Goldstein’s top tips for injury prevention for bottoms include: Goldstein said education about anal sex is key, whether it’s preparation, diet and hygiene, positions, transitioning from being a top to being a bottom, sensations while bottoming (the good, the bad and the ugly, he said), anal ailments, treatments, aftercare and cleanliness.Īs part of his practice he, not surprisingly, recently taught a class, ‘The Art of Bottoming’ at an event in NYC. “It’s the bottom who needs to learn positioning and engagement and its incumbent on the tops to engage the correct way so injury doesn’t happen.” “We want injury prevention - the right way to engage - to gradually get somebody to the point where they can receive,” Goldstein said. Goldstein’s data show that 41 percent of gay men have experienced tearing or other damage from anal sex. “The issue with our culture and community is that most people don’t learn the right way to ‘bottom,’” said Goldstein, 42, a gay man who lives in New York City’s Upper West Side with his partner Andrew Yu and their twin five-year-old boys. He found that 39 percent of gay men have anal sex a couple times a week 24 percent engage a couple times a month and 13 percent have anal sex every day. His recent survey of 600 Americans showed most gay men prefer to be a top (39 percent) followed by versatile (33 percent) and then bottom (29 percent). Goldstein, through his medical practice Bespoke Surgical, provides some numbers and insight into how gay men prepare, or don’t prepare, for anal sex.
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Symptoms include pain, discharge, bleeding or the development of a skin tag. But it is often the case that the tear is associated with the trauma of anal intercourse. Things like passing a hard stool can cause the tear. Don’t let the word small fool you either, just because the tear is small, the pain can be enormous.
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So for those gay men that bottom, anal fissures, small tears in the lining of the anal canal, are a reality.
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New York-based doctor Evan Goldstein said that while anal sex is an important part of many gay men’s lives, injury is usually inevitable at some point - even if precautions are taken.