Health and Safety Issues with Anal Play

There are a variety of health and safety issues that can come into focus when you’re involving the anus and rectum in sex play. Of course, this includes the usual complement of sexually-transmitted diseases, but there is quite the opportunity for a number of physical issues to manifest themselves as well. In order to allow you to enjoy the maximum amount of pleasure, you need to be cognizant of these potential problems to ensure you don’t do any damage while you’re having fun.

No Natural Lubricant

One of the most basic concepts you need to be aware of is that the anus and the rectum do not produce any natural fluid that can be used as a lubricant. This is especially true in the lower one third of the rectum where the initial penetration is going to occur. The net result is that it is much easier to tear the skin and the lining of the anus and the rectum if you don’t use a suitable type and quantity of lubricant when you’re penetrating the asshole for sexual purposes. Because it is so easy to tear these surfaces, it becomes much, much easier to transmit diseases and to cause physical damage to those sensitive little parts back there. And though it is possible to learn to accept “dry” anal penetration, this is not something you should attempt until you have a considerable amount of experience with anal sex.

Perforated Rectums & Colons!

Another major risk associated with anal play is the potential for perforating (tearing an actual hole in) the rectum or, if you engage in some of the deeper stuff, the colon. This is almost impossible to do with a live penis or fingers, but is not unheard of in situations where people are using hard, non-pliable vibrators or dildos for vigorous or deep anal penetration. Fisting is also a potentially dangerous activity that can result in ruptures of the rectum or the colon if you get it in too deeply too quickly.

A perforated rectum/colon is a legitimate medical emergency, and requires surgical intervention to repair. Therefore, if you suspect this has happened to someone, immediately call EMS to come get them and haul them off to an emergency room. An injury of this type results in major bleeding and bacterial contamination of the abdominal cavity, which can lead to death within a few hours if untreated. A perforation will result in severe pain and pressure in the abdomen; it will be difficult to mistake it for the localized pain caused by hemorrhoids or a tear of the anus. There will be no doubt in your mind what is happening. If you are worried that you’ve ruptured a rectum/colon, get yourself to the ER and get it checked out.

The best way to avoid this is to not use hard or rigid sex toys for anal penetration, or if you do, to avoid vigorous penetration with them. Use toys and dildos that are flexible and have no rough edges, and proceed carefully when penetrating yourself. Avoid anal fisting altogether unless you’ve been trained to take a fist in the rectum.

Bleeding from the Anus

Bleeding from the anus is quite common, even for those who have no involvement with anal sex whatsoever. This is typically associated with hemorrhoids or tears of the anus, usually from straining to go to the bathroom, passing an exceptionally thick stool, or getting too vigorous with the wiping after defecating. Bleeding immediately or shortly after anal sex, especially for the anal virgin or for someone who’s engaged in vigorous sodomy, is also rather common. The color of the blood will tell you what level of concern you should exhibit upon discovery.

Bright red blood indicates tears or other issues closer to the exit (anus); these types of injuries usually aren’t long-lived. If you experience this, you should allow it to heal and stay off anal for a few days (whether it was caused by sexual activity or not). This may also be indicative of internal hemorrhoids (see below). If the bleeding doesn’t cease within a day or two, or if it increases to a substantial volume, you should go to a doctor.

Dark red, crimson, or black blood in your stool is indicative of issues further up in the digestive system, such as ulcers, cancers, diverticulitis, gastroenteritis, or other gastrointestinal issue. If you discover this kind of blood in your waste, you should see a physician immediately.


First and foremost among the health concerns with respect to anal play is the possibility of STD transmission. Anal play has one of the greatest potentials for allowing for the interchange of diseases, largely due to the highly vascular nature of the rectal tissue and the ease with which it can be damaged and bleed. Any of the STDs can be transmitted via unprotected anal contact. In fact, unprotected penetrative anal sex is considered the riskiest form of sex play. The more commonly transmitted STDs include:

  • HIV. Unprotected anal sex is the single easiest way to transmit HIV
  • Hepatitis (A, B, and C)
  • Herpes
  • HPV, which can lead to some (fairly rare) forms of anal cancer. Younger people, male and female, should avail themselves of the Gardasil vaccine to help prevent some of those.
  • Gonorrhea
  • Chlamydia
  • Syphilis

Additionally, a variety of other contagious, non-STD diseases can be transmitted this way as well, as can most intestinal parasites. The bacteria in the anal area can lead to urinary tract infections in males or females. Consequently, condoms should always be used when engaging in anal penetration with someone you’re not fluid bonded to.


The term hemorrhoid(s) is thrown around rather loosely to refer to any painful or itchy anus or rectal tissue. In reality, they are inflamed venous tissue at or near the anus. There are two basic types of hemorrhoids.

External hemorrhoids are often visible as abnormally swollen tissue on or around the anus. These are generally just pooled blood under a blister, are usually itchy and painful, and are often accompanied by a burning sensation. These are typically caused by straining during defecation or some type of irritation or damage to the tissue that makes up the anus (either through vigorous wiping, rough anal penetration, atypical stool passage, etc.). They are quite common during pregnancy as well. There are over-the-counter medications (Preparation H, anyone?) that will help treat these symptomatically, but in rare cases, especially when one becomes strangulated, surgical intervention may be required.

Internal hemorrhoids aren’t visible to the naked eye (short of some anal probing) and you often won’t even feel them, but usually obviate themselves through the presence of light amounts of bright red blood during defecation. You’ll notice drippings of blood in the water, along with a light coating of blood on one end of your stool. No one knows for sure what causes these, though some believe straining during defecation and/or rough treatment of the tissue inside the anus (including not using enough lube during anal play!) may be causative.

With respect to anal play, in the case of either condition, you should avoid anal penetration until the bleeding and/or irritation has ceased to be a problem. Continued butt play with these conditions may exacerbate them and lead to it becoming necessary for surgical intervention to correct the issues. If the bleeding continues for more than a few hours to a couple of days, or if it gets heavier, you should seek the advice of a physician.

Anal Sex and Incontinence

There are a lot of people who claim that frequent or recurring anal penetration can lead to incontinence or a weakening of the anus. This defies common sense when you think about it. The anus is a muscle, and as such, the more it is used, the stronger it gets (or, at least, it won’t get “looser”). Of course, if the anus is torn or substantially damaged during anal play, then there may indeed be a possibility of incontinence. There have been no actual scientific studies indicating that frequent anal penetration causes any long lasting issues. The only legitimate study of any note showed no correlation between anal sex and incontinence.(1)

Oral – Anal Contact Issues

There are a couple of scenarios where there is some form of oral contact with the anus or something that has been in the anus/rectum. This includes rimming and ass-to-mouth oral sex. Both of these topics are covered in more depth in later modules in this course. The single greatest issue for most people with respect to oral-anal contact is getting fecal matter in the mouth. Feces is basically composed of water salts, desquamated (peeled off or shed) epithelial cells, bacterial decay products, and undigested food (fiber, etc.). And though that may sound “gross,” it is not inherently unsafe to get a bit of it in your mouth.

Many people fear the e. coli bacteria that are present in the human gut, and are afraid if they ingest some through oral-anal contact, they will get some type of gastrointestinal illness. The truth of the matter is that the strain found in the human gut isn’t the strain that causes digestive system issues/sickness in humans. So getting feces from a human in your mouth, either from yourself or from another human, isn’t going to cause any significant problems for you (though you can catch contagious diseases from someone else, of course). In fact, many gastroenterologists will tell you it is actually safe to eat your own poop. So while it probably isn’t something you want to do, if it happens, you’re not going to be getting sick and/or dying from it.

Anal Penetration to Vaginal Penetration

If there’s one activity you should definitely avoid it is withdrawing something from your asshole and putting it into your vagina, be that a penis, toy, or anything else. Doing this can transfer bacteria from your rectum into your vagina and your urethra. Your vagina needs to maintain a stable pH and bacterial balance in order to keep itself happy. Foreign bacteria transferred from the anus/rectum can often create problems for it. An infected vagina isn’t a pleasant thing, trust me. Additionally, getting that bacteria into your urethra is a great way to catch a urinary tract infection (UTI). If you’ve never had one of those, they really suck. I see ass-to-vagina sex in porn quite a bit, and have read anecdotes about others who’ve done this without experiencing any problems. But my personal guidance is to avoid doing it if possible, especially if you’re prone to getting UTIs. You can use a condom on a penis/toy for anal, and then remove/change it before penetrating the vagina.

Care and Cleaning of the Anus and Rectum

There are two parts to ensuring your back end is clean for anal play, the exterior and the interior. Cleaning the exterior, of course, is pretty straightforward. You just need to wash it with standard soap and water. You’ll want to soap up a finger and insert it into your anus a bit to get the little tunnel clean as well (don’t forget to wash your finger off with water and rinse the soap out of the hole!).

If you’ve gone to the bathroom, be sure and wipe as well as you can, and double check your back end for dinggleberries – those little toilet paper balls and scraps that can accumulate back there if you’re using certain types of toilet paper. Turn around and face a mirror, spread your ass cheeks, and make sure there are none remaining (this should be done for your vaginal area, too, ladies!). I can tell you from experience it’s not fun spreading someone’s a butt cheeks when you’re about to rim them and find a bunch of TP scraps!

If you happen to be in a position where you can’t use soap and water to wash your asshole before you know you’re going to have someone playing with it, carry a wet wipe. The longer you’ve gone since having washed last, the more important this is. The level of importance also goes up if someone’s going to be performing oral on your asshole vs. just sticking something in it.

With respect to cleaning the insides, things can get a bit more complicated. In most people with a normal diet (one with the recommended levels of fiber), there is normally nothing in the rectum unless you feel the need to go to the bathroom. If you’re one who typically has loose stools or is not “regular” with needing to go to the bathroom, however, you may indeed have some fecal material in the rectum. This is the kind of thing you’ll develop a feel for as you move through life. If you’re at a point where you are unsure about your rectum’s contents, you should consider using a condom to protect anything that might be inserted (be it a penis, toy, or whatever).

The primary way of cleaning out the rectum, to include the lower colon, is through the use of enemas. If you’re having issues evacuating your bowels entirely, if you will be playing with someone who has a cock longer than about 6 inches, or if you’re going to be engaging in what I refer to as “porn anal” (the heavy duty, ass pounding, hardcore butt sex), then I highly recommend the use of an enema to prepare your back end for anal sex. The specifics on how to go about doing this are discussed in a later module in this course.

Safe Sex Practices for Anal Play

As we’ve discussed above, there are two basic mechanisms through which contact is made with respect to anal play. The first is oral contact. In the absence of a fluid bond, or in an effort to prevent getting fecal matter in your mouth, the prophylactic method of choice is the barrier.

The other mechanism is of course penetration, either with a penis, fingers, or a toy of some kind. If you are using a toy or your finger(s) and not going to be switching back and forth between your asshole and your cunt, or if you clean it off when you’re done, then there’s no real need to use any kind of cover for it. If you’re being penetrated by a penis, fingers, or toys, however, that will be transferred between your orifices or between two or more people, then you should cover it with a condom prior to insertion and switch the condoms out prior to insertion into another hole/partner. Even if you’re fluid bonded with a male partner, it is recommended you use a condom to help prevent his getting a UTI (fecal matter can enter his urethra, too).

Anal Bleaching

Anal bleaching, also known as anal whitening or anal lightening, is a process of lightening the skin that surrounds the anus. This is done almost exclusively for cosmetic purposes. The desire to do this is often driven by porn, either directly or indirectly. Someone may see porn stars without the brown ring around the anus and want their assholes to appear that way. Some people, especially women, get very self conscious about it. Alternatively, their partners may ask them to lighten the skin tone around the anus. Some people who like wearing swimsuits that expose their butt crack also seek out bleaching.

There is a subconscious tendency to associate the darker skin with the belief that a person may be less than fastidious about keeping their anal area clean, especially after defecating (this person, for example). These two concepts are wholly unrelated, but that mindset persists. Thus, there is often a strong desire to lighten things up and make it “pretty,” especially given the ever increasing popularity of anal sex. I suppose that no one wants to spread their ass cheeks in front of a new partner and have it look as if they didn’t finish their business earlier in the day.

The darker skin around the anus is the result of a higher concentration of melanin (pigment) in the skin in that area, and is perfectly natural and normal. Some people prefer to have that area of skin match the tone of the surrounding areas, so they will “bleach” it or have it treated to to lighten the brown parts up . There are a variety of techniques available. The “do it yourself” varieties involve the use of creams that contain various acids, peptides, or a chemical known as hydroquinone that will change the color of the skin (these can be bought over the counter or online for use at home). There are also clinical procedures that involve lasers or cryogenics.

Regardless of your reasoning, if you wish to pursue lightening the color of your anus, you are highly encouraged to seek the advice and counsel of a dermatologist or a licensed esthetician, rather than randomly picking something off a shelf somewhere and slathering it on your asshole. Some of the chemicals in the products sold on the market have not been certified for use in “lightening” procedures and in fact may damage your skin. No one wants a burned asshole.


(1) Chun AB, Rose S, Mitrani C, Silvestre AJ, Wald A: Anal sphincter structure and function in homosexual males engaging in anal receptive intercourse. American Journal of Gastroenterology 92:465-468, 1997