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Anal sex includes any sexual activity that involves the anus, such as licking (also known as rimming) or touching the anal area and penetration with the penis, fingers or toys. The anus can be an erogenous area for many people, regardless of gender, culture or sexual preference. Some people prefer to receive anal sex rather than perform it, whereas others prefer to perform it and some people prefer both. Some sex workers choose to offer different types of anal stimulation as part of their extras, and some include it as part of their standard service.

Safer Anal Sex

The anus produces little natural lubrication so there is an increased risk of tears and scratches inside the anal cavity from penetration of any kind, providing greater access for infections and viruses to enter your bloodstream. Always use plenty of lubricant when engaging in anal sex, however, be careful not to use oil based lubricants for latex or polyisoprene condoms as oil can cause them to break. Using condoms on toys and penises, and always using a new condom when changing between partners or moving from anal to oral or vaginal sex, reduces the likelihood of transferring STIs, BBVs and other infections.  Even when both sexual partners do not have an STI or BBV, the anus is naturally full of bacteria that can cause infections if transferred to another area. For example, bacteria from the anus transferred into the vagina can cause vaginal or urinary tract infections. Additionally, unprotected rimming can transmit hepatitis A and gut infections.

It is also recommended that you get vaccinated for human papillomavirus (HPV) to reduce the risk of developing anal warts and anal cancer. Additionally, you should incorporate anal screening exams into your regular STI check-ups to keep track of your anal health. The risk of developing anal cancer is higher for people who engage in receptive penetrative anal sex and people living with HIV. However, the HPV vaccination and early diagnosis can increase your chances of treatment success and cure.

Anal Sex Tips

• It is normal to see a little bit of poo when engaging in penetrative anal sex. To reduce discomfort (or awkwardness), it is a good idea to do a poo and wash your anal area with a gentle and perfume-free soap before anal sex.
• Always use a new condom between partners or when transferring from anal to vaginal or oral sex. Washing your hands thoroughly or using a new condom or glove when fingering and transferring between partners and between oral, anal and vaginal reduces the likelihood of transmitting infections.
• Use plenty of lubricant to reduce the risk of tears and scratches. This will also assist in making anal penetration more comfortable and potentially pleasurable for yourself and your sexual partner.
• Try to relax the muscles in your anus before engaging in penetration. Getting into a position that makes penetration more comfortable for you can assist in relaxing the muscles around and in your anus. Some people find that starting on top (such as cowgirl or reverse cowgirl) is easier.
• Stop penetration if you are in pain. You may want to check the anal area for any blood or signs of tears or scratches and wait until you are healed before recommencing sexual activity. When recommencing anal sex, concentrate on relaxing your muscles, getting into a more comfortable position or starting off with a small insertion (such as a finger) and work your way up a larger insertion.
• If you notice anything unusual like sores, discharge, lumps, itching or bleeding, this may be a sign of a greater issue, such as an STI, fungus or bacterial infection, intestinal parasites, haemorrhoids and in some rare cases, cancer. It is best to seek medical attention as soon as possible.  

Looking after your anus:

• Keep your anal area clean by washing with a gentle perfume-free soap and gently pat dry.
• Go to the toilet regularly and avoid straining when passing poo.
• Wear loose and airy clothing to keep your genital area cool and dry.
• Drink plenty of water and eat fibre-rich foods to help soften your poos and reduce likelihood of ruptures, tears and scratches when passing a poo. Additionally, gentle exercise helps encourage healthy bowel movements.
• Gently wipe your anus area with toilet paper to ensure you are not chaffing the skin around your anus which may become infected or inflamed.
• If you are experiencing pain, swelling, irritation, discomfort, bleeding, lumps, ulcers, sores, itching or anything unusual around the anal area, this may be a sign of a more serious condition, and you should seek medical advice.
• There are various over the counter medications that reduce symptoms such as itching. However, it is recommended that you seek medical advice first to clarify the cause of the symptoms to ensure it is not an indication of something more serious.

Enemas

An enema involves liquid been inserted into the rectum (anus) to cause a bowel movement. Enemas clean out further into the lower intestines than anal douching, but like anal douching is used to clear out the bowels before anal sex.

Tips for safer enemas

• The liquid used for the enema should only include water with nothing else added as additives can be easily absorbed into the bloodstream through the delicate lining of the intestines or cause bacterial imbalances. For example, using chlorinated tap water for the enema may impact the bacterial balance in the colon.
• Make sure the liquid is at body temperature as cold water enemas can cause intestinal cramping and if the enema liquid is too hot, it can burn the lower intestines.
• Only insert a comfortable amount of liquid into the intestines as you can always receive or perform another enema if necessary.
• Always use plenty of lube when having anal sex as enemas clear out everything in the rectum including the natural lubricate produced by the rectum.
• If a condom breaks while having anal sex, do not use enemas to flush out any bodily fluids as it will push any infected bodily fluids further into the body.
• While enemas give temporary relief of bowel obstruction and constipation, if used on a regular basis, it can cause damage to the delicate lining of the bowels.
• There are commercial and disposable enemas available from pharmacies.
• Never share enema equipment as sharing can transmit STIs and BBVs.
• For more information on providing enemas as a service, see Sex Work Services.

Douching

See douching in General Sexual Health.