Spoiler: The myth that it always hurts is completely untrue.
By Hannah Smothers
Apr 18, 2016
Is This Normal? is a weekly series that addresses everything you’ve ever wondered about sexual health and your body. This week: pain during anal sex.
Of all the sex acts out there you can try, anal sex comes with some of the most vicious rumors. I don’t just mean the rumor that everyone said Stephanie from high school was doing it, or the weird, creeping thought that all your friends are secretly doing it behind your back (pun intended). I mean the rumor that it’s always painful, but if you want to try it, you just sort of have to put up with it and dive into butt stuff, head- (or I guess ass-) first. And then you just deal with all the insane injuries that happen later.
Some good news though. Just like it’s probably not true that Stephanie was having it with Todd in sixth grade or whatever, it’s also not true that anal sex has to hurt or be dangerous, at all. In fact, like all other sex things, it shouldn’t hurt, so long as you’re properly prepared. Cosmopolitan.com spoke with some experts on anal sex and health to shine some light on an area that so rarely sees the sun.
Dr. Kimberly McBride, assistant professor of public health at the University of Toledo, recently told Cosmopolitan.com that although “we don’t have a lot of good scientific data about pain and trauma [from anal sex], a proportion of women are experiencing high levels of pain with anal intercourse because they’re going straight into penile-anal sex and they’re not able to relax, and aren’t using appropriate lubrication.” (More on the importance of lube, the holy grail of good anal, soon.)
Dr. McBride compared first-time anal to first-time vaginal sex. More than likely, you worked your way up to the full monty with some fingering or oral, and then putting a penis in your vagina for the first time was probably still a bit uncomfy and required some patience from all parties involved. The same is true for anal, except a bit more dramatic because as Dr. McBride pointed out, “the anus doesn’t naturally self-lubricate the way the vagina does.” So the best thing you can do is experiment with smaller items before moving onto a full-on hard penis. These can be things like fingers, butt plugs, or anal beads — whatever you’re cool with. Basically, you’re trying to teach the little muscles and sphincter around your rectum that they can relax when something tries to work its way up there. The second things start hurting, retreat. There’s no rush here — no one (worth knowing) is going to criticize you for going about anal sex too slowly.
But if you do experience pain, Dr. McBride advised waiting a few hours to see if it subsides, unless that pain is severe or there’s bleeding. “Anytime you’re having persistent pain, especially if it’s associated with bleeding or you’re having irregular bowel movements, go to a provider and be honest,” she said. You should always be honest with your doctor, but the worst thing you could do in this situation is be sheepish about having had anal sex in order to avoid any nonexistent embarrassment. “I think a lot of women don’t go and they just bear it because they’re ashamed or whatever, and I think that’s a problem,” Dr. McBride said.
YOU MIGHT GET ANAL TEARS, BUT YOU PROBABLY WON’T NOTICE
“Anal tearing” sounds like it would be the most traumatic terrible thing in the world, but as Dr. McBride said, you can have minor tearing and not even know it. The tears happen because sex is an activity that comes with friction, and the skin around the anus is “much more fragile than vaginal tissue.” She said that “minor tearing happens” but often can’t be see with the naked eye, and often the tears don’t bleed at all. Still, these tears are important to know about because anytime you have bodily fluids near open skin like that, you’re increasing your risks for STIs like HIV.
So the little anal tears you probably won’t even notice, if you’re properly lubed and taking things slowly and carefully, can become real risks if you don’t use a condom. Even if your partner is only sleeping with you and is totally STI-free, and so are you, you should still use a condom every single time you have anal sex, especially since your anus has bacteria living it in that can lead to infections if it comes in contact with other body parts. Nothing that’s been in your butt should ever go into your vagina or mouth or any other body cavity without being washed or covered with a totally new, fresh condom. There are bacteria in your rectum and anus that are specific to that body part, and when they come in contact with other body parts, they can cause infections like bacterial vaginosis and the dreaded UTI.
IT’S NOT AS RISKY AS YOU THINK
Dr. Vanessa Cullins, vice president of external medical affairs at Planned Parenthood, explained that most of the extreme anal sex horror stories you might read about in scary blog posts or on Reddit are usually the result of anal rape or assault, and involve some sort of forcible entry up the anus. The data on how common anal sex injuries are is basically nonexistent, like Dr. McBride said, but in her practice at Planned Parenthood as an ob-gyn, Dr. Cullins said she sees very few cases of extreme trauma or injury from women who’ve had consensual anal sex.
She did emphasize, again, the importance of using good, thick lube that won’t dry up quickly and wearing a condom every single time. “The best course is to use some type of barrier, because you’re dealing with skin-to-skin transmitted diseases like herpes and HPV,” she said. And she clarified that using a barrier doesn’t just apply when you’re talking penile-anal sex. She recommended using something like a latex glove when doing anal fingering, or a dental dam with anal cunnilingus (aka eating ass). While fun, flirty, “throw me down on the bed and take me now” sex can be incredibly sexy, Dr. Cullins said that anal sex just requires a bit more preparation and planning, since that skin-to-skin contact and the tiny little anal tears do create a bit more of a risk than vaginal or oral sex.
Like Dr. McBride, she also emphasized the importance of never taking something that was in your butt and moving it to your vagina or mouth. It might momentarily kill the mood to run to the bathroom just to wash of your finger or mouth, but it’ll save you a lot of pain and trouble in the long run.
YOUR BUTT HOLE ISN’T GOING TO GET “LOOSE”
One of the biggest concerns Dr. McBride said she hears from women considering anal sex for the first time is that they’re worried they’ll become incontinent or just poop all over the place without warning because their butt holes will loosen up and never go back down to their petite, original size. “We don’t really see a lot of evidence, at least at this time, that there is any kind of incontinence associated with routine anal intercourse,” Dr. McBride said. She reminded me that there isn’t a lot of data, of course, but of the data we do have, nothing proves that you’ll lose the ability to control your bowels after having anal sex once a week or however often.
Also, your butt hole isn’t going to expand to some insane size and never shrink back down. And if that’s truly a concern for you, Dr. McBride said that your regular kegel exercises will also address the sphincter muscle around your rectum. But again, you can’t stretch it out. It doesn’t work that way!
LIKE ANY SEX THING, IT’S NOT FOR EVERYONE
As Dr. Cullins said, “There are a lot of people who really do enjoy anal sex, but not everybody does.” Like is true with any sex act, don’t do anything that hurts or makes you uncomfortable. Anal sex, and all sex, should be enjoyable, fun, and feel great. If anything ever starts hurting or becomes uncomfortable, stop.
And not that you have to keep trying it forever, but Cullins did say that your enjoyment of anal can come down to your partner. “Just because you tried it with one partner and didn’t like it doesn’t mean you don’t like anal sex,” she said. “If you’re with someone you trust and who you want to be intimate with, then you’re more likely to be able to enjoy what you’re experiencing.” So really it all comes down to the biggest and most basic rule of anal sex: Relax, and only go as far as you and your partner are willing to go. Oh, and use more lube. You can actually never have too much lube.