Anal douching involves a person flushing out their rectum with water, or other liquid. Some people may douche to feel cleaner and more relaxed before or after anal sex. Knowing how to douche as safely as possible can help to reduce potential risks.

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Anal douching before sex may reduce contact with feces, parasites, and bacteria. People may douche before anal sex because they regard it hygienic and believe it enhances their and their partner’s pleasure. It might also help them feel more relaxed and confident during sex.

This article looks at what anal douching is, its benefits and risks, and whether people should try it. It also discusses types of douches, how to perform anal douching, and some alternatives.

Anal douching is when a person flushes out their rectum with water, saline, or other liquid. It is especially popular among men who have sex with men (MSM).

A 2018 study involving MSMs found that among those who reported douching recently, 87–97% did so before anal sex, and 13–48% did so afterward.

Although anal douching is not essential, it can help a person feel cleaner and more relaxed during sex and reduce the worry of transferring feces to a partner.

It may reduce contact with feces during anal sex, which might help lower the risk of certain infections resulting from bacteria and parasites in fecal matter. Examples include Shigellosis bacteria, which cause shigella.

To avoid shigella, people should not share douching equipment or sex toys. They should wash their hands and genitals with soap before and after:

  • having anal sex
  • touching used condoms
  • handling douching materials

If a person has diarrhea, they should avoid having anal sex for at least 2 weeks after diarrhea has subsided.

Learn more about sexual health by visiting our dedicated hub.

Certain approaches to anal douching can make this practice unsafe. They include:

  • using inappropriate douching equipment
  • using the wrong douching liquid
  • douching too frequently

Risk of infection

A 2019 study has shown that household products not intended for anal douching can damage rectal tissue and increase a person’s risk of HIV and other sexually transmitted infections (STIs).

A recent study from 2021 found an association between inappropriate douching tools, including a shower hose, and a higher risk of HIV infection when engaging in sex without barrier methods.

Other studies have found that anal douching may injure the rectal mucosa and the lining of the rectum, increasing the risk of HIV and other infections. However, more long-term studies are necessary to clarify the association between anal douching and increased risk of infection.

Researchers suggest that the transmission of HIV and other STIs may be due to factors other than or in addition to anal douching. These factors may include prolonged sexual encounters and the use of recreational drugs.

A person can discuss the possible risks with a healthcare professional or undergo testing to rule out potential infections.

Learn about practices that reduce the risk of STI transmission.

Types of anal douches include:

  • Fleet enema: These enema kits are safe and convenient for anal douching. They come in various sizes and have a pre-lubricated nozzle tip to help prevent tearing. They contain an appropriate amount of liquid, which helps a person gauge the correct amount for anal douching. A person should ensure that they get an enema that comes with saline solution.
  • Anal douche bulb: These bulbs have a reusable rubber bulb, which a person can fill with saline solution. They may not suit everyone, as they often have a hard plastic nozzle, which can cause discomfort. A person should use a lubricant for insertion.
  • Shower attachment douche: This requires a person to take extra care, as changes in water pressure and temperature can cause damage or burns.

A person can follow the steps below to anal douche safely:

  • Gently insert the lubricated tip of the douche’s nozzle into the anus while relaxing and breathing out. Ensure it is far enough so the water does not leak out.
  • Squeeze the bottle or bulb of the douche for about 10 seconds to release the saline. The water filling the rectum may initially feel strange, but it should not hurt.
  • Hold the water for a few moments and then expel it into the toilet or down a drain.
  • Repeat the process until the water runs clean.
  • Some people prefer to wait between anal douching and having sex to ensure that all the water has come out.

How to have a safe experience

If a person decides to anal douche, they can take steps to make the experience safer and avoid certain potential risks. These include:

Use the right douching liquid

The safest liquid for anal douching is saline, a water mixture that a person can purchase with certain types of enema or make at home using a cup of water and half a teaspoon of salt. A person should ensure that the water is a safe temperature for the sensitive intestine and colon, which means below lukewarm.

Frequently using tap water for anal douching may cause an electrolyte imbalance, which could affect the proper functioning of the rectum, intestine, and colon.

A person should never use household cleaners, alcohol, soap, olive oil, or any other liquid to douche. Using liquids not intended for anal douching can cause serious damage and result in major health issues.

Use safe douching equipment

A person should use safe douching equipment, such as a fleet enema or anal douche bulb, as well as proper lubrication. They should gently and slowly insert the nozzle of the douche to avoid tearing.

Avoid using too much liquid

The water does not need to reach the intestines to flush out the rectum. The quantity of water that an enema bulb holds is sufficient to clean out the rectum in preparation for anal sex.

Avoid douching too often

Anal douching too often can damage the intestinal lining and increase the risk of infection, even when a person uses appropriate equipment and liquid. If possible, a person should limit anal douching to once a day or 2–3 days a week.

Getting tested for STIs

Regular STI testing plays a significant role in ensuring that people stay safe when having sex.

Testing can occur at a doctor’s clinic or, in some cases, with at-home tests.

Learn more about preparing for anal sex.

Instead of anal douching, a person can keep the anus clean by:

  • cleaning their anus in the shower before anal sex
  • maintaining firm, regular stools by eating a high fiber diet
  • wiping the rectum with wet wipes to remove any fecal matter

Below, we answer some common questions about anal douching.

Should people try anal douching?

Anal douching comes down to personal preference and how it may affect a person’s confidence and enjoyment of sex. However, it is important to know that douching does not reduce the risk of HIV and other STIs during anal sex. People should protect their health using a condom and preexposure prophylaxis (PrEP).

What are the risks of over-douching?

Douching too frequently can irritate and tear the tissue that lines the rectum and intestine. This makes infection with HIV, STIs, and other infections more likely.

How can a person minimize irritation from douching?

A person can minimize irritation from douching by:

  • avoiding douching too often
  • using only the necessary amount of water per douche
  • using only saline solution
  • ensuring that the douche is clean
  • using a water-based lubricant on the nozzle of the douche and inserting it slowly
  • using suitable douching equipment

Anal douching is not necessary, but it can help a person feel cleaner and more relaxed during sex. People should ensure that they use the correct equipment and liquid and apply lubricant to the nozzle of the douche to prevent tearing.

Although research has found associations between anal douching and an increased risk of HIV, more longitudinal studies are necessary to determine whether there is a causal link and to what extent other factors influence these results.

Anal douching too often or with inappropriate equipment and liquid can damage the lining of the intestine and rectum, increasing the risk of HIV and STIs. A person can speak with a doctor about safe sex practices, ways to douche, tests for STIs, and alternatives to douching.