Anal Sex Injuries
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Anal Sex Injuries
Anal injuries carry the same risk as assaults on younger persons due to the increased vasculature of the rectum.
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Copyright © 2022 Elsevier B.V. or its licensors or contributors. ScienceDirect ® is a registered trademark of Elsevier B.V.
ScienceDirect ® is a registered trademark of Elsevier B.V.
Medically Reviewed by Isabel Lowell, MD on October 20, 2021
Anal sex is the term used for any sexual activity that involves the anus. It doesn’t always include anal intercourse.
The anus is full of nerve endings, making it very sensitive, and many people find anal sex pleasurable. An estimated 90% of men who have sex with men and as many as 5% to 10% of sexually active women have anal intercourse.
As with many forms of sex, it has risks, but by planning and communicating with your partner you can reduce a lot of these risks and enjoy the intimacy.
There are other things to be aware of as well:
Use a condom to protect against the spread of infections and diseases.
Some problems need a doctor’s treatment. Talk to your health care provider if you have:
Talk to your doctor about your symptoms. They may suggest:
Treatment for problems from anal sex will depend on your symptoms and diagnosis. For pain, fissures, and hemorrhoids, your doctor may suggest:
To treat an STD, you may need antibiotics or antiviral medication, depending on your infection.
News release, International Microbicides Conference.
University of Illinois at Urbana-Champaign McKinley Health Center: "Anal Sex: Questions and Answers."
News release, New York City Department of Health and Mental Hygiene.
University of California, Santa Barbara, SexInfo Online: "What Are the Dangers of Anal Sex?"
Columbia University's Health Q & A Internet Service, Go Ask Alice: "Pain from anal sex, and how to prevent it."
Cedars-Sinai: “Anal Fissure,” “Anal Fistula.”
Mayo Clinic: “Is colon cleansing a good way to eliminate toxins from your body?” “Sexually transmitted diseases (STDs).”
CDC: “Nail Hygiene,” “Dental Dam Use,” “Anal Sex and HIV Risk,” “Genital HPV Infection -- Fact Sheet.”
Center for Community Health: “Tips for Anal Health -- Ways to Take Care of Your Bottom.”
American Journal of Gastroenterology : “Anal Intercourse and Fecal Incontinence: Evidence from the 2009-2010 National Health and Nutrition Examination Survey.”
Harvard Medical School: “Digital Rectal Exam.”
© 2005 - 2022 WebMD LLC. All rights reserved.
WebMD does not provide medical advice, diagnosis or treatment.
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It is not normal for anal to be painful, seriously.
When it comes to anal sex, there are a LOT of myths out there. Like any other sex act, there are misconceptions everywhere, but with anal, it always seems like there’s more out there than others. Perhaps it’s due in part to the more taboo nature of anal, but it’s totally normal have a lot of questions about anal, like if anal sex hurts, if you can orgasm from anal, and of course, is everyone having anal regularly now?
To help debunk some of the myths around anal, we rounded up a bunch of experts. Namely, Tatyannah King, a sexual health and wellness blogger ; Jenni Skyler, PhD, LMFT, and CST , an AASECT certified sex therapist and sexologist for AdamEve.com ; Sarah Melancon, PhD, clinical sexologist and expert for sextoycollective.com ; expert anal surgeon Evan Goldstein, DO , of Bespoke Surgical ; LGBT sex expert Kryss Shane , MS, MSW, LSW, LMSW; Daire Faust of SmutGeek.com ; Kat Van Kirk, PhD , a clinical sexologist and marriage and family therapist; and board-certified ob-gyn Terri Vanderlinde , a sex counselor.
The truth: Of course, with anal, the elephant in the room is usually about poop. It makes sense to wonder about the likelihood of encountering fecal matter during anal since it is anatomically logical, but anal isn’t quite just the feeling of pooping backwards. As Tatyannah King, a sexual health and wellness blogger explains, anal sex can feel “dissimilar” upon insertion and penetration, but the more relaxed someone is during anal, the more comfortable it will feel. It’s also a good idea to get started with anal training, or having you your partner insert a finger or toy into your anus before going straight in for penetrative anal sex with a penis or larger toy.
The truth: Not true! Orgasming is much more than just being penetrated (in fact, hi, a majority of those with vaginas need external clitoral stimulation to orgasm rather than just penetration), and many pegging toys have built-in vibrators or pockets for vibrators you can use. Some pegging strap-ons are even “strapless” meaning you hold the dildo inside your vagina using your pelvic muscles (or hands!) to peg your partner. And of course, you’re also more than free to touch yourself while pegging your partner.
The truth: It's not normal for pleasurable anal sex to hurt . Nope, pain during sex shouldn’t be a factor if you’re doing it correctly, King explains. If anal is painful because there isn’t enough foreplay beforehand or you’re not lubricated enough, or you’re just diving into things too suddenly to the point of causing pain: stop. “Ultimately, sex should be pleasurable,” King adds, so focus on making it as pleasurable as possible for you instead of approaching it from a “how can this hurt the least” perspective, because when done correctly, it shouldn’t! King also suggests getting a long-lasting silicone lube (be sure it’s condom-safe or toy-safe if you’re using it with either) for anal and making sure you’re wholly turned on and your body is looking forward to the experience. Relaxed anal sphincter muscles make penetration way easier and will help alleviate any concerns about pain, King says.
The truth: “While it’s common to have some bleeding after anal sex, it’s not normal ,” King says. Yikes. The reason behind this is in part because the rectum doesn’t have the same elasticity that the vagina has, so it can be more prone to tears, explains King. Makes sense when you consider that vaginas are built to have babies pass through them whereas what normally exits your anus is uh, not baby-sized. Many anal tears can also be so small that they don’t bleed, King adds, so if you are heavily bleeding, it’s best to check in with your doctor.
The truth: Not necessarily. If you’re taking time for proper foreplay, lubing up, easing the muscles of your anal sphincter enough for pleasurable sex, and also eating a healthy amount of fiber and staying hydrated, your digestive health should keep running smoothly, King says. Making sure you’re eating enough fiber (unsexy, I know, but there’s no way around it) and drinking lotsa water to keep your bowels working correctly is one of the smartest things you can do if you want to make anal a regular activity.
The truth: There isn’t enough clear evidence from doctors and researchers that fecal incontinence is a true long-term risk of anal sex, says King. There was a 2016 study in The American Journal of Gastroenterology that examined the sexual behavior of over 4,000 adults, asking them if they had anal intercourse, and whether they had fecal incontinence. While the study found that men who had anal intercourse had a higher rate of fecal incontinence than women, however , King explains that experts have since criticized the study as it didn’t completely evaluate other possible contributing factors to incontinence. Long story short, more research is needed.
The truth: You absolutely should not use a desensitizing or numbing lube during anal. While the idea of a lube to help ease you into anal seems good at first, in reality you should never use one of these during anal, or any sex, really. Why? Pain is your body’s way of letting you know to slow your roll. If you don’t feel any discomfort during sex because your anus is numbed TF out, you may still feel discomfort later on — and worse, you won’t have the option to go back in time and slow down. Not only that, but desensitizing lubes can also potentially keep you and your partner from enjoying the pleasurable experience of anal, adds King.
The truth: Not really. Pegging can actually be an excellent option for both givers and receivers, especially if the giver doesn’t have a penis, explains Skyler. One great thing about pegging, is that since it’s done with dildos, the receiver has an option of picking exactly what material, size, shape, and functionality (vibrating or not). They can also choose to go up in size or down, depending on how their bodies respond. Pegging can also be empowering for givers, as it gives them an option to experience penetrating their partner and or more dominant pleasure, Skyler adds. And, many pegging harnesses also have special pockets for vibrators, which is also a plus.
The truth: Anal, like any other sex act, can be as intimate or non-intimate as you make it, says Skyler. “Any sex act done as a transaction with someone you don’t care much about will be empty of intimacy,” she adds. However, that also means that any sex act, including anal, “done from a heart-centered place with intention for full-body and mind connection, will feel quite intimate.” Anal is not inherently more or less intimate than other forms of sex like vaginal, oral, or anything else. It’s how you and your partner treat it and each other that informs how it is received.
The truth: “People of any gender have the physiological potential to orgasm from anal sex — giving or recieving,” explains Melancon. While some women can orgasm from anal sex alone, some orgasm when clitoral stimulation is involved. Some men can also orgasm from recieving anal penetration, such as if you’re pegging your partner, and some women can also orgasm while using a strap-on to anally penetrate their partner, Melancon adds. The great thing about anal is that it doesn’t have to be just anal. You’re also free to add other toys and sensation into the mix, like vibrating dildos , clitoral vibrators , cock rings , whatever floats your boat.
The truth: While it’s technically true, the fact of the matter is that depending on where the ejaculating partner ejaculates and how careful you both are at cleaning up, there’s still some risk involved, says Melancon. Let’s say you’re in doggy-style , and your partner ejaculates inside your anus but isn’t careful when they pull out. “It’s rare, but possible semen could leak down south toward the vagina and get inside,” says Melancon. Another good reason to always wear a condom and practice safe sex ! As another bonus, condoms make any potential clean up needed afterwards way easier as well.
The truth: Dr. Goldstein explains that stool actually hangs out higher in your body, above the anus and rectum in a section known as the sigmoid colon. In reality, if you eat healthily and get enough fiber for regular, bulky stools, this should be enough to keep the anal canal clean for play. “People tend not to believe it when we share this information, so take a toy and test the landing strip. Prove it to yourself,” he says.
The truth: “Attempting to equate gender identity with a sexual act is just totally incorrect,” explains Shane. “Although anal sex and vaginal sex both often involve insertion, a transgender woman is, as is true of all people, never required to engage in any sex act at any time.” There are plenty of other ways for transgender women to have sex.
The truth: You don’t need to have a penis to be into anal at all! “Many women are interested in anal, both receiving and giving,” says Faust. “Lesbian couples and nonbinary gendered partners also can, and many do, enjoy anal using toys, finger, and rimming,” she adds.
The truth: Is any kind of sex just like what you see in porn? “Anal sex requires preparation,” Shane explains, and this can include conversations about consent beforehand, ensuring you have condoms ready, and more. When you watch it in porn, anal might seem like something you can launch into spontaneously, but real-life anal requires much more care and consideration and can go more slowly. “It can take multiple rounds to reach a point of full insertion and pleasure for both partners,” says Shane. “Both need to expect to be vocal about the experience and in agreement about how to proceed and when to stop.”
The truth: “It’s critical to train your anal sphincters to accommodate butt plugs, toys, or penises, and that takes time,” says Dr. Goldstein. Just like any other muscle, your anal sphincters need “periodic exercise in order to increase flexibility and overall distensibility.” Dr. Goldstein recommends getting an anal dilation kit with three gradual dilators so you can work your way up. “Try to consciously relax to accommodate and then slowly remove—all in one continuous motion. Re-lubricate and insert again with a similar technique of slowly in, meeting resistance, and then slowly pulling out,” he says. If done correctly, you shouldn’t feel any pain at all. You should try practicing this technique four to six times before going for full penetration. It’s totally fine to take a few weeks to build up to the act too. Dr. Goldstein recommends practicing for two weeks with each of the three sizes before trying penetration with a partner.
The truth: Lots of people are. According to data from 2010 , 40 percent of women between ages 20 to 24 had tried anal sex. That’s a lot of women.
The truth: Mmm, pretty sure there’s no such thing as “needing” an enema before a sex act. But understandably, a major concern about anal sex is that it’ll make you poop. First off, it’s highly unlikely that you’ll actually poop because of anal stimulation. But if you’re extremely worried about it, there are a few things you can do to avoid An Accident. The most obvious thing is to act like you’re preparing for a road trip by going to the bathroom before you embark on this venture. And avoid things like, you know, black bean tacos or that takeout you know always gives you crazy poops. You may feel like you have to go, because anal penetration stimulates the muscles around your rectum in a similar way to having a bowel movement, but that doesn’t necessarily mean you will.
The truth: Wrong! Even without a prostate gland and all the nerve endings it contains, anal sex can still feel great. A study published in the Journal of Sexual Medicine found that a vast majority—94 percent!—of women who received some sort of anal stimulation during their most recent sexual encounter had an orgasm.
The truth: Well, not quite. Your rectum isn’t as pliable as your vagina, and also unlike the vagina, it’s not self-lubricating. Vanderlinde strongly advises taking your time if you’re just starting out and working your way up using smaller things like fingers and thin toys. “Sometimes it takes a few different encounters,” Vanderlinde says. Patience!
The truth: Anal sex doesn’t have to hurt. It’s often just done incorrectly. Many women find it incredibly pleasurable, and some even report having orgasms with it. If you and your partner start slow, work your way into insertion with smaller implements like fingers and sex toys , and use plenty of lube, pain will be the last thing on your mind.
The truth: So you tried it once and insertion hurt really bad. You made your partner stop and vowed never to go “back” there again. You don’t have to shut the backdoor because of one or two negative experiences. Most of these experiences have to do with not following the above instructions: Go slow, graduate in size, and use lube . Plus, there is a nice trick to get you relaxed. If you stimulate your clitoris at the same time, it can encourage the pleasure-over-pain response.
The truth: You’ve always heard that bad girls are the only ones willing to have anal sex. In actuality, anal sex was once voted the number one taboo sexual behavior that heterosexual couples want to try. So obviously, we all can’t be sluts. There’s a natural curiosity about our bodies and if there is pleasure to be had, you should feel you can explore that in a safe and healthy way.
The truth: Yes, I have actually heard this in my office more than once. It usually has to do with a couple that has more than one sexual issue, especially a female who might be inhibited about her sexuality and it is getting in the way of her sex life with her partner. Some men behold anal sex as the holy grail, and if they can just get their wives and girlfriends to partake, then the floodgates (so to speak) about sex would open in general. Those other issues need to be worked out ahead of time and only then, if and when she feels open to the experience, should they approach the subject. If she is just doing it out of fear of losing her relationship, she probably won’t enjoy it anyway.
The truth: So he got what he wanted from you and now wants nothing to do with you? I’m sure this happens occasionally—but with any sort of sexual activity. Most men, though, are modern enough to see anal sex as just one component of a healthy sex life. And because of the taboo of anal sex, it might actually help you feel closer and more emotionally bonded to your partner.
The truth: Having any sort of sex the “wrong way” could cause damage. Think about it: If you are vaginally dry and don’t use additional lube, you can cause micro-tears in the vagina. The same thing can happen with anal sex. Granted, the vagina does create its own lubrication usually (depending on hormones, etc.) and the anus does not, but that just means real lube (not saliva) needs to be used for a healthy experience.
The truth: This is a misconception because many people think that because there is no pregnancy risk, you also don’t need to use a condom. Wrong, wrong, wrong. Most STIs are transferrable through the anus
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