Anus and rectum

The Anus & Sexual Activity

 
For many people the anus and surrounding area are very sensitive and are sexually arousing as the nerve supply to this area of the body is linked to the genital skin. For this reason sexual activity focusing on this part of the body is quite common and it is even possible to enhance and experience orgasm with anal penetration.

Anal sex is more common than people may think among men and women, and is not limited simply to stereotypical "gay" sex. The main problem is that people do not talk openly about this aspect of their sexual interest for fear of being judged as deviant or abnormal. Some people hold very strong views about anal sex.

Stimulation or penetration of the anus may be achieved by fingers, penis, tongue, vibrator or other means; however, since the main function of the anus is not penetration and it has strong muscles, this has to be helped by lubrication to lessen the risk of damage to the entrance or lining on the inside.

Any unprotected oral or penetrative anal sex makes you vulnerable to the numerous sexually transmitted infections which are outlined in detail in the sexually transmitted infections section of the website.

STIs can be passed during oral-anal sex (rimming).  To prevent STIs during oral-anal sex you can use a barrier such as a dam or a condom (you can cut the end off a condom and cut it down the side to make a large rectangle).  Any condom will work for this purpose - have a look at the range of condoms available from the Free Condoms service.

Complications - what can go wrong?


There are a number of conditions which affect the anus and rectum which may or may not be directly related to sexual activity. This is an area of illness which some people find very difficult to talk about even with their doctor. Remember that your doctor is non-judgemental and is unlikely to find the things that you find embarrassing particularly unusual - they've seen and heard it all before. Do not compromise your health and well-being to spare your blushes!.

Anal fissure


This can occur naturally from the passage of large or hard stools (faeces) which can cut and tear the anus as they pass through the anal opening, or from forceful or energetic penetration during anal sex. The symptoms can include pain and bleeding. This should go away after several hours, but may recur at the next bowel movement. Stool softeners may be used as a temporary measure to allow normal healing. Occasionally, your doctor may prescribe an ointment to reduce pain and inflammation, or reduce muscle spasms.

Penetration by objects


If you are inserting objects into the anus for sexual enjoyment, avoid objects with sharp edges or jagged points as anal fissures can be caused by these. There are a range of sex toys commercially available for the specific purpose of anal insertion. Remember, objects inserted sometimes get stuck inside and can be difficult to remove without medical help. They tend to get stuck in a place called the sacral hollow where the bowel turns around a sharp corner. They are usually removed using a little light sedation but this is done in hospital. Trying to remove them yourself at home is not recommended.

Remember that any object inserted or used around the anus must be cleaned before using it again on another body area such as the vagina or mouth, as bacteria from the anus could cause infection at other sites when transferred on the toy's surface. This idea also applies to hand washing so that bacteria from the bowel do not get passed to other parts of the body. Remember to wash your hands or wear special medical gloves.

Physical injury can be caused by rough insertion of fingers, vibrators, penises and douching equipment. Injury can include puncturing the bowel lining or tearing it particularly where the bowel turns a corner at a point called the recto-sigmoid junction, even a well lubricated toy or penis can do this. Toys and other sharp objects are more likely to puncture the bowel whereas a penis is more likely to cause a tear of the inner skin without causing a complete puncture. Fisting is also a risk for perforating the bowel. If you develop severe abdominal pain or bleeding after anal penetration, medical help should be sought as serious damage could have been done to the bowel wall - this can be a very serious complication leading to peritonitis.

Proctitis


Proctitis is inflammation of the rectum. You may have pain in the anus, or bleeding when opening your bowels and you can also get a sticky discharge. Sexually transmissible infections are a recognised cause of this, including gonorrhoea, chlamydia, herpes and syphilis. There are also other causes, including non-sexual infections such as salmonella, shigella and amoebic dysentery. If infection does not seem to be the cause, your doctor might consider causes of bowel inflammation like ulcerative colitis or Crohn's disease. It is possible for bowel tumours to cause proctitis but this is unusual. Allergy to drugs and chemicals should also be kept in mind especially reactions to lubricants and latex of condoms. Remember that some people douche before anal sex and these cleansing substances can cause a reaction on the inside of the anus. If you have symptoms that could be related to proctitis and have anal sex, tell your doctor so that all the possible causes can be considered. The presence of proctitis also makes it easier to catch other infections if the penetration is done without using protection such as condoms. To protect against sexual infections including HIV, always use a condom.

Will anal sex make me incontinent?

Being penetrated (receptive anal intercourse) by a penis or vibrator on a regular basis is linked to a change in the way the anal muscles work. The tone of the muscle is lower or more relaxed - this tone is similar in idea to muscle tone when people talk about gym-work and toning their muscles. There is no evidence that repeated anal penetration causes anal incontinence even though the muscles are a bit more relaxed. Men who have sex with men and have anal penetration are more likely to experience problems like anal fissures and abscesses but this may be related to the risk of getting infections or having more partners. The main type of activity that does sometimes lead to incontinence is fisting because it causes damage to the function of the muscles by tearing and stretching them.


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