Mills & Boon's romance novels should come with a health warning, according to a report published in an academic journal.

Blaming romance novels for unprotected sex, unwanted pregnancies, unrealistic sexual expectations and relationship breakdowns, author and psychologist Susan Quilliam says that "what we see in our consulting rooms is more likely to be informed by Mills & Boon than by the Family Planning Association", advising readers of the Journal of Family Planning and Reproductive Health Care that "sometimes the kindest and wisest thing we can do for our clients is to encourage them to put down the books – and pick up reality".

Her comments follow a recent claim that romance novels can "dangerously unbalance" their readers, with Christian psychologist Dr Juli Slattery saying she was seeing "more and more women who are clinically addicted to romantic books", and that "for many women, these novels really do promote dissatisfaction with their real relationships".

Writing in the latest issue of the academic magazine, published by the British Medical Journal, Quilliam said that the messages of "the post-sexual revolution bodice rippers of the 1970s", which typically see "the heroine being rescued from danger by the hero, and then abandoning herself joyfully to a life of intercourse-driven multiple orgasms and endless trouble-free pregnancies in order to cement their marital devotion", run "totally counter to those we try to promote".

"We don't condone non-consensual sex. We want women to be aware of their own desires rather than be 'awakened'. We aim to reassure our female clients that their first time may not be utterly joyful and that they may not gain reliable orgasms through penetration, but that they themselves are nonetheless existentially valid and that with affection and good humour things can improve immensely," writes Quilliam. "We warn of the stresses of pregnancy and child-rearing, and we discourage relentless baby-making as proof of a relationship's strength. Above all, we teach that sex may be wonderful and relationships loving, but neither are ever perfect and that idealising them is the short way to heartbreak. But are our lessons falling on deaf ears when compared to the values of the Regency heroine gazing adoringly across the Assembly Rooms to catch a glimpse of her man?"

While Quilliam admits that more recent Mills & Boon novels are truer to life, with female characters holding jobs and addressing challenges such as disability and domestic violence, as well as enjoying "many and varied" sexual activities, "still a deep strand of escapism, perfectionism and idealisation runs through the genre". Highlighting her concern that in a recent survey only 11.5% of romantic novels mentioned condom use, Quilliam says there was also a "clear correlation" between the frequency of romance reading and a negative attitude towards condoms.

A "huge number of the issues that we see in our clinics and therapy rooms are influenced by romantic fiction", according to Quilliam, who believes romance readers are inclined to suspend rationality in favour of romanticism. This could, she says, lead to a reader not using contraception because she wants "to be swept up by the moment as a heroine would", to the termination of a pregnancy "against all her moral codes because that same man asks her to", to panic if sexual desire "takes a nose dive ... after all, such failure never happens to a heroine", and from there to the end of the relationship.

"If readers start to believe the story that romantic fiction offers, then they store up trouble for themselves – and then they bring that trouble into our consulting rooms," writes Quilliam. "When it comes to romantic fiction, the clue's in the name; the genre is fiction not fact, and while romance may be the wonderful foundation for a novel, it's not in itself a sufficiently strong foundation for running a lifelong relationship. But I do wonder how many of our clients truly realise that. Yes, they say that they can distinguish fact from fantasy, but when it comes to making life decisions, are they not much more tempted to let heart dictate simply because they are romance fans?"

Mills & Boon said in a statement: "Mills & Boon is synonymous with the romantic fiction genre, which is of course an enjoyable means of escaping everyday life, but not a guide to reality. Our readers are intelligent enough to understand the difference, just as the many fans of rom coms and chick flicks would not choose to mirror in their lives what they see on film."