Risks of anal sex, other than STIs?

Originally Published: May 9, 2008
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Alice,

I heard that anal sex causes the rectum/anus to become larger and creates problems with going to the bathroom. Can you please tell me what the risks are when it comes to anal sex beyond the normal STI/STD and pregnancy risk? Are there any risks involved with anal sex that are not involved with oral or vaginal? Thanks in advance.

—Anal Wonders

Dear Anal Wonders,

Anal sex enthusiasts can relax (a good thing to do during anal sex!), because contrary to what you heard, anal sex does not loosen the anus or cause an inability to control bowel movements. However, there can be risks associated with anal sex other than sexually transmitted infections (STIs), so it's important to take steps to minimize these risks.

Friction, the enemy of pleasure and safety during sex, is produced during anal sex, much as it is during vaginal sex. However, friction may be more of an issue during anal sex because the lining of the anus is more delicate and produces less natural lubricant than the vagina.

Steps to safer anal sex include:

  • Being very gentle and moving slowly
  • Using plenty of lubricants (not just saliva)
  • Using a condom
  • Avoiding spermicide, which may irritate the rectum
  • Never moving from anal to vaginal sex without first changing condoms
  • Stopping if there is severe pain during penetration

Anal sex may make a person more susceptible to bacterial infection around the anus and rectum. This is because the lining of the rectum is not as heavy as the lining of the vagina, so it is more susceptible to tears. If the anus or rectum does get torn, it does not heal as quickly. Because feces that pass through the rectum contain bacteria, any tear in the lining is at risk of getting infected. Lining tears may lead to other problems such as an anal abscess, which can make transmission of STIs and HIV more likely. This is why unprotected anal sex is often considered riskier than unprotected oral or vaginal sex. The tips above will help you avoid tears and other uncomfortable complications.

In extreme cases, a tear in the lining can develop into a fissure (a larger tear or crack) and may extend outside of the bowel. This is called a fistula and it is a significant medical issue because it allows feces to pass outside of the bowel, and requires major surgery to repair.

Additionally, there is some suggestion that anal sex may worsen existing hemorrhoids, so you may want to carefully consider anal sex activities if you have them. Pregnancy is not a concern during anal sex (unless vaginal sex is also included on your agenda). And although you already seem aware, it is important to mention that STIs, including HIV, can be passed to or from an anal sex partner, so using condoms is always a good idea.

So, whether you are a beginner, an old hat, or simply curious, you can relax, move slowly, and enjoy.

Alice

January 22, 2013

522158
Good information thanks!!!
Good information thanks!!!

September 14, 2012

516264
My current boyfriend and I often have anal sex. In addition to relaxation and plenty of lube, I would add that POSITION is very important to safe, pleasurable anal sex. I like to be on top of him....
My current boyfriend and I often have anal sex. In addition to relaxation and plenty of lube, I would add that POSITION is very important to safe, pleasurable anal sex. I like to be on top of him. Being on top allows you to control the movements and depth of penetration. My current boyfriend has a large penis. I discovered through experimenting that mounting him is the easiest way.