By Dr. Janet Williams, MD, Ob/Gyn
Every year during the holidays I let an ex of mine visit me…I know, I know…maybe I should avoid him but I just can't seem to let him go. Before you stage an intervention on my behalf, I’m actually not talking about a man. That’s a whole different conversation for another time. But what I am referring to is the oh-so-yummy but constipating mac and cheese I love so much. For a few minutes he’s a smooth, creamy, cheesy delight but without fail, he makes me uncomfortable, stays around too long and ultimately blocks my good times. And no one wants to back that thing up when the thing is backed up. So how can I welcome my love back without ruining my bedroom fun? Read on and I’ll share some easy solutions.
What is Constipation?
Constipation is when a person has difficulty emptying the bowels. Based on studies 1 done in both the United States and the United Kingdom, it is technically defined as a stool frequency of less than three times per week. But, constipation may be happening if a person is straining with bowel movements, has lumpy or hard stools, has an incomplete evacuation sensation and/or is needing to use a finger or other manual manipulation to help pass a bowel movement.
According to the American Gastroenterological Association about 16 out of 100 adults have symptoms of constipation and about 33 out of 100 adults ages 60 and older have symptoms of constipation.2 Women are more likely than men to report problems with constipation and it’s even more common as we age.
I like to think of the gastrointestinal system as a giant winding tube made out of muscle, nerves and nutrient absorbing tissues. The top part of the tube holds the esophagus and stomach, the middle part has the small intestine and the bottom section has the colon and rectum. Very simply put, the nerves stimulate the muscle, the muscle contracts and releases the tube moving the contents through it and the absorbing tissue gets the nutrients out of the food we eat. For the most part constipation mainly refers to when the bottom part of the tube isn’t functioning properly and the stool isn’t being released on a regular basis.
Any number of mechanism that effects the normal function of the tube can result in stool getting stuck or backed up. My beloved mac and cheese is a perfect example of this. Cheese is high in fat and low in fiber. Fiber normally helps bowel contents move through the gut. Fat moves slowly through the GI track, increasing the time for water to be extracted from the bowel contents and resulting in hard dried stool. Finally, milk, cream and cheese all contain lactose and when lactose is fermented, it can produce methane gas. Methane gas slows down the time it takes food to travel through the gut, again, resulting in constipation.
A Few Causes of Constipation
- Low Fiber Diet
- Certain medications (ex: iron supplements, narcotic pain medications, select antidepressants)
- Certain neurologic conditions (ex: spinal cord injury, Parkinson’s disease)
- Hormone changes (ex: pregnancy, low thyroid)
- Structural problems (ex: anal tears and scaring, tumors
- Certain foods (ex: high fat, fried foods, low fiber, diary)
Sex and Constipation
So what does this mean for sex? If you are a person who has vaginal intercourse it is not generally harmful to have sex while constipated but it definitely can lead to discomfort and may even cause pain. When the colon is full of firm stool (see figure) it may put pressure on the vagina and bladder making intercourse feel uncomfortable.
Anal Sex and Constipation
If you are a person who has anal sex avoiding constipation is even more important. Anal sex while constipated will undoubtedly lead to a poopy sex session. Either by stimulating a bowel movement or by stool that is in the large intestine getting onto the penetrating partner or toy. A regular daily bowel movement and isotonic pre-play cleansing are essential steps in preparation for an enjoyable stool free anal sex experience.
So, does all this mean I’m giving up on the bomb ass mac and cheese during the holidays in order to have a great sex life? There are many schools of thought on this but in my experience, patients (myself included) are more successful when they avoid an all or nothing mentality and instead implement simple changes that effect their overall health in a lasting way. In general, certain foods should be left for only occasional use if at all. But more importantly, we can integrate a daily regimen that will keep the constipation at bay.
You can win at the bowel game by including these simple additions in your self-care regimen:
- Hydration – being well hydrated keeps the stool soft enough to travel through the bowel with ease.
- Add some green and/or a fiber supplement – fiber found in green vegetables and supplements helps the bowel contents to move through more consistently.
- Exercise – activity helps to increase muscle tone, blood flow and bowel motility.
- Probiotics – Clinical trials 3 show probiotics increase the number of weekly bowel movements and help soften stools, making them easier to pass.
Constipation doesn’t have to be a c*ck blocker. With a few easy steps you can find a happy gut balance and get back to having the pleasure you deserve. Get started with our favorite probiotic: Butt & Gut Pre + Probiotic by Future Method and let us know how it goes!
- Gastroenterology. 2013;144(1):211–217.
- Am J Gastroenterol. 2011;106(9):1582.
- The American Journal of Clinical Nutrition, 2014; 100(4): 1075–1084.
Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.