of bacteria and other potential hazards into this area. (Obviously sharing enemas would be a bad idea).
2. Be safe: Along the same lines as being clean, the wearing-down of this protective lining makes the recipient in a gay sex interaction more vulnerable to sexually-transmitted infections such as HIV, HPV, and Chlamydia. We suggest using a condom, adhering to a daily Truvada regimen, and consistent full-panel STD testing.
3. Be proactive: There are also ways you can help restore your internal healthy intestinal flora by consuming certain foods. One example would be by eating probiotic foods, vitamin supplements, or drinks. You can read more about how to restore intestinal flora here.
4. Consider frequency: How often do you douche? What kind of enemas are you using? For more information, read on about how often you can do an enema without harming your body.
Interesting Findings Related to Rectal Douching
According to one study that sampled New York City gay residents, 53% of HIV-negative participants regularly douched prior to anal sex while 96% (almost all) of the HIV-positive participants douched. However, it is possible that one explanation for this difference is that those who participate in receptive anal intercourse (bottoming) are at higher risk for contracting sexually-transmitted diseases.
Another study found that the rate of douching was higher in casual partnerships and anonymous hook-ups compared to men who have the same, consistent sexual partners. This suggests that those who are most at risk are also more likely to douche prior to receptive anal intercourse.
Is There a Safer Alternative to Douching?
Many health professionals push for fibrous supplements that can have similar effects on clearing out the rectum and lower digestive tract in a more natural manner. Fibre is generally accepted as a healthy and necessary part of the human diet, and consuming optimal levels can make bowel movements more complete and full, leaving your “runway” clear for landing. Some even contain antioxidants, omega-3 fatty acids, and other healthy materials that can be a bonus to your health.
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