The good people over at VICE.COM have a few words for you about your (pre)game ritual. For years we at GMJ, during our time working for other organizations, have cautioned against this practice. The real issue is that most gay men that do it believe it must be done, and most doctors have no idea that guys are being so destructive to their colon and intestines. This comes down to misunderstanding male biology and the truth about gay male anal sex.

Yes, sometimes shit does happen. Below is some relevant information from their piece, which we strongly recommend. Dr. Evan Goldstein, who founded the gay men’s sexual wellness practice Bespoke Surgical (and is one of the country’s foremost anal rejuvenators), provided a helpful hypothetical. “Imagine if you line up ten guys, and you’re going to top them all,” he said, describing a modest Thursday evening at The Eagle. “Even if they haven’t prepared, nine out of ten would be completely stool-free.” Dr. Goldstein said stool resides in the sigmoid colon, the part of the large intestine closest to the rectum and anus. There, you’ll find a muscle that keeps poo from going into the rectum and through the anus until you’re ready to, you know, poo. That means there shouldn’t be any stool where the top’s dick is going unless your top is hung like Jon Hamm times, Justin Theroux. Dr. Goldstone also points out that douching too often can lead to other, long-lasting problems. “If you’re doing it every day, there are a lot of issues with enemas.

You can lengthen your colon, leading to constipation later in life,” he said. Yep, your worst fears are confirmed: the constant pushing required to expel all that water-logged poop can blow out the anal sphincters that keep it in, causing irreparable harm that can mess up bowel movements down the road. Dr. Goldstone said symptoms of that damage aren’t often evident until it’s too late. What should you do instead? Well, probably nothing. Doctors recommended a simple shower before bottoming, using plain water to clean the butthole and a little inside. If that’s not sufficient, there’s probably something wrong with your diet. Try adding fiber for bulkier stools, which can be found in leafy green vegetables and other fiber-rich foods. If you don’t like waiting in line at Sweetgreen, you can always try fiber supplements like Metamucil. There’s even a supplement that explicitly targets the gay market: Pure for Men, made with the same psyllium husk, flaxseed, and chia found in other over-the-counter fiber products presumably manufactured extra… homosexually. Dr. Goldstein noted that every booty is different, so you’ll need to experiment to find the timing and dosage of fiber to ensure maximum cleanliness. Now, because we’re not new here and know that nothing we just wrote will click with many of you, maybe you’ll believe a more “adult” take on the situation from our friends over at

Douching and HIV/STD infection: There have always been questions about why gay men with anal sex are at a much greater risk for contracting HIV and other STDs than straights with anal sex. Our contention, backed up by scientific research and studies, is that it has to do with douching. This process cleanses all of the necessary mucus within the rectal and anal cavities while leaving the areas sensitive and with minor cuts and abrasions. This would, of course, lead to more significant risks of infections for any STDs, even if the parties were to use condoms. 

Men who have sex with men (MSM) are “disproportionately affected by HIV and other STIs worldwide. Rectal douching, commonly used by MSM in preparation for anal sex, may increase the risk of HIV and other STIs by injuring the rectal mucosa. Results from individual studies reporting associations between rectal douching and HIV and other STIs among MSM are inconsistent. We performed a systematic review and meta-analysis to estimate the association between rectal douching and HIV and other STIs among MSM”. “Rectal douching was associated with increased odds of infection with HIV (OR 2.80, 95% CI 2.32 to 3.39), and any STI other than HIV (including hepatitis B virus (HBV), hepatitis C virus (HCV), chlamydia, gonorrhea, syphilis, and human papillomavirus) (OR 2.46, 95% CI 1.95 to 3.11) among MSM. For specific STIs, douching was associated with increased odds of viral hepatitis (HBV, HCV) (OR 3.29, 95% CI 2.79 to 3.87) and chlamydia or gonorrhea (OR 3.25, 95% CI 2.02 to 5.23). These associations remained significant in studies that adjusted for potential confounders.” “Rectal douching may put MSM at increased risk for infection with HIV and other STIs.

Longitudinal studies are needed to clarify this association, and health education materials should inform men of the potential for increased risk of infection with rectal douching”. Finally, we understand what this is all about. When having anal sex, as the receptive partner, you want to be comfortable and sure everything is clean below. We get it. Also, there’s a lot of pressure on bottoms to be perfect for inspection. But, these are unreasonable expectations that others and we place on ourselves. Here are some techniques that you can perform to see if you are ready to step away from the water hose for good and live a douche-free life.

  1. Get some alone time with your favorite dildo (you know the one)
  2. Using the methods listed above, see if you are “clean” enough for the real thing
  3. If not, try to find out why. Is it diet, stress, or lack of bowel movement?
  4. Give yourself time to adjust to this new reality. It may be quick or slow
  5. Not everyone is going to be able to ditch the douche, but you should at least give it a try; your future self will thank you

Yes, what we are saying goes against just about everything you’ve ever been told about anal sex, so it will take time to make the mental adjustments, but it is worth it. You shouldn’t risk severe damage for a few moments of pleasure.

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