The Vagina Bible. Jen Gunter
States, United Kingdom, Sweden, and Croatia. It is unknown if this is a true increase, meaning more women are truly practicing anal sex, or if more women feel comfortable reporting it due to changes in sexual mores. Currently, 30–46 percent of women report at least one lifetime experience with receptive anal sex, and 10–12 percent report it is a regular part of their sexual repertoire. Reasons women give for engaging in anal sex include pleasing their partner (the most common reason), their own pleasure, vaginal sex is painful, and to maintain their virginity. Some people report seeing anal sex in pornography as a reason to try it, just as some have drawn inspiration from the food scene in the movie 9½ Weeks. Remember, sex in mainstream movies, pornography included, is often as realistic as the driving in car-chase scenes in action movies. According to one study, anal sex featured in 55 percent of scenes in the most commonly viewed pornography, which could lead to false beliefs about its frequency in heterosexual relationships.
Some women report coercion regarding anal sex, as well as so-called “accidental” but actually planned anal penetration by their male partner. It is important when we discuss anal sex as a society that we do not trivialize or normalize this behavior.
Anal sex is often promoted as “better” for men because the anus is a “tighter” orifice. This plays on tired tropes that a vagina is “too loose” for male enjoyment, especially after a woman has been sexually active vaginally or after pregnancy.
Women should try anal sex if the idea appeals to them and they want to explore their sexuality, not because their male partner thinks everyone is doing it or is obsessed with the imagined size of his penis.
WHAT DOES ANAL SEX FEEL LIKE? Studies indicate that approximately 50 percent of women who have anal intercourse find it arousing, although pain is often an issue. At least 50 percent of women report their first episode of anal sex was painful enough that they needed to stop, so it is important to ensure your partner is willing to go slow and abandon the effort if required. Only 27 percent of women who are sexually active anally report little or no pain, so whether the pleasure payoff is worth it for you will be an individual choice.
A good lubricant is essential for anal sex. This will reduce pain, as well as microtrauma to the tissues. Anal sex is the most efficient way to sexually transmit HIV (human immunodeficiency virus), due to the combination of microtrauma and the specific cells in the anus being more susceptible to infection with the virus.
If you are not in a mutually monogamous relationship or there is a concern about HIV transmission, then it is essential to use condoms, whether a male condom for your partner or a female condom in your anus (see chapter 25 for more on condoms). If you plan to also have vaginal sex, you need one condom for anal and another for vaginal penetration. Even if you are in a mutually monogamous relationship, having a condom for anal sex can help you transition between anal and vaginal penetration without needing your partner to clean his penis.
Another reason for using a condom with anal sex is to reduce the risk of transmission of the human papilloma virus (HPV), as this virus also causes anal cancer, and the data is conflicting regarding whether receptive anal intercourse is a risk factor or not. Currently, we have no screening programs for anal precancer and cancer for women, so protection is even more important.
For women interested in anal play, either during masturbation, with a female partner, or with men, there are a multitude of anal toys, such as anal beads and plugs, for experimentation. About 4 percent of women report they used anal plugs and toys regularly in their sexual practice. This is also a good way for women who may wish to try anal intercourse with a male partner to see how they like anal stimulation when they are in control of the situation. An anal vibrator or dildo should have a flared base so it cannot move up inside the rectum. Every general surgeon I know has taken someone to the operating room to remove toys that have become lodged—this can result in very serious bowel injury, so choosing a medically safe anal vibrator is essential.
Some women wonder about anal injury with anal penetration. There is no data to suggest that receptive anal intercourse or anal play can damage the muscles of the anus, but one study (women with an average age of 46) did report that women who had receptive anal intercourse in the past month reported a higher incidence of fecal incontinence—28 percent for women who had anal intercourse versus 14 percent who did not. Whether this was an isolated incident immediately related to the sex or something that happened later on in the month was not described. There was no association of fecal incontinence with anal toys.
BOTTOM LINE
• About 50 percent of women are satisfied with their sex lives.
• A penis is not the most reliable way to achieve female orgasm.
• There is no specific G-spot; the sensitive area that many women describe just inside the vagina is part of the clitoral complex.
• Female ejaculation is tiny drops of fluid, not “squirting” as depicted in most online videos and porn.
• For women interested in anal play or anal sex, starting with a vibrator designed for anal stimulation is a safe, noncoercive way to begin.
CHAPTER 5
Pregnancy and Childbirth
IF A HUMAN COMES OUT OF YOUR BODY there will be physical changes. While I believe that most women understand this intuitively, the magnitude or the reality (or perhaps both) are often a surprise, especially when almost no one talks about the changes they experience after pregnancy. Knowing what to expect after you are finished expecting is very helpful, both so you have a realistic baseline, but also so you know when there is a medical concern and should ask for help.
We don’t talk openly about the postpartum period for a lot of reasons. Women are shamed when their body doesn’t conform to an impossible ideal set by the patriarchy. Until relatively recently, both society and the medical profession have focused almost exclusively on the baby after delivery. Women also used to stay in the hospital much longer after delivery than they do today and/or they had a home visit from a knowledgeable nurse, so there was someone who they could easily ask about pain, bleeding, or bowel movements without having to figure out how to take a one-week-old to a doctor’s appointment.
Pregnancy Changes
Changes to the cervix, vagina, and vulva can start as soon as 4–5 weeks into the pregnancy. Increased blood flow and hormonal changes cause the vagina and vulva to engorge with blood. Consequently, the vaginal mucosa (skin) may look blue due to a change called Chadwick’s sign. The skin and muscles soften. The cells on the inside of the cervix proliferate and expand onto the portion of the cervix in the vagina. This is called an ectropion. It can result in more vaginal discharge, and these cells may bleed when touched—for example, after penetrative sex or a Pap smear. Never assume this is the source of any vaginal bleeding, as there are also serious medical conditions that can cause bleeding during pregnancy.
Yeast infections are more common during pregnancy, although the exact mechanisms are unknown. It may be due to the very high levels of estrogen and/or progesterone, the immune suppression during pregnancy, or other factors.
In the third trimester, around thirty-five weeks, a vaginal test for a bacteria called group B streptococci (strep) is performed. The bacteria is normally found in the vagina and/or rectum of 10–30 percent of women. This requires treatment with intravenous antibiotics during labor to reduce the risk of serious infection for the newborn. It should not be treated with home remedies, such as garlic, that you might find suggested online. A pregnant woman with group B strep who does not receive antibiotics has a 1 in 200 chance that her baby will develop the infection, but if she is treated that risk drops to 1 in 4,000.
Sex during pregnancy
It is not uncommon for women to report a decrease in desire in the first and third trimesters. Whether this is due to worries about a complication in the pregnancy caused by sexual activity, a changing body image, discomfort with sex, or back pain is not known. Some women do report an increase in desire.
Some women worry that heterosexual sex during pregnancy could trigger a miscarriage or preterm labor and delivery. Fortunately, we know that women