sexual health: we need more conversations about anal sex, experts say

it can be hard to talk about sex, but open discussions will help to prevent infections, injuries and stigma.

by dave yasvinski

published aug 26, 2022

last updated aug 29, 2022

5 minute read

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5 minute read

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we should talk more about anal sex, experts say

societal taboos have made health professionals reluctant to have frank discussions. getty

when a pair of surgeons warned that doctors are “failing a generation of young women by not talking about anal sex,” it laid bare an uncomfortable truth: many people feel the same way — at least outside of the bedroom. with national surveys revealing that anal sex is on the rise among heterosexual couples, tabitha gana and lesley hunt were disappointed that societal taboos have made health professionals reluctant to talk about a growing activity and only willing to do so in the context of avoiding sexually transmitted infections (stis). this, of course, glosses over many important issues and leaves curious individuals fumbling in the dark when it comes to what should be a pleasurable activity among consenting adults.

one of the most important things to consider before engaging in any sexual activity is how to protect your health.

safe anal sex

anal sex is considered riskier than other types of sex because the delicate nature of the skin inside the anus increases the risk of tiny tears that can make it easier to contract an sti or suffer an injury. there’s also the added complication that comes from potential contact with bacteria that can lead to urinary tract infections or gastrointestinal illness if anal sex is quickly followed by vaginal or oral sex.

even if you’re in a monogamous relationship and both partners have been tested for stis, such as hiv, hpv and gonorrhea, it’s a good idea to have barriers like condoms on hand and to carefully wash toys or anything else that enters the anus before it goes anywhere else. there are also other protective options, such as hand condoms (surgical gloves) and finger condoms — also known as finger cots — which work as a one-finger barrier. both can be found in the first aid section of a pharmacy. dental dams are rectangular latex barriers that can be used for protection during oral sex.

and if you happen to be having regular anal sex, especially if you are immunosuppressed, you can request an anal pap test — just like the one done on the cervix — to check for hpv.

there are also claims that anal sex can cause fecal incontinence by stretching the anal sphincter muscle, causing nerve damage which can lead to a loss of control, but according to gastroenterologist frederick gandalfo, there’s still a lot we don’t know about the implications of anal sex. and new york city sex therapist ian kerner, author of she comes first, told women’s health that although none of his clients who have anal sex have complained of this issue, a weakened the sphincter muscle — which holds in feces — is not impossible. he recommends doing kegel exercises to keep your sphincter muscles toned.

oh and anal sex does not eliminate all possibility of getting pregnant — another reason to use a condom.

give it a test run

anal sex can mean putting a penis in an anus, or using toys, fingers or even a tongue to get things going. figuring out what you’re up for ahead of time will help make things go more smoothly, jill mcdevitt, a sex educator, told self magazine.

“i always recommend people try most things on their own first before a partner,” she says. “it helps you gain comfort and confidence, learn what you like and want and don’t like and don’t want.”

speaking of toys, there are plenty of options — from butt plugs to anal beads to dildos — but the best way to start down this road is to spend a little time with yourself to figure out what you’re comfortable with. it’s important to note that not all toys are safe for anal play, so make sure whatever you use has a flared base to minimize the risk of it getting lost inside of you.

don’t skip the lube

when it comes to anal sex, lubrication is important, as it minimizes the risk of tearing the delicate skin around the anus which increases your risk of transmitting — or exposing yourself to — an sti and bacteria. oil and silicone-based lubes are generally good options for anal sex because they are thicker and longer lasting. if you’re using condoms, however, avoid oil-based options as they can break down the condom and introduce unnecessary risks. similarly, silicone-based lubes don’t play well with silicone toys, so water-based lubes may be the way to go, depending on what you have planned.

it’s also a good idea to avoid numbing lubes as they decrease sensitivity and may make it difficult to tell if you’re pushing your body further than its ready to go.

what about the poop factor?

although a common concern, the odds of actually pooping on your partner are low as the rectum (where anal sex occurs) doesn’t usually have fecal matter in it. there is always a chance, of course, that tiny amounts of poop may make an unwelcome appearance but as long as everyone is aware of the possibility, it will be less embarrassing. plus it’s pretty easy to clean up (or change condoms) and get back to business.

some people prepare in advance by washing with a soapy cloth or even having an enema to ensure the area is clean. while not strictly necessary, this all depends on your comfort level.

take it slow

if you’re moving on to penetrative anal sex, it’s always a good idea to start small and move slow. this can involve using lots of lube and fingers or toys that gradually increase in size to help your body adjust and relax. trust and communication between partners is a key part of making sure everyone is comfortable.

if it’s your first time, consider positions that make the experience easier and allow you to control the depth and angle of the activity, such as being on top. also, “anal play doesn’t have to mean anal penetration,” mcdevitt says. “certainly, it can include that, but you don’t have to ‘work up to’ that if you don’t want to.”

the bottom line

if you prepare and take it slow, you can ensure your experiences with anal sex are more likely to be safe and enjoyable. injuries are possible, however, depending on how much foreplay you engage in, how much lube you use and how vigorous things get. if you experience any persistent pain or unusual bleeding within a few days, or have symptoms that seem indicative of an injury or sti, consult a doctor to make sure there’s nothing to be concerned about.

update: 2022-08-29: the headline of this article was updated to reflect the opinion of experts in the field.

dave yasvinski is a toronto-based writer.

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dave yasvinski

sexual health: we need more conversations about anal sex, experts say