Anal Sex: Questions and Answers

KNOW YOUR ANATOMY

• The anus is the entry to the rectum; it is one and half inches long, and is surrounded by two rings of muscles: the external sphincter and the internal sphincter.
• External sphincter - muscle that is closest to the anal opening. It can be contracted at will because it is controlled by the central nervous system.
• Internal sphincter - internal muscle that is involuntarily controlled by the body. The internal sphincter cannot be contracted.
• Rectum - tube like structure made of soft tissue that is eight to nine inches in length and is surrounded by muscles. The rectum is able to expand, like the anus or vagina.

WHAT IS ANAL SEX?

• Anal Intercourse - Anal intercourse is sexual activity that involves insertion of the penis or a sex toy into the anus.
• Rimming - “Rimming” is a slang expression that refers to oral stimulation of the anus. The official term for this is analingus.
• Manual Stimulation - Manual stimulation can include rubbing the anus externally or insertion of a finger(s) - one’s own or a partner’s - into the anal opening and gently rotated.
• Fisting - “Fisting” is a form of anal sex in which several fingers or even the entire hand and forearm are inserted into the rectum and sometimes into the lower colon.

WHO DOES IT?

• A variety of people engage in anal sex and stimulation despite their sexual orientation.
• 25% of heterosexual undergraduate students have experimented with anal sex at one point in their lives. This statistic is also consistent with national trends for heterosexual adults.

HEALTH CONSIDERATIONS

• Unprotected anal intercourse is considered a high-risk activity for both males and females. People who have unprotected anal intercourse are at high risk for many sexually transmitted infections, including HIV due to lack of natural lubrication, which can lead to tears and exposure to blood. Condom use during anal sex is a must.
• Sexually Transmitted Infections (STI’s) can and do occur around the anus and inside the rectum, including intestinal parasites, gonorrhea, HIV, chlamydia, syphilis, herpes, HPV, and hepatitis.
• Oral sex, including rimming, or analingus, can put both partners at risk for hepatitis, herpes, HPV, and parasites.
• If you notice any pain, sores, discharge, or lumps around or inside the anus, make an appointment with a health care provider as soon as possible. Appointments can be made at McKinley Health Center by calling Dial-A-Nurse at 333-2700.
• For heterosexual couples, pregnancy can occur if semen is deposited near or around the vaginal opening.
• Anal complications not related to anal sex include: irritable bowel syndrome, hemorrhoids, fissures or tears. If you are suffering from any of these medical concerns, do not engage in anal sex until you have consulted with a physician.

TAKING CARE OF HYGIENE

• Proper hygiene should also be taken into account with anal sexual activity. With routine daily hygiene, the anus is as clean as other parts of your body. It contains its own natural bacteria to help fight against infections.
• The main function of the rectum is to act as a passageway for feces. But feces are not normally stored in the rectum except just prior to a bowel movement. Small amounts may remain in the rectum, especially if the feces are not well formed.
• Anal douching before lovemaking sex may help some people especially who are concerned with cleanliness to relax. Additionally, the use of enemas before anal sex can be used to feel cleaner and to prevent the need to evacuate the bowels during sex. However, enemas may cause trauma to the rectum which can increase the risk for HIV and other STI’s. It may be best to allow a few hours to pass after an enema before anal sex.
• Using anti-bacterial soap after direct contact with feces is also recommended.
• Slipping a soapy finger inside you while showering is another good way to cleanse the anal area. Remember to go light on the soap as it can be irritating to your insides.

PUTTING SAFETY FIRST

• Proper use of latex condoms or female condoms can significantly reduce the risk of contracting dangerous infections such as HIV. Men and women can contract an STI during anal sex. The risk for HIV increases for the receptive partner, whether male or female.
• To prevent other infections, do not insert a penis or sex toy into the mouth or vagina after it’s been inserted in the rectum until your partner puts on a new condom or cleans the sex toy in between (rubbing alcohol, or a mixture of one part bleach to 9 parts water).
• Anal sex should not be painful. It is also important to stop if anything hurts and communicate with your partner about how you feel - sex play that is painful or uncomfortable should not continue.
• To prepare for anal sex, the first thing to do is to relax. The sphincter muscles around the anus will not allow things to pass through unless you relax and take it slow.
• If you are not comfortable with anal sex, then don’t do it! Empower yourself to choose what sexual acts are most pleasurable in meeting your sexual needs. It’s also important not to pressure partners to engage in anal sex if they are not comfortable.
• Remember to always use only water-based lubricants with latex condoms. The anus does not produce a sufficient amount of lubricant for comfortable intercourse and adding more lubricant reduces the risk of tearing anal tissue and having a condom break. A thicker lubricant may be needed for anal sex.
• For safer rimming, people use latex barriers - thin pieces of latex - placed over the anus. This acts as a barrier between the mouth and anus. Plastic wrap and cut-open condoms can also be used as a barrier for analingus. Like condoms, some latex barriers come in different flavors.
• It is also important to utilize latex gloves during digital intercourse or “finger sex” or fisting of with the anus.

WHY DO SOME PEOPLE DO IT?

• The anus is full of thousands of nerve endings both inside and outside, making it very sensitive. For some people, the anus is an erogenous zone that can respond to sexual touch and stimulation.
• The highest concentration of nerve endings is around the anal opening itself. The outer portion of the rectum, like the vagina, has several nerve endings. The inner portion responds mostly to pressure. Some people enjoy the feelings of pressure and fullness once they understand that these sensations do not presage an impending bowel movement.
• In men, the prostate - which is just beyond the rectal wall, a few inches in, towards the front of the body - can be a source of pleasure when massaged by a finger, an object, or a penis. Also, the lower end of the penis, or "bulb," is near the anal opening. It is stimulated indirectly by most types of anal sex.
• Anal pleasure can be psychological as well as physical.

CAN ANAL SEX LEAD TO ORGASM?

• Most people require direct genital stimulation in order to climax. On the other hand, a few people have orgasms only with anal stimulation.
• A minority of men and women can achieve orgasm from anal sex without direct genital stimulation. Women probably do so through pelvic muscle contractions - and a small minority even through the sheer excitement of being anally penetrated. When men experience an orgasm from anal stimulation, they tend to focus on the prostate.  They may they are also be responding to indirect stimulation of the penile bulb.
• Orgasms from anal stimulation are most likely to occur when the participants become thoroughly absorbed in their sensations and fantasies (as with vaginal or oral sex).

REFERENCES AND ADDITIONAL READING
Melby, T. (2007). Anal Sex: An ‘extraordinary taboo.” Contemporary Sexuality Vol. 41 No. 11
Morin, J. (1998). Anal pleasure and health (3rd ed.). San Francisco, CA: Down There Press
Hutcherson, H. (2002). What your mother never told you about sex. New York: NY: G. P. Putnam’s Son. Sexuality. Org: Society for human sexuality. Retrieved from http://www.sexuality.org
Halperin, D. T. (1999). Heterosexual anal intercourse: Prevalence, cultural factors, and HIV infection ad other health risks. AIDS Patient CARE & Stds, 13, 717-730. Baldwin, J. I., & Baldwin, J. D. (2000). Heterosexual anal intercourse: An understudied high-risk sexual behavior. Archives of Sexual Behavior, 29, 357-373.

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