Whether you're an anal sex pro or new to the outback, it's important to go into any situation fully informed. More to our point, if the possibility of anal sex or butt penetration in general is on the table, you need to know about certain risks that can come along with using the backdoor.
Anal sex requires a bit more prep and can feel more difficult, but those hurdles can be overcome with knowledge,-planning, communication, and lube. Lots of lube!
For those who are interested in diving into the world of pleasurable anal sex, make sure to read our linked guide on how to have an anal orgasm!
Can anal sex have any long-term effects on my body?
Anal sex has been stigmatized in the cultural zeitgeist for a while now, and a number of myths have popped up to scare and shame people away from partaking in back door pleasure (there’s a whole other set of nerve endings back there!). One such myth is that regular anal sex can somehow permanently damage the anus.
Luckily for the anal-interested, for the majority of people, this is patently false. Both anal and vaginal intercourse can cause their respective prolapses, but that outcome is highly unlikely. For most of us, having safe sex is, indeed, safe. And fun!
How to reduce pain and discomfort during anal sex
The best way to have backdoor activities go well is to do them with either just yourself (anal sex toys anyone?) , or someone you really trust to keep your health, safety, and pleasure top of mind. Anal penetration with someone who’s impatient, coercive, or self-absorbed is problematic because they might not hear or respect your check-ins and/or your no.
Sexual shame comes into play here as well. Having anal sex with a new partner (or with a known partner, but doing it for the first time) can be a very vulnerable experience, and if your partner is inexperienced, they might not know that things can get a little messy down there. The fact is, that’s just part of the territory. Bowel movements are completely natural, and if you’re a regular anal sex-haver, you’re bound to have some fecal matter up there eventually.
If you’re new to anal sex, it’s really, really really-really-really important to go slow. Use lots o’ lube, do your best to relax into the sensations, and stop if something isn’t going well. If you’re trusting your health, safety, and pleasure to someone else and you’re going to try out some anal stimulation, they’d better be up to the task of properly taking care of you. For more information on anal sex for beginners, read our linked comprehensive guide!
What are the risks of anal sex?
Folks who engage in unprotected anal sex (like other forms of unprotected sex) are at an elevated risk of sexually transmitted infections, and that risk is even higher for those with the receiving rectum. This is in large part because anal tissue is extremely delicate, and without proper precautions, tearing can be a problem. Tears back there are called anal fissures, and can, according to the Mayo Clinic, look like paper cuts. An acute anal fissure is more surface-level, while a chronic one may have internal or external fleshy growths. Physicians will consider a fissure chronic if it persists for more than eight weeks.
Something to keep in mind is that unlike a vagina, the anus doesn’t create its own lubricant. And without lube, the sensitive skin of the anus is much more likely to tear, creating a variety of possible issues.
Risk of tearing mainly comes from a lack of preparation. In order to have smooth and pleasurable anal sex, there’s some prep work to be done; you need a bit of finesse to make sure that everything fits correctly and comfortably (For more information read our linked guide on how to prepare for anal sex).
Anal sex-havers also are at higher risk of anal cancer due to HPV (human papillomavirus) and hepatitis. HPV is a sexually-transmitted infection that can cause cancers. Many strains of HPV are harmless, but according to the Mayo Clinic some can cause complications, like anal warts or even cancer. There are HPV vaccines out there to help reduce these risks, so if one of your pleasures is anal intercourse (or any form of sex), you could consider getting the HPV vaccine. It’s worth noting that the vaccine will work best for those who’ve not yet been exposed to HPV, so if you’re over the age of 26 and/or already sexually active, it’s less likely to offer comprehensive protection.
Hepatitis A, B, and C are also all potentially transferred through anal sexual activity. Hepatitis A spreads via ingestion of fecal matter (the fancy word for poo), which can happen if you’re rimming or if you’re fingering someone’s anus and then somehow matter from there gets into your mouth. Same goes for anal sex toys. You want to be careful when it comes to butt stuff, because if even a tiny amount of fecal matter gets into your mouth, you could get infected if there’s virus in it. Again, this could be from oral sex on the anal sphincter (analingus), or from putting your mouth on something that’s been in a butt without being cleaned, or having a condom swapped out first.
Hepatitis B (HBV) can be transmitted through P-in-the-V sexual intercourse, and if you’re having unprotected anal intercourse or going down anally, HBV can also be passed through your or your partner’s saliva, vaginal fluids, or semen. You’re in luck though, because there’s a vaccine for HBV, and you probably got it if you got all your shots as a kiddo.
According to the Centers for Disease Control (CDC), anal sex is the riskiest sexual activity when it comes to possible HIV infection, especially for the receiver. Gay men, hetero folks, and anyone else who has anal sex should thus be aware of this: If you’re having anal sex and are worried about HIV transmission, there are medicines out there that can help limit your possibility of infection — namely, PrEP.
Finally, if you’re pregnant and have been diagnosed with placenta previa (a condition where the placenta covers all or part of your cervix), anal sex might cause trauma to the placenta. Both anal sex and vaginal sex are generally perfectly fine to have during pregnancy, but there may be complications you want to investigate to ensure the health of everyone involved.
Anal sex can also be painful if not done with proper patience and relaxation. Sometimes things just don’t work the way you thought they would down there, and even with preparation, anal sex might be off the table for that day/week. Always trust your own body, and if something isn’t feeling right, stop. Check it out, and feel free to refrain from continuing.
Is it possible to injure your anus?
While it’s possible for anal sex to be extremely pleasurable for both penis- and vulva-owners, injury through bad practices is possible. As mentioned, anal fissures are a thing.
Can you get an infection from anal?
Yes, it’s possible to get infections from anal sex, such as urinary tract infections or worse — especially if you go from anal to vaginal contact. Going from vaginal sex to anal sex poses no problems, but you really don't want the bacteria that resides in your anus to also reside in your vagina. Do not do butt stuff and then vaginal stuff. This is what can create a bacterial infection. No bueno, no thanks.
As mentioned earlier, HPV and HIV are also more likely to be passed through anal sex, so practicing safe sex and/or knowing your partner’s past and current sexual health so you can gauge and understand what level of risk they — and you — bring to the table is a must.
Are there any more serious long-term risks?
All sex inherently carries some level of risk. Anal is included in this, so a matter of figuring out what level of risk you and your partner(s) are willing to take on. HPV and HIV can have lasting effects if they develop into diseases, but both are manageable. As mentioned, when it comes to HIV, there are also medicines available to prevent transmission, which can be taken as a precaution or as an immediate, after-the-fact protection.
Some studies suggest that those who have anal sex regularly also have a higher risk of developing fecal incontinence (not being able to control your bowel movements), but the data has been inconsistent in terms of defining of what anal sex is, and also had the potential of being incorrect due to couples’ reluctance in terms of divulging their anal sex practices.
Are there any signs I shouldn't have anal sex?
As with all types of sexual contact, the first sign that you shouldn’t have anal sex is if you’re not an enthusiastic participant. Only do it if you’re consenting and into it. If you’re not interested in anal sex and your partner is trying to pressure you into it, this is a great sign to not go there.
If you’ve experienced significant discomfort from anal play in the past and you’re worried that will happen again, abstaining from anal sex is also a good choice. Your whole anal area is only going to be able to relax into the pleasure if you’re comfortable with yourself and your partner. If there’s any distrust there, your rectum and anal cavity won’t be ready for that.
If you and your partner can’t agree on ways to have safe anal sex, that’s also a good indication to not.
What else should I know?
The types of lube you use for anal sex can also negatively affect your toys and protective barriers, so be careful and educate yourself. For example, if you’re using a latex condom, don’t use an oil-based lube because it can degrade the effectiveness of that barrier and potentially cause problems. Water-based lubes are generally a safe bet.
If you have more questions like “do women like anal sex?”, “why do men like anal sex?”, read our lined blogs. Because, whether you're a man, woman, or nonbinary, anal play can be pleasurable for you; you’ve got the P-spot, that sort of naughty fun that comes with doing something society still sees as taboo, and novel sensations. As with any type of sex, there are some risks and complications involved, some of which are more intense than others. But when you know what’s up, you can open yourself up to a whole new world of sexual fun. And who doesn’t want that?