Risks of Anal Sex

Apart from contracting STDs, there are other risks associated with anal sex, tells Dr. Taz

I received a hapless call in the early morning, from a friend who seemed frightened because after a relatively “wild” session in the bed the previous night, he noticed that it was terribly painful to go to the loo in the morning and there were streaks of bleeding too. I reassured him and found out later that it was just an anal tear, however, why I must come up with this incidence today is because of the question he asked me afterwards.

He asked, “I have been having anal sex from a long time, would that at any stage in life make me incontinent?” There was a definite note of concern in his voice and to my surprise, I didn’t seem to have an answer to his query! Later, when I looked up into the medical literature I realized there aren’t many studies that could answer the question either, but what I did find out was that there are a lot of questions that people have about anal sex and its complications and there is a lot of ignorance as well.

It isn’t just STD’S that you need to be worried about, however does it mean that you can’t have it at all? Let’s find out.

Know your anatomy

Anus- The anus is the entry to the rectum; it is one and half inches long, and is surrounded by two rings of muscles: the external sphincter and the internal sphincter.

External sphincter – Muscle that is closest to the anal opening. It can be contracted at will.

• Internal sphincter – Internal muscle that is involuntarily controlled by the body. The internal sphincter cannot be contracted.

• Rectum – Tube like structure made of soft tissue that is eight to nine inches in length and is surrounded by muscles.

The rectum is able to expand, like the anus or vagina.

However , what makes it precarious is that unlike the vagina, the anal canal is not lined by a lining that is resilient to friction, and it doesn’t produce as much lubrication, and the muscles that support the anal canal are not as strong as the one’s that support the vagina.

What are the risks of engaging in anal sex other than STD’S?

  • Anal Fissures: Breaks in the lining of the anal canal produces fissures , which are mainly characterized by intense pain while straining to pass stools and streaks of blood. Though the anal lining has ability to heal itself, recurrent contamination by stool, and repeated anal sex could lead to chronic fissures. It’s easy to treat. Rest to anal lining and sitz bath in warm water with adequate pain relief is the key to treatment.
  • Anal Fistula: Anal sex damages the anal lining , thereby making it more susceptible to infections, and leading to formation of abcesses (collection of pus), sinus tracts and fistula (which are the external openings of the pus cavity). It’s a treatable condition and usually requires minor surgical procedures.
  • Anal tears: If the “top” or the “pitcher” is rough and the penis is not properly inserted without sufficient dilation of the anal canal, it could lead to tears of not just the lining , but adjacent muscles as well. It’s not very common; however a serious condition would require surgery.
  • Worsening of Hemorrhoids : Hemorrhoids are nothing but cushions of tissue that contain blood vessels. It’s not known if anal sex could lead to “piles” but it is known that it could lead to worsening of piles and therefore lead to bleeding and its exacerbation. There are different grades of piles and consultation with appropriate surgeon is warranted.
  • Perforation: It’s a rare and much more serious complication, which produces a gape in the entire thickness of rectum or anal canal and if not properly treated, could be fatal. It’s a surgical emergency.

Does repeated anal sex produce fecal incontinence at a later stage of life?

There are conflicting reports, there aren’t many head on trials and research base is inadequate. There are some doctors who have reported an increase in fecal incontinence in a number of their homosexual patients who have engaged in promiscuous anal sex, however there are others who have seen no significant difference.

The risk is uncertain as of now and it needs further validation. But had it really been the case, wouldn’t we have had so many guys with dirty linens?

Could anal sex lead to anal cancer?

Semen contains immune suppressants and viruses that cause warts, so repeated anal sex, done with multiple partners and without condoms, predisposes an individual to the risk of anal cancers.

Am sure a lot of you boys would be swearing off anal sex by now, but it isn’t necessary to practice complete abstinence, and if you take necessary precautions, you could still take your trips to heaven and back.

The most important factors are

  • Sufficient Relaxation: Please remember, the muscles around anal canal need to be sufficiently dilated before you can attempt to take inside a throbbing dick. There are not just physical, but psychological and emotional factors at play here. My advice is to practice anal sex with a partner you can trust, in a setting that makes you feel relaxed, with sufficient time on hand. Extensive foreplay is an effective means to achieve muscle relaxation. “Rimming” or “anilingus” which is stimulation of anal nerve ending by tongue is an effective way but it should be practiced with proper precautions using cut condoms and diaphragms to prevent transmission of parasites.Many people use techniques like sequential fingering which provide relaxation and prepares the rear for the entry, but please do not forget to clip the fingernails.If you are using objects like anal beads or dildos, make sure to use soft rubber ones.
  • Hygiene: It could play a major role during successful anal intercourse. Evacuation of bowels before sex and using warm water enemas are good ways not only to achieve hygiene but also for muscle relaxations. However too much of enemas can be dangerous since they cause drying up of anal lining.
  • Lubrication: Friction is a big enemy. It is very important to use proper lubrication only with water based lubricants, and since they dry up quickly it is important to use it at intervals during intercourse. Use of local anesthetics like xylocaine is highly practiced, and though it does take care of the pain, it has major disadvantages as it also interferes with sexual pleasures, delays orgasms and could lead to tears because the sex could get rough in absence of any painful stimulus and inadequacy of pleasure.


Having said a lot, there aren’t fool proof measures, to prevent damage and have a great session. You must remember that an effective anal intercourse is a two way process, and it is very important to communicate with the partner while having it.

For the “bottoms” it is important to be able to deny it if they feel uncomfortable or if the pain is too much, and for the “tops”, you must be gentle and patient before you make an entry and considerate while you are thumping down there .

And if in the morning, something doesn’t feel right, there’s always a doctor you can go to.

Be honest, fall in love, let him inside you or be inside him, but remember there’s more to sex than ejaculation!

It’s good to be hung, but not hung up.