Sexual Anal Pain in Gay and Bisexual Men: In Search of Explanatory Factors

Abstract

Background Sexual anal pain—or anodyspareunia—in gay and bisexual men is a scientifically and clinically neglected topic. More understanding of its origins and correlates is needed. Aim To search for correlates of painful anal intercourse with the inclusion of minority stress processes. Methods The analysis is based on data collected in an Internet study on the sexuality of Polish gay, bisexual, and straight men. Multiple ordinal regression analysis was used to search for the correlates of painful receptive anal intercourse in a group of 1,443 nonheterosexual men who declared practicing this type of intercourse within the last 12 months. The investigated correlates included demographics, sexual patterns and experiences, experiencing minority stress, sexual problems, and mental and physical health. To assess the level of minority stress, we used the Sexual Minority Stress Scale based on Ilan Meyer's Minority Stress Model, with its subscales relating to internalized homophobia, expectation of rejection, concealment, and sexual minority negative events. Sexual problems were measured with single-item questions adapted from the National Health and Social Life Survey. Data on the remaining correlates were obtained using a survey that we developed. Main Outcome Measures The intensity of pain during receptive anal sexual intercourse as rated on a 5-point Likert scale was a dependent variable. Results Age (odds ratio [OR]: 0.97; P < .001), performance anxiety (OR: 1.94; P < .001), and internalized homophobia (OR: 1.04; P < .001) were the only statistically significant predictors of the intensity of pain during receptive anal sexual intercourse. Clinical Implications Clinicians addressing sexual anal pain should consider performance anxiety, internalized homophobia, and younger age as possible operating factors. Strengths & Limitations The major strengths of the study include the provision of additional data on this neglected topic derived from a large sample of participants from the little recognized Central European cultural context and the major limitations are the nonrepresentative sampling, retrospective data collection, cross-sectional design, Internet methodology, and lack of information on the clinical relevance of experienced pain, that is, distress or help-seeking, as well as its recurrent or persistent character. Conclusion Painful sexual anal activity requires further investigation.

Prevalence of Anodyspareunia and its Impact on Daily Life in a Population of Men Who Have Receptive Anal Sex: an Observational Study

“…Since 80% of the survey population has reported involvement in RAI within the past 6 months, the proportion of pain should not be dismissed. These results are consistent with previous research indicating that pain during anal intercourse is of common occurrence among GB-MSM [2,[10][11][12][13][14]. Even though, we cannot clearly say they all suffered from AD since there are controversies about the magnitude of pain that must be experienced to de ne it as AD [14,16], this high prevalence underscores the signi cance of addressing AD as a critical health issue for GB-MSM.…”

“…Even though Rosser et al rst described AD back in 1998 there is no clear consensus on de nition or diagnostic criteria of the level of pain that individuals must have to be diagnosed with AD. This might be the reason for the disparities in prevalence of AD ranging from 14-88.9% [2,[10][11][12][13][14].…”

“…Different factors have been pointed out for higher risk of AD, such as: young age, lack of oral/digital stimulation prior to penetration, insu cient lubrication, decreased frequency of sex and numbers of sexual partners, lack of sexual arousal, psychological factors (anxiety, internalized homophobia...) and even the size of the partner's penis or depth and rate of thrusting [10][11][12][13]. Most patients who experienced AD do not seek help and the current prevalence of this dysfunction could be underestimated.…”

Factors associated with decreased anal sphincter tone and the accuracy of forced anal examinations to detect individuals having receptive anal intercourse: An observational study

“…Note that for those preferring RAI, age-related decreased sphincter tone may result in decreased anodyspareunia. 27 28…”

The diverse joys of sex and relationships in straight, gay, and bisexual Polish men.

“…The present analysis drew on a database obtained from as part of a larger research project on the sexuality of Polish SM, GM and BM, whose methodology has been elaborately described in previous publications [13,14]. This was an online cross-sectional study involving 3,697 men.…”