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    Is Anal Sex Safe? Key Rules to Follow

    Updated 03 February 2023
    Fact Checked
    Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist
    Flo Fact-Checking Standards

    Every piece of content at Flo Health adheres to the highest editorial standards for language, style, and medical accuracy. To learn what we do to deliver the best health and lifestyle insights to you, check out our content review principles.

    According to research, nearly 10 percent of sexually active women participate in anal sex. Despite being a common activity, it’s still a fairly taboo subject. Next, let’s analyze its downsides and ways to stay safe.

    Is it safe to have anal sex? 

    If you think of anal sex as anal penetration with a penis, you’ll be surprised to discover that there are many other alternatives. Anal sex can actually be performed with your tongue or fingers, or with the use of dildos, vibrators, toys, and butt plugs. 

    Unfortunately, however, it’s one of the riskiest forms of sexual activity for a number of reasons. Safe anal sex requires extensive planning, preparation, and open communication with your partner. There are also multiple health concerns associated with anal sex. 

    • Anal bacteria: 

    Strains of bacteria such as E. coli live in the anal canal and spread easily. Even if you and your partner are both free of STDs and STIs, bacterial infections can still affect the partner who is performing the act. Always exercise good hygiene and remember to put on a fresh condom before switching to vaginal intercourse. 

    •  Delicate anal tissue:

    Although the skin around your anus is tougher and provides a barrier against infection, the soft tissues inside the anus are thin and delicate. Penetration can result in trauma like anal fissures or tears, and even bleeding – making you more vulnerable to viruses and bacteria.  

    • Lack of lubrication:

    Unlike the vaginal canal, your anus doesn’t produce a natural lubricant for sex. Therefore, practicing safe anal sex includes using some form of over-the-counter lubrication. Failure to do so may cause pain, injury, or bleeding after penetration.  

    • Aggravation of hemorrhoids: 

    Anal sex isn’t usually linked to the formation of new hemorrhoids. However, the stretching and pushing might cause internal or external flare-ups, worsening symptoms such as itching, swelling, and discomfort.  

    • Colon damage: 

    Though it’s rare, anal penetration could potentially puncture your colon and require surgery. Consult with your doctor immediately if you notice heavy rectal bleeding and abdominal pain after participating in anal sex. 

    How to have safe anal sex 

    With proper planning and preparation, anal sex can be a safe and pleasurable experience for you and your partner. Protect your health by following the guidelines on how to have safe anal sex below.  

    • Be open with your partner: 

    If you’re hoping to explore anal sex, start an honest conversation with your partner and discuss any concerns. It’s OK to have second thoughts even after you’ve decided to spice things up in the bedroom. Sex should never make you feel embarrassed or uncomfortable.  

    • Use an enema: 

    Yes, anal sex can get messy, and there are a few different options available for maintaining good hygiene. Consider using an enema to rinse out your rectum if you think it’ll put both of you at ease and up the enjoyment factor.  

    • Wear a condom: 

    Do condoms help protect you from most STDs and STIs during anal sex? Absolutely. Though condoms don’t take the place of regular testing, they can be just as effective at safeguarding your health as they are during vaginal intercourse. Simply remember to swap out your condom prior to vaginal penetration to prevent the transfer of bacteria from anus to vagina.  

    • Wash your hands and trim your nails:

    Another way to ensure you’re engaging in safe anal sex is by keeping your hands clean and your fingernails short. This will lessen your chances of tearing delicate anal tissues and causing abrasions or bleeding. Scrub thoroughly, including under the nails, with warm, soapy water before inserting your fingers into the anus, vagina, or mouth. 

    • Clean your sex toys: 

    Take a few moments to clean and disinfect all toys before and after anal sex. E. coli, hepatitis B, and other dangerous viruses and bacteria are easily spread by these objects. 

    • Use a lubricant: 

    Apply plenty of lube during anal sex to decrease your chances of injuring sensitive anal tissues. Many couples turn to Vaseline as a convenient and inexpensive option but it is not recommended. But is vaseline safe for anal sex? If you’re wearing a latex condom, stick with water-based lubricants since oil-based varieties weaken latex and lead to breakage. Furthermore, Vaseline can ruin your sex toys, stain your bedsheets, and be tough to remove.  

    • Warm up with foreplay: 

    A brief 10 to 15 minute period of foreplay prior to anal sex creates a more pleasurable experience for both you and your partner. It’s particularly essential for safe anal sex as it allows your anal sphincter muscles to loosen up and relax.

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    Is it safe to have anal sex without a condom?

    Absolutely not. Many infectious diseases are shared with anal intercourse, including HIV, chlamydia, HPV, herpes, and gonorrhea. In fact, research shows especially high transmission rates for HIV and HPV through anal sex. Experts recommend always using protection, even if you’re involved in a monogamous relationship. 

    Is anal sex safe while pregnant?

    You and your partner might choose to indulge in anal sex during pregnancy when vaginal intercourse becomes difficult due to your growing belly. In most cases, anal sex is safe as long as you apply a generous amount of lubricant and ask your partner to be extra gentle. Any pain or discomfort is a sign to stop immediately. 

    There are some exceptions to the rule, however. You shouldn’t engage in anal sex while pregnant if you or your partner has: 

    • A low-lying placenta, which may undergo trauma and result in heavy bleeding
    • A sexually transmitted disease or infection 
    • Hemorrhoids that may become inflamed and pose a hazard to your baby 

    One thing’s for certain: safe anal sex can be a fun, adventurous way to explore your sexuality. Be honest with your partner, take the necessary steps to protect them and yourself, and create a pleasurable experience for everyone concerned. 

    History of updates

    Current version (03 February 2023)

    Reviewed by Kate Shkodzik, MD, Obstetrician and gynecologist

    Published (30 April 2019)

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