Anal Sex Dangers
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Anal Sex Dangers
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March 3, 2022 / Sex & Relationships
Anal sex can be safe if you’re prepared for the experience
August 8, 2022 / Sex & Relationships
August 8, 2022 / Sex & Relationships
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If you’re considering anal sex for the first time, you’re not alone. Though it may have once been taboo, it’s become more widely accepted over the last few decades.
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And if you think anal sex only involves penetration by a penis, you’d be wrong: Anal sex can include fingers, tongues and accessories, too. It can also be enjoyed by any gender and sexual orientation.
Of course, like sexual activity of any kind, there are some risks. But with the right amount of communication, preparation and patience, anal sex can be a positive experience for all parties involved.
Gastroenterologist Michelle Inkster, MD, PhD, walks us through the anatomy of the anus while offering helpful tips to avoid injury and infection.
Getting started might sound really intimidating. But it can be less scary (and actually fun) the more you learn.
Your anus doesn’t create its own lubricant. That means you’ll need to lubricate it yourself. Without lubrication, the delicate tissue inside of your anus can tear, which can be painful and put you at risk for infection.
Sometimes during foreplay, people will lubricate their anus with their mouth before moving on to water or silicone-based lubricant. This process, medically known as analingus, can help your partner relax. But it does add its own set of risks.
“It’s a good way to get infections if you’re not clean,” says Dr. Inkster. “If you’ve got cracks in the skin in your mouth or you have irritated gums from brushing your teeth, it’s a really easy way to get a bacterial or sexually transmitted infection.”
You can use barrier protection like a dental dam to avoid possible infection. Ultimately, your method of lubrication is a personal choice. What’s important is that you and your partner are both well-prepped for the experience. You’ll want to lubricate the outside of your anus, as well as the penis or accessory that’s penetrating it. And if you’re ever uncomfortable — try more lube.
“Making sure you’re adequately lubricated is the main thing,” says Dr. Inkster.
Your anus provides a protective barrier to your intestines. While the tissue on the outside of your anus tends to be rigid, the tissue on the inside is thin and delicate making it easier to tear or bleed. This means there’s a higher chance of transferring an infection or virus to your partner if a tear occurs.
“Whatever bacteria is back there shouldn’t be an issue when you’re using a condom,” says Dr. Inkster.
There are also many blood vessels supplying blood to the entire area. When pressure occurs inside of your anus, this can cause those blood vessels to swell, resulting in hemorrhoids . If left untreated, this can cause more pain and potential bleeding.
But there are also a ton of nerve endings on the inside and outside of your anus, making the entire area more sensitive.
“A massage there before you do anything else can help people relax,” suggests Dr. Inkster.
Your anal sphincters are elastic rings of muscle. They open and close so you can push bowel movements out of your body and keep other things from getting inside. You can relax those muscles to allow for anal sex, too.
“If you’re anxious, your anus can tighten up and it can make it hard to insert anything,” says Dr. Inkster.
You probably wanted to hear something different, but accidents can happen. And even if this never happens to you, there are billions of bacteria inside of your anus (just like the vagina). This means it’s important to be prepared whenever possible.
Dr. Inkster suggests going to the bathroom up to 30 minutes beforehand. If you have time, showering before sex can be helpful as well. Using your fingers with a little bit of water may help you relax, too. When cleaning daily, make sure you don’t over-wipe or use any chemical products because that can irritate your skin.
Non-chemical, unscented baby wipes are best for staying fresh. But some people prefer to douche or use an enema. Most doctors advise against douching or using an enema because it can thin the tissue inside of your anus if it’s done excessively. Plus, thinning of your anal tissue can make you more likely to get an infection. If you do intend to use an enema or douche, it’s important you only use warm water an inch or two inside of your anus. “You don’t have to clean everything out,” says Dr. Inkster.
“For some people, the only way they think they might be able to have anal sex is by using an enema or douching, but as long as it’s water and it’s not chemical, it’s not as bad,” notes Dr. Inkster. “Anything that’s chemical on a chronic basis is not a good idea.”
If you’re having diarrhea, it can be a possible sign of infection or cause further irritation.
Of course, we can’t always plan for every occasion. If you find you’re not prepped for the occasion, make sure you communicate. A quick trip to the bathroom while your partner gets things ready might save you both some headache.
“You might have to do a short rinse with water or something like that just for cleansing,” says Dr. Inkster.
Anal sex can present a lot of complications. But you can avoid a lot of risks if you’re patient, communicative and safe.
As with any sexual activity, you and your partner should hold each other accountable. It’s important to check in with one another often or whenever you experience a sign of pain or discomfort. Sometimes, people have a safe word, just in case, to let their partner know they’ve had enough. But you could just say no, too, if it gets too intense.
“If you penetrate someone and there’s a little bit of discomfort, you can pause and gently move along when they’re ready,” says Dr. Inkster.
The first time is always the most uncomfortable. Your anus may not be used to being penetrated, so it’s important that you work up to the moment. If you rush, you can cause serious injury, and no one wants that.
It’s normal to experience some discomfort and pressure the first time you try anal sex. But if pain increases or if it’s consistent, you should stop. Pain often means you may not be lubricated enough or your anal muscles are too tight. Some people just have a tighter sphincter, which can also make it difficult for them to have bowel movements.
Being anxious about the experience can also cause you to clench and tighten up. It’s important that you trust the person you’re having anal sex with, and it’s important that person takes their time. Start gradually and move your way up to what you’re comfortable with.
“Once you’re used to the actual act itself, and you know you’re enjoying it, that anxiety tends to go away,” says Dr. Inkster.
If you’re still having difficulty, you can train your anus — like any other muscle — by using dilators, a tube-shaped stretching device. Ideally, you would start with a small dilator, leaving it inside your anus for 10 minutes at a time a couple of times a day for about a week. But if it’s not enough, you can then move up to a larger dilator and repeat the process until you’ve relaxed your anus enough to allow for penetration.
“After about three weeks, it might be relaxed enough to be able to have sex and not have pain,” says Dr. Inkster.
If you’re a first-timer or you’ve never used a dilator before, Dr. Inkster suggests having your healthcare provider show you how to use them properly before trying it yourself to avoid injury.
Thin tissue means it can tear easily. It’s important that your partner trims their nails to avoid any jagged edges. If you’re using sex accessories, it’s also important that you avoid ridges or those large in size. If your accessory has a base, make sure you avoid putting the base inside of your anus, as it can tear the opening.
If you experience a sharp, intense shooting pain, that means you may have perforated or torn a hole in your rectum and you should stop immediately. If the pain doesn’t go away within 30 minutes, you should go to the emergency room.
“You would know because it would be the most incredible pain,” says Dr. Inkster. “This can happen with fingernails or accessories if you put them in sideways, or if they’ve got sharp edges or they’re too long.”
Small spots of blood are normal, especially if it’s your first time. But if you’re bleeding heavily, or you’re experiencing blood an hour or more after sex, you should see your doctor.
“Bleeding can happen with perforation because you rip some blood vessels,” says Dr. Inkster. “It can also happen when you’re forcing things or if you’re having rough sex.”
Syphilis, chlamydia, gonorrhea, HIV — you name it, you can catch it if you’re not cautious.
“But with a condom, it’s less risky,” says Dr. Inkster.
Even if you or your partner don’t have any sexually transmitted infections, you can pass bacterial infections and viruses to each other. This is also why it’s incredibly important that you don’t pass accessories back and forth and that you clean them between uses or before you use them in areas other than your anus.
If you’re with a consensual partner and don’t use a condom, it’s important that you consider using PrEP (pre-exposure prophylaxis) because it can be 99% effective in reducing the risk of contracting HIV.
HPV (human papillomavirus) is a highly contagious sexually transmitted disease you should be concerned about especially if you’re engaging in anal sex.
“It’s really important to wear a condom because if you have HPV that’s not treated, it can lead to anal cancer,” says Dr. Inkster.
There are more than 200 types of HPV. While healthcare providers often perform HPV tests during Pap smears or Pap tests , you can also request an anal Pap test.
“If you see something in the cervix where HPV can live, it’s probably in the anus, too,” says Dr. Inkster.
Whether you have a cervix or not, Dr. Inkster suggests getting an anal Pap each year if you’re regularly having anal sex — especially if you’re immunosuppressed.
“If someone has a negative anal Pap smear, we may skip a year here or there, but if you actually have something, then we try to find whatever is causing the problem,” says Dr. Inkster
Anal sex can be risky if you’re not prepared. By making time to prep for proper hygiene and relaxation, you can have an enjoyable experience. Like vaginal sex or oral sex, condoms and barrier protection are most important when avoiding bacterial infection or sexually transmitted infections.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
If you’re considering anal sex for the first time, you might be feeling nervous. But with a little preparation and ample communication, you can have a safe and positive experience.
Originally Published: Feb. 5, 2016
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When it comes to the negative side effects of anal sex , it's hard to get a straight answer. Because the act of anal sex is still relatively taboo, it’s now easier than ever to get helpful information about all its aspects, including how to do it safely. For people who like it (and who use lots of lube), there are some benefits of anal sex, like the possibility of anal orgasms and feeling closer to your partner. But there are also dangers of anal sex that doctors want you to know about before getting into it.
Whether the thought of anal makes you swoon or cringe, people are doing it in droves. Research by the National Survey of Family Growth, published by the Centers for Disease Control and Prevention (CDC) in 2019, found that 32.6% of women had had anal sex with an opposite-sex partner (no stats were available for same-sex anal between women). These stats, according to the CDC, are up quite a bit from the 1990s, when only 20% of women had tried it (or, revealed that they'd tried it).
But, as with everything in life, there are definitely some negatives to having anal sex. Bottoming may not be your style, or you may need to take it very slow as a beginner . For those who love anal sex , are apprehensive about it, or are just plain curious, here are five possible negative side effects to having anal sex.
The reason anal sex aficionados are so adamant about using lube isn’t just because it makes it feel better, but because it also helps limit anal tearing.
“Your anal canal is really absorbent, and unlike a vagina, your butt is not self-lubricating, so you absolutely need to use lube when you're having anal sex to avoid tearing, which can increase risk for STI transmission ,” sex educator Emma McGowan previously wrote for Bustle . While anal tearing may not seem like that big of a deal (although uncomfortable), and all STIs are treatable , having cuts in your butthole is a recipe for all sorts of bacteria that can easily make their way into the bloodstream.
Harvard Health notes that while some tears can be superficial, others can be deeper, harder to heal, and more likely to get infected. Doctors recommend that people doing anal sex use both lube and a condom in order to minimize anal tears and protect from STIs. Double check that the lube itself is compatible with the condom, since oil-based lubes can degrade latex .
According to the CDC, anal sex is the riskiest type of sex that people can have. One of the major dangers of anal sex is how easily it can be to contract and transmit HIV when having it. Because the anus doesn't naturally produce lubrication and the skin in this area is very thin, anal tears are basically welcome mats for HIV, HPV, and other STIs. It’s one of the potential side effects of bottoming.
"It's important to remember that [STIs] can be transmitted through anal sex as well as vaginal sex," Dr. Jennifer Caudle M.D., a family physician and assistant professor at Rowan University School of Osteopathic Medicine, tells Bustle. A review of data from the National Survey of Family Growth in 2016 found that in women who had anal sex recently — within the past three months — rectal chlamydia and gonorrhea were almost as common as UTIs . But these illnesses were often missed because a lot of sexual health checks for women only involve the front, not the back door.
Condom use can help prevent transmission of all STIs, and therefore are a must during anal (or any non-monogamous sex you’re having). And doctors now recommending that if you have anal sex, you tell the person conducting your next sexual wellness check about it.
One of the STIs anal sex puts people at risk of is human papilloma virus (HPV), which is linked with oral, cervical, and anal cancers , according to the American Cancer Society. Not all kinds of HPV are linked to cancer (and you can be vaccinated against those that are), and many strains are asymptomatic, but experts advise that HPV and its associated illnesses are one of the risks of anal sex.
"Even though [HPV] usually goes away on its own , in some cases it does cause cancer," Jill McDevitt , Ph.D., CalExotics resident sexologist and sexuality educator, tells Bustle. "HPV is considered the main cause of anal cancer ." The CDC estimates that every year in the U.S., around 4,700 cases of HPV-associated anal cancers are diagnosed in women and 2,300 in men. A 2020 study published in Journal of the National Cancer Institute found that anal cancers have been rising in the past 15 years, in part because of higher HPV rates.
While McDevitt points out that pap smears — cervical screening for the presence of possible pre-cancerous and cancerous cells — aren't just well-known but routine, the case is not the same for anal pap smears . "Anal paps also exist," McDevitt says. "But there are currently no national guidelines for routine screenings , to my knowledge." You can still request an anal pap from your health care provider if you're concerned about contracting a cancer-linked strain of HPV.
Let’s not beat around the bush: The anus is a direct path to the bowels. Bowels are, of course, home to poop. Poop is a waste product that's bursting at the seams with bacteria and other not so fun stuff.
Once you subtract the STI part of the equation, it's time to think of the infections that come with E. coli — the bacteria that live in the bowels . Spreading E.coli to mouths or other orifices carries risks; for one, E.coli is one of the main causes of a urinary tract infection in women after anal sex , according to a 2015 study in African Journal of Reproductive Health.
This also means that going from anal sex to vaginal sex , without properly washing in between, may increase the risk of a partner with a vagina getting a UTI, as well as other possible unpleasant infections.
"A condom is the safest thing in terms of not sharing good old fashioned bacterial infections [during anal]," Laura Deitsch , a licensed clinical counselor and sexologist, told Bustle in a previous article. "If rimming is going to be part of your play (mouth to anus) be sure to clean really well around the area ahead of time."
Newton’s third law of motion states, “What comes up, must come down.” This applies to both gravity and poop coming out of your butt after anal. Puns aside, this sh*tty situation extends far past the possibility of anal sex with a side of poop. A 2016 study published in Journal of Gastroenterology found that anal sex may lead to fecal incontinence . While the research found that both men and women can experience fecal incontinence because of anal sex, it’s men who deal with it more.
For people who have any sort of gastrointestinal (GI) problems, then the dangers of anal sex become even more complicated. "Something else to note as far as the negative side of anal sex is for folks who have GI issues, like Irritable Bowel Syndrome (IBS) or Crohn's Disease," McDevitt says. "It can already be a painful area of the body, and anecdotally, many people who have GI problems struggle with anal sex."
While anal sex may have some negative side effects, some that may even be considered dangerous, experts say bottoming can have its benefits, and it’s good to be knowledgable about the dangers and how to manage them. "There is a downside to most things, including sex," McDevitt says. "It's about being informed and weighing risks, and ultimately doing what's best for you."
Jill McDevitt , Ph.D., CalExotics resident sexologist and sexuality educator
Dr. Jennifer Caudle , MD, family physician and assistant professor
L aura Deitsch , DHS, MS, NCC, licensed clinical counselor and sexologist
Deshmukh, A. A., Suk, R., Shiels, M. S., Sonawane, K., Nyitray, A. G., Liu, Y., Gaisa, M. M., Palefsky, J. M., & Sigel, K. (2020). Recent Trends in Sq
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