TY - JOUR
T1 - Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus
AU - Dickstein, Daniel R.
AU - Edwards, Collin R.
AU - Rowan, Catherine R.
AU - Avanessian, Bella
AU - Chubak, Barbara M.
AU - Wheldon, Christopher W.
AU - Simoes, Priya K.
AU - Buckstein, Michael H.
AU - Keefer, Laurie A.
AU - Safer, Joshua D.
AU - Sigel, Keith
AU - Goodman, Karyn A.
AU - Rosser, B. R.Simon
AU - Goldstone, Stephen E.
AU - Wong, Serre Yu
AU - Marshall, Deborah C.
N1 - Publisher Copyright:
© Springer Nature Limited 2024.
PY - 2024/5
Y1 - 2024/5
N2 - The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI — encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.
AB - The ability to experience pleasurable sexual activity is important for human health. Receptive anal intercourse (RAI) is a common, though frequently stigmatized, pleasurable sexual activity. Little is known about how diseases of the colon, rectum, and anus and their treatments affect RAI. Engaging in RAI with gastrointestinal disease can be difficult due to the unpredictability of symptoms and treatment-related toxic effects. Patients might experience sphincter hypertonicity, gastrointestinal symptom-specific anxiety, altered pelvic blood flow from structural disorders, decreased sensation from cancer-directed therapies or body image issues from stoma creation. These can result in problematic RAI — encompassing anodyspareunia (painful RAI), arousal dysfunction, orgasm dysfunction and decreased sexual desire. Therapeutic strategies for problematic RAI in patients living with gastrointestinal diseases and/or treatment-related dysfunction include pelvic floor muscle strengthening and stretching, psychological interventions, and restorative devices. Providing health-care professionals with a framework to discuss pleasurable RAI and diagnose problematic RAI can help improve patient outcomes. Normalizing RAI, affirming pleasure from RAI and acknowledging that the gastrointestinal system is involved in sexual pleasure, sexual function and sexual health will help transform the scientific paradigm of sexual health to one that is more just and equitable.
KW - Anus Diseases/therapy
KW - Colonic Diseases/therapy
KW - Humans
KW - Pleasure/physiology
KW - Rectal Diseases/physiopathology
KW - Sexual Behavior/physiology
KW - Sexual Dysfunction, Physiological/etiology
UR - http://www.scopus.com/inward/record.url?scp=85192508109&partnerID=8YFLogxK
U2 - 10.1038/s41575-024-00932-1
DO - 10.1038/s41575-024-00932-1
M3 - Review article
C2 - 38763974
AN - SCOPUS:85192508109
SN - 1759-5045
VL - 21
SP - 377
EP - 405
JO - Nature Reviews Gastroenterology and Hepatology
JF - Nature Reviews Gastroenterology and Hepatology
IS - 6
ER -
