Sex Files: Butt seriously, folks

Apparently anal sex is becoming more popular—and not just among gay men. Among straight couples, studies show that 1 in 3 enjoy anal intercourse up from 1 in 10 a decade ago.

Mind you, just because you enjoy anal pleasure, that doesn’t mean your partner likes it as much, and vice versa. Some people think it just plain hurts too much or they find it unpleasant. For some, it’s simply too taboo to even consider.

Here’s the scoop on anal sex, starting with why so many people like it. One of the four main nerves to the genitals, the pelvic nerve, not only innervates the vagina, G spot and cervix but also the rectum. Many men and women can reach orgasm through anal stimulation. And even more folks enjoy inserting anything from a finger, a butt plug, or a dildo or penis into their anus during lovemaking. Many lesbians use regular or strap-on-dildos for anal sex for the same reason—to experience pleasure.

But here are some things you should know. Don’t insert anything in there that might slip away from you. You don’t want to have to take a trip to the ER with something anchored in your rectum just because you can’t get it out yourself. That not only would be humiliating, but painful and potentially dangerous. The lining of the anus and rectum is more delicate and richer in blood vessels than your vagina, so it’s easy to scratch or even tear. Therefore, never insert anything that does not have a smooth surface into your anus.

The anal canal contains feces only during defecation; otherwise it’s an empty space leading up to the rectum. Some people like to clean out their anal canal before having anal sex, but it is better to avoid water enemas or rectal douching, since this actually can damage the rectal lining and increase the risk of HIV and hepatitis B infection. Showering or bathing in advance of anal sex is of course fine.

Unlike your vagina, which gets wet when you are sexually aroused, your anal canal does not. So if you are practicing anal intercourse you need to use lots and lots of lubrication. Keep in mind that oil-based lubes break down latex condoms and sex toys; so use only water based ones. And be sure to reapply them regularly as most lubes dry out after a while. And you need to go very slowly. Give yourself plenty of time to relax your anal sphincter fully.
 
Since your anus contains loads of bacteria (E. coli and others), it’s very important to keep strict hygiene during anal play. Never insert anything that has been inside an anus into your vagina without thoroughly washing it before or changing condoms.

Speaking of which, you need to use safer sex techniques during anal sex. Even though anal intercourse won’t get you pregnant, you need to use condoms unless you are completely sure that your partner does not have a sexually transmitted infection. And you can use latex gloves when inserting fingers.           

Anyone who engages in regular, unprotected anal sex should consider getting a test for anal HPV. The reason is that HPV is associated with cancer and anal cancer rates are increasing. According to the American Cancer Society, the incidence of anal cancer in 2006 increased by 14 percent from the previous year to 4,660 new anal cancer cases. Women represent the majority of those new anal cancer cases: 2,750 compared to 1,910 for men.

I have heard of some women that have anal sex to protect their virginity. I have to wonder if that isn’t a bit like saying you don’t smoke unless you inhale. But then again, whatever works for you is fine, as long as no one gets hurt and you know what you are getting into.

Annette Owens, MD, Ph.D., is certified by the American Association of Sexuality Educators, Counselors, and Therapists. She sees clients in her Charlottesville office (cvillewellness.com) and answers questions online at LoveandHealth.info and SexualHealth.com. She has co-edited the new four-volume book, Sexual Health (Praeger).