When it comes to having anal sex, there are a few things you should know ahead of time [1] to guarantee a pleasurable and safe experience. When done right, and when both people are super game, it can be awesome; yet, as with anything that's new and sexual, it can also put your health at risk [2]. That's why speaking with your gynaecologist before could help. Here's what they really want you to consider and discuss with them before doing the deed.
Use Condoms
Put a glove on it. "Anal sex has an increased risk of transmitting STDs [4] compared to vaginal sex. STDs include HIV, Hep B and C, syphilis, HPV, warts, herpes, chlamydia, gonorrhoea, and parasite infections, such as giardia or shigella," says Karen Brodman, MD, [5] an OB/GYN in New York. Condoms will decrease your risk of most of these STDs, but HPV and herpes can still be transmitted by skin-to-skin contact.
Lube Up
"The tissue of the anus and rectum is more fragile than that of the vagina and more prone to breaking. These small skin breaks, known as anal fissures, can increase a person's risk for contracting infections and developing anal cuts called fissures," explains Wendy Goodall McDonald [6], MD, an OB/GYN. So, yes, you'll want to keep lube on hand.
Since your anus doesn't naturally lubricate well, adequate external lubrication with a water-based or silicone-based lubricant is a must to prevent these tears. What's more, "inflammatory bowel disorders like ulcerative colitis and Crohn's disease make the tissue especially susceptible to tears of the rectum. People with those disorders should probably avoid anal sex," she adds. You'll know if you do get a fissure: expect pain and bleeding.
Don't Have Vaginal Sex Afterwards
"If one follows anal penetration with vaginal, the chances of developing bacterial infections of the vagina are significant. Going from vaginal to anal intercourse should not pose a problem, but when going from anal to vagina, change that condom or clean the toy with the proper solution and/or use a condom," Goodall McDonald explains. Plus, "bacteria from the rectum puts you at risk of pelvic inflammatory disease (PID), if bacteria gets into the uterus or fallopian tubes," adds Brodman.
Be Careful With Sex Toys
Make sure any toys used have a handle, for easy removal. "You'd be surprised what can get stuck up there. The anus is not a finite or limited space like the vagina," she says. "In the vagina, items can only go so far because at the top of the vagina there's the cervix and uterus. Since the anus connects to the rectum, which connects to the colon, items can easily reach a point of no return and require medical or surgical intervention for removal," Brodman says. Don't let that happen to you. It doesn't seem pretty.
Get Tested For Anal STDs
If you're having anal sex, you'll need to get tested in that area, too. "Make sure that your periodic STI screening includes anal screening [7]. In many offices, this may not be routinely offered. Be sure to get screened for human Papillomavirus (HPV), the virus that can lead to precancerous and cancerous changes in cells, as well as gonorrhoea and chlamydia anal swabs," says Goodall McDonald. "Periodic HIV testing is also recommended for anyone who is sexually active, anal or otherwise," she adds.
Don't be afraid to ask your doctor to do anal testing if it's not an automatic part of your check-up. "We clinicians only want to keep you safe, so informing us of all areas that may be susceptible to possible infection is important," the doctor adds.
Be Careful If You Have Haemorrhoids
If you have these, which are bulging veins around the rectum, you may want to avoid anal sex or be super super careful. "These bulging veins, which are common, can bleed easily when traumatised. So, use lube liberally" to prevent them from becoming irritated and inflamed, says Alyssa Dweck [8], MD, a gynaecologist in New York.
Consider Heading to the Bathroom Before
It's pretty clear that anal sex can make you feel like you gotta go, really badly, as it stimulates sensations of bowel movements [9], where you feel nice and loose and relaxed. "Some will empty the rectum with a natural bowel movement, enema or suppository laxative for a cleaner experience. This is not essential, but preferred for some," says Dweck.
Don't Skip Birth Control
Ditching a condom for anal sex is a bad idea either way, but more so if there's no other form of contraception. "If you're not using a condom, pregnancy can occur if semen from the anus gets into the vagina," explains Brodman.