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Still leaking when you sneeze, run, jump or laugh years after having children? You might have been told it's "just part of having kids." It may be common, but that doesn't mean you have to live with it. Why does leaking happen after childbirth? Pregnancy and childbirth place significant demands on your pelvic floor. Changes can affect the muscles, connective tissues and the way your pelvic floor works with your breathing and abdominal muscles. You may notice leaking when you: Cough or sneeze Run or jump Exercise Lift something heavy Laugh Suddenly need to empty your bladder But leaking doesn't automatically mean your pelvic floor is simply "weak." Sometimes the issue is strength. Other times it's coordination, timing, muscle tension, bladder habits or how your body manages pressure. "But my kids are years old..." It's never too late to address pelvic floor symptoms. You may have adapted by wearing pads, avoiding running or jumping, crossing your legs when you sneeze, or always finding a toilet before leaving the house. These things can become so normal that you forget they're symptoms. You shouldn't have to organise your life around your bladder. What can help? A pelvic health physiotherapist can assess what's contributing to your leakage and develop a treatment plan based on your symptoms and goals. This may include pelvic floor muscle training, breathing and pressure management, bladder strategies, strengthening and movement retraining. And no — it's not always as simple as "just do more Kegels." The bottom line Having children can explain why your symptoms started. It doesn't mean you have to accept them forever. Whether your youngest is six months old or 16 years old, pelvic floor symptoms are worth assessing. If you're leaking after having children, talk to a pelvic health physiotherapist. You don't have to put up with it.

Finding skid marks in your child's underwear can be frustrating. But before assuming they're being lazy or not wiping properly, there's something important to know: Repeated poo stains can be a sign of constipation. And your child may not be doing it on purpose. How can constipation cause skid marks? When children hold their poo, stool can build up in the rectum. Over time, the rectum can become stretched and less sensitive to the feeling of needing to poo. Softer stool can then leak around the harder stool and into their underwear. This can look like: Brown marks or smears Small amounts of poo in their underwear Strong-smelling underwear Regular accidents despite being toilet trained Your child may genuinely not feel it happening. Why do kids hold their poo? Often, it starts with a painful bowel movement. A child may then become afraid of pooing and start holding it in. You might notice them: Crossing their legs Squeezing their bottom Standing on their tiptoes Hiding when they need to poo Avoiding the toilet Unfortunately, holding on can make the stool harder and larger, creating a cycle of pain → withholding → constipation → leakage. Could the pelvic floor be involved? Yes. To poo comfortably, the pelvic floor needs to relax and coordinate with the bowel and abdominal muscles. Some children have difficulty relaxing these muscles when trying to poo. This can make emptying harder and contribute to constipation and soiling. What can parents and carers do? If your child regularly has skid marks, look for other signs of constipation: Large or hard poos Straining Pain when pooing Tummy aches or bloating Hiding to poo Toilet avoidance Frequent underwear accidents Rather than blaming or shaming your child, speak with your GP or a healthcare professional experienced in children's bowel health. A paediatric pelvic health physiotherapist can assess toileting habits, positioning, pelvic floor coordination and relaxation, and help your child develop more comfortable bowel habits. The Bottom Line Skid marks aren't always a hygiene problem. If they're happening regularly, they may be your child's body's way of telling you they're constipated or struggling to empty their bowel properly. Your child isn't necessarily being lazy—and shame won't fix the problem. If your child is regularly soiling their underwear or struggling with constipation, a paediatric pelvic health physiotherapist can help you work out why and what to do next.

Ever finish urinating and immediately feel like there's still some left? Maybe you find yourself sitting on the toilet for longer, going back for a second wee, or returning to the bathroom shortly after. That feeling of incomplete bladder emptying is common, but it's not something you should automatically ignore. Why might this happen? There are several reasons you might feel like you haven't completely emptied your bladder. Your pelvic floor may not be relaxing properly Your pelvic floor muscles need to relax to allow urine to flow freely. If they're tense or you're unconsciously holding them while trying to wee, the bladder outlet may not open as effectively. This can make it feel like you need to push, wait or try again. You're rushing or hovering Your bladder generally works best when you can sit comfortably, relax and give yourself time to empty. Hovering over the toilet, rushing, or constantly tightening your abdominal or pelvic muscles can make it harder to fully relax. And straining or pushing your urine out isn't usually the answer. Constipation can play a role Your bowel and bladder sit very close together. A full or constipated bowel can put pressure on the bladder and may affect bladder sensation and emptying. You don't necessarily need to be severely constipated for this to have an impact. If you're also experiencing bloating, infrequent bowel movements, hard stools or difficulty fully emptying your bowels, it's worth considering the bowel–bladder connection. Your bladder may be sending confusing signals Sometimes the sensation of incomplete emptying doesn't necessarily mean your bladder is actually full. Bladder irritation, urgency, infection and changes in pelvic floor sensitivity can all affect the way you perceive bladder filling and emptying. This is why the sensation you experience doesn't always tell us exactly what's happening. Should you keep trying to "get the last bit out"? You might find yourself doing a second wee immediately after the first, just to make sure you've completely emptied. Occasionally this is harmless, but repeatedly going back and trying to squeeze out more urine can reinforce the habit of checking your bladder. Instead, try sitting comfortably, relaxing your belly and pelvic floor, and allowing your bladder time to empty without pushing. If you consistently feel unable to empty, however, it's worth getting assessed rather than simply trying harder. When should you get checked? Speak with your GP or pelvic health physiotherapist if you regularly experience: A persistent feeling of incomplete emptying Difficulty starting your urine stream A weak or interrupted stream Needing to strain to urinate Needing to urinate again immediately after finishing Frequent or urgent urination Recurrent urinary tract infections Pain or burning when urinating Difficulty emptying your bladder If you suddenly cannot urinate at all despite having a strong urge, seek urgent medical attention. What can a pelvic health physiotherapist do? Your physiotherapist can look at your bladder habits, bowel function, pelvic floor muscle coordination and how you're actually using your muscles when you urinate. Sometimes the answer isn't to strengthen the pelvic floor — it may be learning how to relax it properly. Treatment may include bladder strategies, pelvic floor relaxation, breathing techniques, bowel management and changes to toileting habits. The Bottom Line Feeling like you haven't fully emptied your bladder doesn't always mean your bladder is the problem. Your pelvic floor, bowel, toileting habits and bladder sensitivity can all play a role. If you're regularly finishing a wee and thinking, "I still need to go," don't just keep pushing or making endless trips back to the toilet. Understanding why you're getting that sensation is the first step towards finding a solution.

Prostate surgery can affect the muscles, nerves and structures that help control your bladder. Urinary leakage is very common in the early weeks and months after surgery, and some men also experience urgency, changes in bladder sensation or sexual difficulties. The good news is that bladder control usually improves significantly with time and the right rehabilitation. Pelvic floor physiotherapy can play an important role in recovery. Why does prostate surgery affect bladder control? The impact depends on the type of surgery and which structures are affected or preserved. Radical prostatectomy During a radical prostatectomy, the prostate is removed. This can affect: · The bladder neck: This normally contributes to urinary control. In some surgeries, it can be preserved. · The external urethral sphincter: After prostate removal, this becomes particularly important for keeping urine in. · The pelvic floor muscles: These muscles support the urethra and help with bladder control. They can become weak, poorly coordinated or, in some cases, overly tight. · Nerves: Nerves involved in bladder and sexual function can be affected during surgery and may take months or longer to recover. · Urethral support: Removing the prostate changes the anatomy and the way the bladder and urethra work together. Surgery for an enlarged prostate (BPH) Procedures such as TURP and TUIP affect the prostate and bladder neck in different ways. The amount of tissue removed and whether the bladder neck is preserved depends on the procedure used. What can you expect after surgery? The first few months Urinary leakage is very common after prostate surgery, particularly after the catheter is removed. Leakage is often worse with coughing, sneezing, lifting, walking or exercise. You may also notice: · Difficulty activating your pelvic floor muscles · Reduced awareness of bladder fullness · Urgency or increased frequency · Pelvic floor tightness or muscle guarding · Changes in sexual function Recovery over time Recovery is different for everyone, but bladder control generally improves significantly during the first 3–6 months. Some men continue to notice improvements beyond 12 months as the pelvic floor muscles and nerves recover and coordination improves. Factors such as age, pre-existing bladder symptoms, prostate size and muscle strength can influence recovery. You may need pads for a while, but needing a pad in the early stages doesn't mean you'll always need one. How can a pelvic health physiotherapist help? A pelvic health physiotherapist can assess how your pelvic floor is working and develop a rehabilitation program specific to you. This may include: · Checking pelvic floor strength, endurance and coordination · Teaching you how to correctly contract and relax your pelvic floor · Bladder training and strategies for urgency · Improving your breathing and muscle coordination during movement · Addressing pelvic floor tightness or pain · Helping you return to exercise and everyday activities · Working alongside your urologist or medical team if further treatment is needed When should you seek help? Consider seeing a pelvic health physiotherapist if you: · Have urinary leakage after your catheter is removed · Are using pads regularly · Have urgency or frequent urination · Have difficulty emptying your bladder · Experience pelvic pain or tension · Are concerned about sexual function · Feel you're not making progress with your exercises Frequently Asked Questions How soon can I start pelvic floor exercises? Pelvic floor exercises can generally begin after your catheter has been removed, once your surgical team says it is appropriate. Don't perform pelvic floor exercises while your catheter is in place. Will I need pads after prostate surgery? Many men use pads during the first few weeks or months. Leakage usually reduces as the pelvic floor and bladder control mechanisms recover. What if my leakage doesn't improve? If leakage continues despite consistent pelvic floor exercises and bladder training, speak with your urologist. Further treatment options may be available, including surgical options for persistent incontinence. Can pelvic floor physiotherapy help with erectile dysfunction? Pelvic floor rehabilitation may support sexual function after prostate surgery, although erectile difficulties can also be related to nerves and blood flow. Your physiotherapist can work alongside your medical team as part of your recovery. The Bottom Line Prostate surgery can temporarily disrupt the muscles and structures responsible for bladder control, but leakage is not something you simply have to put up with. Recovery takes time, and everyone's journey is different. The right pelvic floor exercises, bladder strategies and individualised rehabilitation can help you regain bladder control and confidence after prostate surgery. You don't have to manage it alone. Our pelvic health physiotherapists can assess what's happening, make sure you're doing the right exercises for your body and help you work towards getting back to the things you enjoy.

If you've been told that your pelvic pain, bladder symptoms or pelvic floor problems are because your core isn't strong enough, you might have been given a familiar prescription: “Just do more core.” Planks. Crunches. Leg raises. More bracing. But for some people, this advice can actually make symptoms worse. Especially if your pelvic floor is already overactive or struggling to relax. Your pelvic floor is part of your core Your pelvic floor works together with your diaphragm, abdominal muscles and back muscles to help support your body and manage pressure. So yes, core strength matters. But more tension doesn't always equal more support. Your pelvic floor needs to be able to contract when necessary and relax when it's supposed to. When can more core work be a problem? If you're already holding a lot of tension through your abdomen and pelvic floor, constantly bracing your core may increase pressure and muscle activity. This can be particularly relevant if you experience: Pelvic pain Pain during sex Difficulty relaxing your pelvic floor Constipation or difficulty emptying your bowel Urinary urgency or frequency Pain that increases with exercise A feeling of constant pelvic tension In these situations, the goal may not be to make everything stronger. It may be to improve coordination and relaxation. But aren't core exercises good for you? Absolutely. Core exercises can be an important part of rehabilitation and general fitness. The problem is assuming that everyone needs more of them. Someone with poor abdominal strength may benefit from strengthening. Someone who is constantly bracing may need to learn how to let go. And many people need a combination of both. What should you do instead? Rather than asking: “How can I strengthen my core?” The better question is: “How is my core and pelvic floor functioning?” A pelvic health physiotherapist can assess how your breathing, abdominal muscles and pelvic floor work together during movement. Your program might involve strengthening—but it might also include: Breathing exercises Pelvic floor relaxation Movement retraining Mobility work Gradual strengthening Pressure management Exercise modification The right exercise depends on why you're having symptoms. When should you get assessed? If you've been exercising your core regularly but your symptoms aren't improving—or are getting worse—it's worth getting an individual assessment. Particularly if you're experiencing pelvic pain, painful sex, constipation, urinary urgency or persistent pelvic tension. The Bottom Line Your pelvic floor doesn't always need more strength. Sometimes it needs better coordination and the ability to relax. Core training isn't bad. But “just do more core” isn't a complete treatment plan for pelvic floor dysfunction. If your symptoms aren't improving, stop guessing and find out what your muscles actually need. A pelvic health physiotherapist can assess your pelvic floor, breathing and core function and help you exercise in a way that supports your symptoms—not aggravates them.

Yes. Some children deliberately limit fluids to avoid using the toilet, and it is more common than many parents realise. This "drink to wee" avoidance can set up a cycle of concentrated urine, bladder irritation, toileting anxiety and even accidents or pain. Why children restrict fluids Children may cut back on drinks for several understandable reasons: Toilet anxiety or embarrassment : school toilets, noise, lack of privacy, or fear of accidents can make a child reluctant to go, so they drink less to "stay safe". Previous pain or urgency : if weeing has stung (often from concentrated urine or a mild UTI), a child may try to avoid the sensation by drinking less. Control or routine issues: some children dislike interrupting play, screen time or classroom activities to use the bathroom. Sensory or neurodivergent factors : bathroom sounds, smells, seat texture or transitions can be overwhelming for some kids. The unintended consequence is that low fluid intake makes urine more concentrated, which can sting, increase urgency, and ironically make accidents and bladder symptoms more likely. Signs your child may be avoiding drinks to avoid weeing Watch for patterns such as: Very low fluid intake – rarely asking for drinks, refusing water bottles, or only taking tiny sips. Infrequent toileting – going fewer than 4–5 times in the day, or holding for long stretches at school or during activities. Urgency, accidents or "dancing" behaviours – crossing legs, squatting, fidgeting, or rushing to the toilet at the last minute. Concentrated, dark or strong-smelling urine – a sign they are under-hydrated. Complaints of tummy or bladder discomfort , or pain when weeing. Avoiding certain places or situations – refusing outings, school trips or activities where toilet access is uncertain. How a pelvic health physiotherapist can help Pelvic health physiotherapists assess and treat bladder habits, toileting behaviours and the muscle patterns that support healthy emptying. Your child's assessment may include: Bladder and bowel habits : frequency, urgency, accidents, fluid intake, stool patterns. Toileting posture and routine: how they sit, foot support, relaxation and timing. Pelvic floor muscle function : whether muscles are overactive, tight or poorly coordinated. Breathing and relaxation strategies : to reduce guarding and improve emptying. Lifestyle and school factors : access to toilets, sensory issues, anxiety, and daily routines. T reatment may involve: Education for you and your child about healthy bladder habits and why regular drinking matters. Fluid planning – structured drink targets across the day, with school-friendly strategies. Timed toileting – scheduled sits every 2–3 hours to retrain bladder habits and reduce urgency. Relaxation and breathing techniques – to make weeing easier and less stressful. Pelvic floor down-training – gentle exercises to reduce overactivity and improve coordination. Collaboration with your GP, paediatrician or school – to address pain, UTIs, constipation, anxiety or toileting accommodations. When to seek help It is worth seeing a healthcare professional if your child: Regularly restricts fluids to avoid using the toilet. Wees fewer than 4–5 times per day or holds for very long periods. Has frequent urgency, accidents or "holding" behaviours . Complains of pain, burning or discomfort when weeing. Has dark, strong-smelling urine most days. Shows signs of anxiety about toilets at school, in public or away from home. Has recurrent UTIs, constipation or bedwetting alongside daytime symptoms. Early assessment can prevent a cycle of pain, anxiety and bladder dysfunction from becoming entrenched. Frequently Asked Questions Is it normal for a child to avoid drinking to avoid weeing? It is not "normal" in the sense of being healthy, but it is a recognised pattern, especially in children with toilet anxiety, previous pain, or sensory sensitivities. It is important to address because it can lead to concentrated urine, bladder irritation and more accidents. How much should my child be drinking? As per the guidelines from Healthdirect and the Royal Children’s Hospital (RCH) Melbourne (total fluids from all drinks and foods): 1 to 3 years : about 4 cups (≈1 L) per day 4 to 8 years : about 5 cups (≈1.2 L) per day 9 to 13 years : about 5–6 cups (≈1.4–1.6 L) per day 14 to 18 years : about 6–8 cups (≈1.6–1.9 L) per day Water should be the main drink. Limit caffeine, fizzy drinks and very sugary juices, which can irritate the bladder. When to increase fluids Children need extra drinks when: Playing sports or being very active The weather is hot or humid They have a fever, vomiting, or diarrhoea In these situations, encourage small, frequent sips before, during and after activity or illness, and use oral rehydration solutions if they are unwell. Won't more drinking mean more accidents? Initially, yes. Your child may wee more often. But regular, adequate fluids produce lighter, less irritating urine and help the bladder learn a normal capacity and rhythm. Over time, this usually reduces urgency and accidents. What if my child refuses to drink at school? Work with the teacher to: Allow a visible water bottle on the desk Use a marked water bottle with time-based targets (for example, "finish to this line by recess") so your child has a clear, visual goal. Use a reward system for sips and toilet sits Agree on a consistent routine (for example, drink and toilet at morning snack, lunch and afternoon snack) so it becomes a normal part of the day. Small, frequent sips are often easier than big drinks. Can pelvic floor physiotherapy help if my child is scared of the toilet? Yes. Pelvic health physios use child-friendly strategies to reduce fear, improve relaxation on the toilet, and retrain bladder habits. They often work alongside psychologists, GPs and schools when anxiety or sensory issues are significant. The Bottom Line Avoiding drinks to avoid weeing is a common but fixable pattern. It often stems from toilet anxiety, previous pain, or routine pressures, and it can make bladder symptoms worse by concentrating urine and increasing urgency. If your child is restricting fluids, having frequent accidents, or showing signs of bladder discomfort, a pelvic health assessment can help. Together, you can build a simple, school-friendly plan for drinking, timed toileting and relaxation so your child feels more comfortable, confident and in control of their bladder. You do not have to manage this alone. Our pelvic health physiotherapists can assess your child's bladder habits, address any muscle tension or coordination issues, and work with you and your school to create a practical plan that makes drinking and weeing feel safe and manageable again.

Putting in a tampon should not feel like you're fighting your own body. Yet for many people, tampon insertion can cause: Pain or burning A feeling of tightness Resistance or a “wall” Difficulty inserting it at all Pain when removing it Discomfort that lingers afterwards And often, the response is, “Just relax.” But if you've tried to relax and it still hurts, there's probably more to the story. Why can tampons hurt? There are many possible reasons. Painful tampon use can be associated with: Pelvic floor muscle tension Vaginal dryness Irritation or infection Skin or vulval conditions Hormonal changes Previous painful experiences Conditions affecting the vulva or vagina Sometimes more than one factor is involved. Could your pelvic floor be too tight? It could be. Your pelvic floor muscles surround the vaginal opening and need to relax to allow comfortable insertion. If these muscles are overactive or you're unconsciously tightening them, inserting a tampon can feel painful, difficult or even impossible. This can happen even if you are otherwise healthy. And importantly, a tight pelvic floor isn't necessarily something you can simply “relax” on command. Pain can create a cycle Imagine inserting a tampon hurts. The next time you try, you naturally expect it to hurt. Your body may respond by tightening the pelvic floor muscles before you've even realised it. Then insertion hurts again. Over time, this can create a cycle: Pain → fear or anticipation → muscle tightening → more pain. Breaking this cycle often requires more than simply trying harder to relax. Does painful tampon use mean something is wrong? Not necessarily, but persistent pain deserves attention. If tampon use has always been painful, has suddenly become painful, or is becoming increasingly difficult, it's worth finding out why. A GP, gynaecologist or pelvic health physiotherapist can help identify potential contributors. How can pelvic floor physiotherapy help? A pelvic floor physiotherapist can assess whether your pelvic floor muscles are contributing to the pain. Depending on your symptoms and comfort level, treatment may include: Education about pelvic floor function Breathing and relaxation strategies Pelvic floor down-training Gentle manual therapy where appropriate Gradual desensitisation Advice around comfortable tampon insertion Strategies to reduce muscle guarding An internal examination is not automatically required. Your physiotherapist should explain your options and work within your comfort and consent. Don't force it If inserting a tampon is painful, don't keep pushing through significant pain. Pain is useful information. And if you're experiencing significant pain, burning, unusual discharge, bleeding or other new symptoms, speak with your GP or gynaecologist to rule out medical causes. Frequently Asked Questions Why does inserting a tampon hurt? Tampon insertion can hurt for many reasons, including pelvic floor muscle tension, vaginal dryness, irritation, infection, hormonal changes or vulval conditions. A healthcare professional can help identify the cause. Can a tight pelvic floor make tampons difficult to insert? Yes. If the pelvic floor muscles around the vaginal opening are overactive or unable to relax, insertion may feel painful, tight or blocked. Can pelvic floor physiotherapy help with painful tampon insertion? Yes. When pelvic floor muscle tension or poor relaxation is contributing to symptoms, pelvic health physiotherapy can help with relaxation, coordination and gradually reducing sensitivity and muscle guarding. The Bottom Line Tampon use shouldn't be something you have to grit your teeth through. If inserting a tampon is consistently painful, difficult or impossible, there may be a reason—and it's worth investigating. You don't need to simply “get used to it,” and you certainly don't need to push through pain. If painful tampon use is affecting your periods, exercise, swimming or everyday life, a pelvic health physiotherapist can help you understand whether your pelvic floor is contributing and work with you towards more comfortable, confident movement.

If you've ever wondered whether you need to douche before anal sex, you're certainly not alone. For some people, rectal douching can help them feel cleaner, more comfortable and more confident before intimacy. But there's one important thing that's often misunderstood : Douching doesn't protect you from HIV or STIs. In fact, frequent or forceful douching can irritate the delicate lining of the rectum and potentially increase the risk of infection. So, if you choose to douche, what do you actually need to know? What exactly is rectal douching? Rectal douching involves putting water or another fluid into the rectum and then releasing it, usually to clear stool from the lower part of the bowel. People may choose to douche before anal sex because it can help them feel more comfortable or confident. And that's a perfectly valid personal choice. The important thing is understanding tha t douching is about comfort and preparation — not protection from infection. Does douching reduce the risk of HIV or STIs? No. One of the biggest myths about rectal douching is that it "washes away" bacteria or viruses and therefore makes sex safer. Unfortunately, that's not how it works. The lining of the rectum is delicate. Douching can cause irritation and, particularly when it's frequent or forceful, may cause small areas of damage to the tissue. This can potentially make it easier for infections to enter the body. So while you may feel cleaner afterwards, you aren't necessarily safer. Why can douching increase risk? Think about the inside of your rectum like a delicate lining that you don't want to scrub or strip. Douching can: · Irritate the rectal lining · Cause small tears or inflammation · Disrupt the natural environment of the rectum · Potentially make the tissue more vulnerable to infection The risk may be greater when douching involve s high pressure, larger volumes or repeated flushing. And this is where the idea of "more cleaning = better" can actually backfire. Your rectum doesn't need to be spotless. But isn't douching helpful for some people? It can be. Some people choose to douche because it helps them: · Feel more confident · Feel more comfortable during intimacy · Reduce anxiety about mess · Feel prepared and in control These are real benefits for the person choosing to douche. The key is simply understanding what douching can and can't do. It may help you feel more comfortable. It does not prevent HIV or STIs. Is there a "right" way to douche? There's no universally agreed safe volume or frequency for rectal douching. However, it is recommended to use bulb douching systems of up to 300 ml ideally no more than 2 flushes as gentle squeeze pressure. Keep the pressure low. Avoid forceful flushing or high-pressure systems. The rectal lining is delicate, and unnecessary pressure can cause irritation or injury. Never use household cleaning products such as: · Soap · Detergent · Bleach · Vinegar · Lemon juice These can irritate or chemically damage the rectal lining. Don't keep flushing. You don't need to keep douching until the water runs perfectly clear. Repeated flushing can increase irritation without necessarily giving you any additional benefit. Aim for gentle and minimal rather than repeated and forceful. What about using lubricant? Lubricant is an important part of safer and more comfortable anal sex. But not all lubricants are the same. Some products can be more irritating to sensitive tissue, particularly highly concentrated or hyperosmolar lubricants . Silicone-based lubricants can be a good option for anal sex because they provide long-lasting lubrication and don't dry out as quickly. The most important thing is choosing a product that's designed for the type of sexual activity you're having and using plenty of it. When should you avoid douching? It's best to avoid douching if you're already experiencing: · Anal or rectal pain · Rectal bleeding · An anal fissure · Painful haemorrhoids · Significant irritation or sores If something is already irritated, flushing it isn't likely to help. If you're experiencing ongoing pain, bleeding or other symptoms, it's worth getting assessed rather than trying to manage the problem yourself. What actually reduces the risk of HIV and STIs? This is the really important part. Douching isn't a safer-sex strategy. Depending on your circumstances, strategies that can actually reduce your risk include: Condoms - Condoms can reduce the risk of HIV and many other STIs when used correctly. PrEP - PrEP, or pre-exposure prophylaxis, is highly effective at preventing HIV when taken as prescribed. If you're at risk of HIV, talk to your GP or sexual health service about whether PrEP is right for you. Regular STI testing - Regular sexual health checks are important, particularly if you have new or multiple partners. Communication - Talking openly with your partner about sexual health, testing, condoms and PrEP can help you make informed decisions about your sexual health. What about microbicide enemas? You may have heard about research into rectal microbicides, including products containing tenofovir. This is an interesting area of research, but these products are not currently an established replacement for proven HIV prevention strategies such as PrEP and condoms. Frequently Asked Questions Does rectal douching prevent HIV? No. Douching does not prevent HIV and may potentially increase vulnerability to infection by irritating or damaging the rectal lining. Does douching prevent STIs? No. Douching doesn't protect against STIs. In fact, irritation or damage to the rectal lining may potentially increase the risk of infection. How often should I douche? There's no established "safe" frequency. As a general harm-reduction approach, less frequent and gentler is better than repeated, forceful douching. Can I use soap or other cleaning products? No. Soap, detergents, bleach, vinegar, lemon juice and other household products can irritate or damage the delicate rectal lining. Stick with plain, lukewarm water if you choose to douche. Do I need to douche before anal sex? Not necessarily. Whether you douche is a personal choice. Some people find it helps them feel more comfortable or confident, while others don't feel the need to do it at all. You don't have to douche to have enjoyable anal sex. The Bottom Line Douching is about comfort — not protection. If you choose to douche, keeping it gentle, simple and infrequent can help minimise irritation to the delicate rectal tissue. But don't rely on douching to protect you from HIV or STIs. Condoms, PrEP and regular STI testing are far more important when it comes to safer sex. And remember: your body doesn't need to be perfectly clean to enjoy sex. If you're experiencing pain, bleeding, irritation or ongoing anal or rectal symptoms, a pelvic health physiotherapist or healthcare professional can help you work out what's going on.