How to make anal sex less painful

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For most people, anal sex can be painful, especially when it is their first time or is with a partner who is not gentle. In a survey of 412 people by the San Francisco Aids Foundation, 96% of participants reported having, or having had, anal sex. Of those participants:

• 86% said that they had experienced pain at least once, while 9% had never experienced pain
• 36% said that they had enjoyed pain during anal sex
• 64% of people who had anally penetrated a partner said that their partner had asked them to stop because of the pain

Anal sex may hurt for several reasons, including:

• the anus not producing lubrication for sex
• the sphincter muscles of the anus being very tight
• certain health issues, such as hemorrhoids, making it painful

However, anal sex does not have to hurt, and severe pain may indicate that a person is doing something potentially harmful.

Before having anal sex, it is important to talk with a partner about consent, why they want to have anal sex, and how to make the experience as pleasurable as possible. Some topics to discuss include:

• testing for sexually transmitted infections (STIs)
• monogamy and other partners, as having anal sex with multiple people can greatly increase the risk of transmitting viruses, such as HIV
• prior experience with anal sex
• strategies for making sex more comfortable
• the use of condoms to reduce the chance of transmitting STIs
• using pre-exposure prophylaxis (PrEP), such as Truvada or Descovy, as these medications may reduce the risk of transmitting HIV to a partner

Some strategies that can make anal sex less painful include:

• Using plenty of lubricant: The anus does not produce any lubrication, so pause to relubricate if sexual penetration becomes painful. If using a latex condom, use only water-based or silicone lubricants. Other lubricants may damage the condom.
• Using water or a gentle soap to clean the anus before anal sex: Doing this helps some people feel more comfortable because they worry about poop or being “unclean.”
• Starting slowly: A slow and gentle approach reduces the risk of injury and can make anal sex more pleasurable. Try starting with fingers or small sex toys and then gradually work up to penetration with a penis or larger sex toy.
• Relaxing the anal muscles before penetration: Gently pushing down as though having a bowel movement may make penetration easier and reduce anxiety.
• Breathing slowly and deeply: Focusing on the breath may help a person relax.
• Communicating with a partner during sex: If it hurts, tell them to slow down or stop.
• Stopping immediately if there is blood or intense pain: These symptoms could indicate an injury or be due to anal sex irritating a hemorrhoid.

Many people worry that anal sex will be messy, but for most people in good health, there is little or no poop afterward. Having some wipes or towels on hand can help with the cleanup process. It is important to wash any toys that penetrated the anus.

Learn more about cleaning up after sex.

Other hygiene practices include:

• avoid penetrating the anus and then the vagina or mouth without washing first, as this can transmit dangerous bacteria, increasing the risk of an infection
• wash the hands after penetrating the anus with the hands or fingers
• do not reuse anal toys without washing and disinfecting them first

No sex can be fully safe, but a few strategies can reduce the risk of both anal sex injuries and transmitting an infection to a partner:

• wearing a condom during anal sex and replacing it with a clean one before switching to any other form of penetration
• cleaning anal toys, and, if possible, putting a condom on them
• stopping if the pain is unbearable or does not get better on changing position or using more lubrication
• going to the emergency room if a toy becomes stuck in the anus

It is a myth that anal sex damages the anus or causes the leakage of poop. As long as a person moves slowly and does not do anything that injures them, long-term anal sex is safe. Some common questions about anal sex include:

Will there be poop?

There is usually only poop in the rectum or anus when a person needs to poop. So, unless a person feels the need to have a bowel movement, there should not be significant poop during anal sex. Sometimes, a person will notice trace bits of poop, but not large quantities.

Will anal sex make a person poop?

Anal sex should not make a person poop unless there is something else wrong. For example, a person who is severely constipated or has nerve damage may not notice that they need to poop before anal sex and might get the urge to go during it.

Does anal sex affect pooping?

Gentle, careful anal sex should not affect pooping or damage the muscles of the anus. However, very aggressive anal sex, penetration with large objects, or anal sex that causes significant bleeding may tear the anus or damage the muscles, causing fecal incontinence.

While more research is necessary, a 2016 study suggests that anal sex may be a contributing factor toward fecal incontinence in adults.

Does anal sex cause bleeding?

Anal sex should not cause bleeding. However, people with hemorrhoids may find that anal penetration irritates the hemorrhoids, leading to bleeding.

Similarly, rough anal sex may cause anal fissures, which are tiny tears in the wall of the anus. A few drops of blood are not usually cause for concern, but heavy bleeding may be a sign of an emergency.

Can anal sex cause serious injuries?

Gentle, careful anal sex should not cause serious injuries. However, penetrating a person with objects that can slip into their rectum, such as dildos without a flared base, may cause those objects to get stuck, making medical care necessary.

Rough anal sex may damage the walls of the anus, injuring the muscles and skin.

The sensation of anal sex may feel unfamiliar or uncomfortable, even to people who eventually grow to enjoy it.

A person should not feel obligated or pressured to have anal sex, and people should only perform anal sex if all parties enthusiastically consent.

With a gentle and cautious approach, plenty of communication, and an understanding of safer sex, many people of all sexes and genders may find anal sex pleasurable.

Read this article in Spanish.