Anal Sex Safety: Pain Risks Possible Complications More

If you’re adding anal sex to your repertoire of pleasure, safety needs to be a priority. Good news: You can be safe without sacrificing satisfaction. Here’s how. All

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Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — Written by Adrienne Santos-Longhurst — Updated on July 21, 2023If you’re adding anal sex to your repertoire of pleasure, safety needs to be a priority. The cool thing about it — aside from keeping all involved healthy — is that you can be safe without sacrificing satisfaction.

Between the lack of naturally occurring lubricant and the bacteria living in and around the anus, the potential for injury during anal sex or transmitting an infection is high.

So if you only take one thing away from the article, make it this: Store-bought lubricant is a must for anal play.

Lube makes penetration easier and reduces the risk of skin tears, in turn lowering the risk of infection. Condoms help, too!

You can further reduce your risk by taking a few additional precautions. Read on to learn what side effects or risks are possible and what you can do to increase your overall pleasure.

What risks are possible with penetrative anal sex and other anal play?

Anal fissures

The delicate skin of the anus is more susceptible to tiny tears or anal fissures. Small but deep, fissures can cause severe pain and bright red bleeding after anal play or a bowel movement.

Anal fissures usually heal on their own in a few weeks. Taking a break from anal play can help speed things along. You might also consider a stool softener to prevent hard poop from irritating the fissure further.

Infections

Although any type of sex without a barrier increases your risk of contracting or transmitting a sexually transmitted infection (STI), the risk is a tad higher with anal play.

STIs transmitted through vaginal or anal secretions, semen, or blood can enter the body through anal fissures.

Likewise, the receiver’s anal secretions or blood can transmit an STI to the person performing oral-anal, fingering, or penetrative anal sex.

There’s also the potential contact with bacteria that could potentially lead to other infections, like urinary tract infections (UTIs) or gastrointestinal illnesses, depending on the sort of contact made.

Colon perforation

Colon perforation is rare, but possible. Head to the nearest emergency room if you experience heavy or prolonged rectal bleeding and abdominal pain following anal penetration with a penis, toy, or other object.

What can you do to reduce the risk of injury or infection during anal sex?

Cut your nails

Anal fingering is a great way to get started, but clean, trimmed nails are a must. Unkempt nails increase the likelihood of tearing the thin and delicate skin of the anus and spreading bacteria.

Clip or file your nails to eliminate sharp edges, then wash well and scrub under the nails before and after anal play. Make sure your partners do the same.

Consider an enema

Soap and water will suffice, but if you’re worried about the poo thing to the point that it might interfere with your pleasure, consider using an enema. An enema pushes water into the rectum for a deeper clean.

Put a dark towel or sheet down to keep any mess discreet and off your sheets… or hardwood.

Use a condom or other barrier method

Using a barrier — be it a condom, finger cot, dental dam, or other method — greatly reduces the risk of STIs.

Just be sure to use a new barrier when switching from anal to vaginal or oral play. The same goes for switching between partners!

Lube up and reapply often

When choosing lube for anal, silicone lube’s thicker consistency is often preferred, but water-based lubes — or a hybrid of both — work, too. Both are also safe to use with latex condoms and barriers.

The downside to silicone-containing lubes is that they can degrade silicone sex toys, so keep that in mind when choosing. Oil-based lubes, while great for anal, aren’t safe for use with condoms.

Get in position

Doggy style is an anal sex staple, especially for partnered play. Easy access from above means, well, easy access!

Reverse missionary is another popular position, though standard missionary can also work. Use a pillow or wedge to adjust the point of entry.

Go slow

Give yourself time to get amply aroused to help relax those tense muscles and get you primed for play.

To help things along, you can:

  • masturbate — solo or with a partner
  • engage in your favorite nonpenetrative moves, like dry humping
  • show your erogenous zones some soapy love in a hot shower or bath
  • use a finger, toy, or tongue on the outside of the anus to leave it wanting more

Clean up afterward or before you do anything else

Thoroughly wash anything that makes contact with the anus when you’re done or before moving on to another activity. This includes your hands, genitals, and sex toys.

If using condoms, roll on a new one before switching to oral, manual, or other penetrative play. Bacteria from the anus that gets into the urethra can cause UTIs. This goes for a penis, fingers, or sex toy.

Frequently asked questions

What is anal sex?

Anal sex is so much more than anal penetration with a penis. Oral-anal activity (aka rimming), fingering (with or without penetration!), fisting, and other forms of stimulation all fall under the anal sex umbrella.

Does penetrative anal sex hurt?

It could, but if you use lots of lube and take it slow, you should be fine.

A little discomfort is to be expected as your anus gets used to the sensation. Being aroused and relaxed, and starting small with a finger or small toy, will help you get there.

Is it normal to bleed after anal sex?

Yes and no. A tiny bit of blood your first time or two isn’t unusual. Same if you have an especially enthusiastic sesh, or don’t apply lots of lube or reapply as needed.

All that said, if you experience severe or continuous bleeding, stop what you’re doing and contact a healthcare professional as soon as possible.

Will anal sex affect your ability to poop?

Nope, that’s just a myth. Anal sex won’t affect your ability to poop or to hold it in.

Just a heads-up: You might *feel* like you need to poop when your anus is first entered or shortly after you finish your romp, but it’s highly unlikely that you’ll have an accident.

Can anal sex lead to orgasm?

Penetrative anal sex and other anal play can absolutely lead to orgasm — but it can still be incredibly pleasurable if it doesn’t.

For receptive partners with a prostate, the stimulation from a penis, finger, or toy can result in full-body pleasure.

For those with a vulva, penetrative anal play can indirectly stimulate the A-spot on the anterior wall of the vaginal canal.

Adding some external stimulation can also be pleasurable for everyone involved.

The bottom line

Anal sex is considered somewhat riskier than other types of sex, but probably not for the reasons you think. Penetrative play won’t stretch your anus to the point of causing anal leakage or anything like that. Promise.

External tissue and skin work as a protective barrier to help keep bacteria and other unwanted organisms out of your body — your anal skin and tissue included.

The tissue on the inside, on the other hand, is a lot thinner and therefore prone to tearing and bleeding. Taking a little time to prep before play can help reduce the risk of injury and transmission of bacteria.

Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.- Anal fissures (2022).https://www.ncbi.nlm.nih.gov/books/NBK526063/

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  • Hirst J, et al. (2022). A qualitative exploration of perceptions of anal sex: implications for sex education and sexual health services in England.https://www.tandfonline.com/doi/full/10.1080/13691058.2022.2037020
  • Kennedy CE, et al. (2022). Lubricants for the promotion of sexual health and well-being: a systematic review.https://www.tandfonline.com/doi/full/10.1080/26410397.2022.2044198
  • Lee A, et al. (2021). Lubrication practices and receptive anal sex: Implications for STI transmission and prevention.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240147/
  • Overview. (2023).https://www.nhs.uk/conditions/anal-fistula/
  • Stewart J, et al. (2021). Promoting safer sex in the context of heterosexual anal intercourse: A scoping review.https://pubmed.ncbi.nlm.nih.gov/33377555/
  • Ways HIV can be transmitted. (2022).https://www.cdc.gov/hiv/basics/hiv-transmission/ways-people-get-hiv.html
  • Zhang Z, et al. (2022). Natural history of anal papillomavirus infection in HIV-negative men who have sex with men based on a Markov model: A 5-year prospective cohort study.https://www.frontiersin.org/articles/10.3389/fpubh.2022.891991/full

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SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.- Anal fissures (2022).https://www.ncbi.nlm.nih.gov/books/NBK526063/

  • Caballero-Hoyos R, et al. (2022). Factors associated with unprotected anal sex among men who have sex with men in mexico.https://www.mdpi.com/2036-7449/14/4/58
  • Does anal sex have any health risks? (2022).https://www.nhs.uk/common-health-questions/sexual-health/does-anal-sex-have-any-health-risks/
  • Gilani A, et al. (2022). Chronic anal fissure in adults. https://www.bmj.com/content/376/bmj-2021-066834
  • Hirst J, et al. (2022). A qualitative exploration of perceptions of anal sex: implications for sex education and sexual health services in England.https://www.tandfonline.com/doi/full/10.1080/13691058.2022.2037020
  • Kennedy CE, et al. (2022). Lubricants for the promotion of sexual health and well-being: a systematic review.https://www.tandfonline.com/doi/full/10.1080/26410397.2022.2044198
  • Lee A, et al. (2021). Lubrication practices and receptive anal sex: Implications for STI transmission and prevention.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8240147/
  • Overview. (2023).https://www.nhs.uk/conditions/anal-fistula/
  • Stewart J, et al. (2021). Promoting safer sex in the context of heterosexual anal intercourse: A scoping review.https://pubmed.ncbi.nlm.nih.gov/33377555/
  • Ways HIV can be transmitted. (2022).https://www.cdc.gov/hiv/basics/hiv-transmission/ways-people-get-hiv.html
  • Zhang Z, et al. (2022). Natural history of anal papillomavirus infection in HIV-negative men who have sex with men based on a Markov model: A 5-year prospective cohort study.https://www.frontiersin.org/articles/10.3389/fpubh.2022.891991/full

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