Question: Is Anal Sex Safe?
In theory, yes.
Anal sex can absolutely be a safe way to experience sex, just as vaginal intercourse can be a safe way to experience sex.
With any type of sex, however, there are ways to make it more or less safe.
Research shows that heterosexual women and men tend to use condoms less often during anal sex as compared to vaginal sex. As anal sex carries a greater risk of passing sexually transmissible infections, or STIs, condom use during anal intercourse is important.
More men and women should be using condoms if and when they have anal intercourse. STIs including chlamydia, gonorrhea, HPV, and HIV can all be passed through anal intercourse, so if you plan to have anal sex, it would be a wise idea to use condoms.
Because the anus doesn’t lubricate as the vagina does, using a lubricant can help make anal sex feel more comfortable, more pleasurable, and reduce the risk of anal tearing. Minor rectal bleeding from small anal cuts or tears is relatively common following anal sex.
This is not necessarily a serious problem but if you have questions about your anal health, or about anal tearing, ask your healthcare provider. Keep in mind that as many as about 40% of Americans have tried anal sex at least once in their lives, and more people would do well to ask their healthcare provider about their genital and anal health, including safer sex. Asking about your health is nothing to be embarrassed about!
Since we originally published this post in 2013, there have also been two new studies (one from 2016 and another in 2017) suggesting that penile-anal intercourse may be associated with a higher risk of fecal incontinence for women and men. However, as neither study was particularly detailed in their questions about anal sex (for example, neither asked about frequency of anal intercourse; to what extent the anal sex was wanted, consensual or enjoyable; or whether the anal sex engaged in was typically gentle or rough), we still have much to learn on the topic. What we do know is that most people who have anal sex do not develop fecal incontinence. There is also a general sense from other areas of research that forceful sex in general (even vaginal sex) carries greater risk for trauma or damage, as one might expect, so if you are engaging in anal intercourse you might want to consider (a) using lubricant, as mentioned above and (b) engaging in anal sex that is more gentle than rough.
Also – as with any kind of sex – it’s helpful to think about why one is engaging in it. One study found that it was somewhat common for women to feel pressured into having anal intercourse, or to say that they had anal sex to please their partner or in hopes of keeping their partner from having sex with others. Interestingly, these reasons were more common among women who had been diagnosed with a rectal STI; women without rectal STIs more often talked about having anal sex for their own pleasure or to enhance intimacy with a partner. For me, this study underscores how sexual behavior and its influences are complex, and tied together with women’s feelings about themselves, their relationships, their self-worth, and of course their own insecurities and sense of power and emotional well-being (or strain).
Data from our recent 2012 National Survey of Sexual Health and Behavior shows that anal sex can be painful for many people, and perhaps especially for women. About 70% of women reported pain during their most recent experience of anal intercourse.
In some (particularly younger) age groups, 100% of the women who reported having anal sex said that it was painful. Quite often, the pain was rated as moderate or severe. The good news is that, compared with vaginal sex, women and men who experienced pain during anal sex were more likely to tell their sexual partners that they were in pain.
Although some people enjoy pain as part of their sexual experiences, many people do not like sex to feel painful. If you feel pain and don’t like it, remember that you can stop or avoid any sexual behavior you don’t want to engage in.
You can also try to adjust the way you have sex to make it less painful, or more comfortable.
It Is Up To You
When it comes to anal sex, using a condom, using lubricant, and choosing partners with whom you feel comfortable and relaxed can be key to having more pleasurable – and safer – anal sex.
Updated with links to and descriptions of newer research, available since the 2013 publication of this post, on May 3, 2017.