The ultimate beginner’s guide to anal sex

medspace.me/health-promotion/anal-sex

Dr Suresh Khirwadkar January 18,

2020

Anal sex can be enjoyable for all parties involved if done correctly and
safely. However it’s very important that you understand what is
happening, agree and consent, and are prepared properly. Dr Suresh
gives the ultimate beginner’s guide to anal sex.

Anal is not something we should be ashamed of

Anal sex. Anal intercourse. Bumming. Butt fucking. Whatever you

want to call it.

That taboo topic. The subject that we just never talk about. The thing
that good people just don’t do. It’s disgusting and horrible and just
gross. Right?

Wrong

Many people do it. From all walks of life. All colours and creeds. All
races and religions. We live in the ’50 shades of Grey‘ generation, which
has the benefit of shining the spotlight on sex and allowing some people
to open up about their sexuality and sexual preferences.
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 It’s estimated around that 40% of people have tried anal sex

As a GP a lot of what I do is talk about sex. It just comes up so much in

all sorts of issues. If I had to guess I’d say probably at least 1 in 10, if
not more of my GP consultations involve something to do with sex.

Anal often comes up and people usually have lots of questions about
it. It does usually take them a little while to open up about it, and lots
of prompting, but once those flood gates open then usually the
questions just come pouring out.

Is anal sex normal?

Define normal. I actually rarely use the word. I don’t like it in medical
consults. Nobody is ‘normal’. We are all individuals and we do what we
do. I prefer the words ‘usual’, ‘often’ or ‘commonplace’. So is anal sex
commonplace? Absolutely. It’s estimated around 40% of people have
either tried or are are regularly having anal sex. That’s almost 1 in 2
people. That sounds pretty ‘normal’ to me. Now some do it once and
never again, some do it all the time as the sole form of sex. Some do it
by themselves, some do it in groups.

Sex is complicated and yet wondrously simple at the same time. If you enjoy it and it’s
safe, nobody gets hurt, then keep doing it.

Does it hurt?
Probably the most common question I get asked, and this is a very
common myth. The the answer is: not really if done correctly. When
you do anal in the right way it shouldn’t hurt at all, but if you are
forced, or rushed, it’ll hurt a lot and be a deeply unpleasant
experience for you.

If it hurts then something is wrong. You should stop. Do not

continue thinking it’ll get better. However we do need to talk about
the pain. Sometimes differentiating our sensations can be difficult,
and what you may perceive as pain could be the sensation of the
anus (butthole) stretching. The anus isn’t really designed to

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accomodate objects for a long time and so that stretching can be a
very odd sensation and for some quite unpleasant to begin with.
Some people really like the ‘stretch’ and are in to ‘stretching’ but that’s
an advanced topic.

Once you have passed the initial discomfort of the stretch then anal
should be very pleasurable for you. If it hurts then something is
wrong and there could be a cut or tear and you should stop. If it just
feels too damn tight and the stretch is too much for you to take then
you should stop and spend some time training your butt to
accomodate objects (see below).

You will feel full. That’s normal. You are putting things in your ass.
That fullness can be very disconcerting the first time you experience it.
It’s an odd sensation to get used to, but you will. The fullness can also
become very pleasurable in time.

When done right, anal sex can be an extremely enjoyable, pleasant experience for all those
involved. If you do it correctly then you will find it can be extremely intimate and
pleasurable and can and should be enjoyed to its fullest extent, but that means doing it
correctly.

How do we do it correctly?

To answer this we need to set the scene. Almost quite literally. Anal is
not just something you can jump straight into. It usually needs to be
prepared for, the atmosphere correct, the mood right, everybody
understanding what’s going on and prepared for what’s to come.

Before anything else, preparation is the key to success

Unknown

Yep. Preparation is key. The real art of anal is in the preparation. As

we said it’s not something you should usually just jump into, although
it can be spontaenous, unplanned and still be amazing for those
involved.

How do we prepare?

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Well the first step is probably a shower or a bath. You don’t have to,
but cleaning is is pretty important. It’s not the cleanest of areas so
washing is not a bad idea – it’ll make you feel better about it, whether
you are giving or receiving.

To wash it’s generally advised to use non fragranced soaps or

cleansers as fragranced products can sometimes sting that area. Give
the area a good clean but dont’ scrub, you don’t want a raw anus if
you are about to receive a penis or toy.

The giving party should also wash. Same deal. Don’t scrub. If it’s penis-
in-anus sex then the giver should wash thoroughly as above. If you
are using a dildo or vibrator then clean it using the appropriate
cleaner for the toy. Soaps can sometimes damage these products so
use the right stuff. If you aren’t sure check the manufacturer advice.

Poo

Ok so we are talking about anal sex and putting things in the butt, we
kinda need to talk about poo. One of the top concerns patients have
when talking about anal sex with me is the mess and they worry
about pooing everywhere. I’ll just say this now, it doesn’t really
happen. It’s another common myth.

It’s a good idea to try to open your bowels before receiving anal
penetration to reduce the mess but also it’s not going to feel great
getting a finger, penis or toy in your butt if it’s full of poo. You don’t
need to take laxatives or do anything special, just try to do a poo.
Make sure you clean afterwards.

Douching

What’s douching. It’s the process of cleaning inside the rectum (in this
case). You can get products that claim to make it much easier for you,
but do you even need to do it?

There’s actually no evidence that rectal douching is of any benefit

when it comes to anal sex. It may make it cleaner inside which you
would think would be a good thing, but there’s actually some evidence
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that anal douching can actually increase the risk of getting infections
and having problems with anal sex. Word of warning: it can be a
messy process.

It’s not needed and anal sex isn’t actually very messy, but if you want
to do it then make sure you get the right products.

Foreplay

Foreplay is very important. The easiest way to enjoy anal is to be

comfortable, relaxed and prepared. We’ve already discussed the
physical preparation, but what about the mental, emotional
prepation?

You don’t need to have smooth jazz on repeat to enjoy sex

As we said earlier setting the mood is important. You don’t need to

put on Barry White and light candles, but you should be being
emotionally and mentally prepared and ready to have sex. Now this
goes for all sex not just anal, but it’s even more important for anal
sex. Unlike the vagina the anus doesn’t really relax as much so it
doesn’t accommodate inserted objects easily, so the most important
thing is that you are relaxed and willing.

Foreplay is important for all parties whether they are giving or

receiving. It allows the receiver to physically be more accommodating,
to be more much more engaged and willing for sex, to be much more
in the mood. It will enable a much easier orgasm for the receiver if it’s
comfortable and not hurting them, and as we know orgasm isn’t just
purely physical. In fact most females in particular need emotional and
mental stimulation during foreplay and sex as well as physical to
achieve orgasm. If males are receiving then this will also enable a
much better orgasm due to reduced pain and increased feelings of
intimacy with their partner.

My partner wants to ‘rim’ me, what do they mean?

Rimming, giving a rimjob, getting a rimmer. To give it its medical term

– analingus. Mouth and tongue on asshole. That’s right, this refers to
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putting a mouth or more appropriately putting a tongue on to or in to
your butthole. Basically it’s licking your asshole. Don’t freak out. Lots
of people do it. It can be very pleasurable and an extremely intimate
act between willing partners. Just make sure you are clean first as this
is much higher risk for getting a gastro infection.

Physical preparation

We discussed cleaning and douching already. Now we are talking

physically getting the anus ready for insertion.

You can’t have too much lube

It goes hand in hand with emotional and mental foreplay, so please

don’t forget those parts, but we also need to discuss physical foreplay.

As we said already the anus isn’t as accomodating as a vagina when it

comes to penetration, but it can be ‘stretched’ a little. This will
ultimately allow for a much easier insertion. Depending on your
experience and frequency of anal sex this could either be fairly easy
or more difficult. Take your time if you are new to anal play as you
may struggle a little to get the anus physically ready to be penetrated.
Start with lube. Lots of lube. You can’t have too much lube.

If you take one thing away from this then it’s this: use lubrication and
plenty of it

Lubrication is one of, if not the most important things when it comes
to anal sex. It’s necessary. It’ll make it far easier and far more
enjoyable for both parties, and without it it’s going to be bloody
painful, maybe literally.

If you are wondering if you have enough lube then you definitely don’t have enough

The anus is not self lubricating like the vagina and so it needs help.
We don’t recommended saliva as lube because it doesn’t work well
enough and doesn’t last long enough and neither are things like water
(e.g. bath/shower), moisturisers, cooking oil, butter etc. Particularly oil
is often a bad idea because whilst it’s very lubricating it is extremely
messy and often causes the rectum to contract and squeeze a lot
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which won’t be pleasant.

Types of lube

Get a proper lubricant, either water or silicone based. Silicone based

lubrication tends to be better for penis-in-anus sex because it is
typically a bit thicker and lasts much longer, but can be bad for
silicone based toys (you should use water based with those). WebMD
has a good guide on lubes so check it out if you have more questions
about that.

As we said you simply cannot have too much lube. If you are
wondering if you have enough lube then you definitely don’t have
enough so use more. The more the merrier. Ideally lube should be
applied to the anus, inside the rectum using a finger, and whatever is
going in to the butt as well.

Some luricants come with fragrances or flavours in them, or are ‘2 in 1’

products like massage oil / lube. Whilst you can use these for anal
play, they generally aren’t recommended because they can cause
irritation and stinging on the anu or cause the anus and rectum to
contract. They also tend not to last very long. You don’t want the lube
running dry half way through.

Numbing creams

The other thing that I’d suggest is that you stay clear of any lubricant
or product with any numbing agent in it. You might think it would be a
good idea to numb your bum a little because it’ll hurt less, but if you
do anal right then it shouldn’t hurt much if at all. Numbing
creams/lubes are a bad idea because whilst they can reduce the pain
you might feel, they can cause you go to really quite numb and not
feel anything.

This will vastly reduce the pleasure you get from anal sex but also
runs the risk that if you can’t really feel what’s going on then you
won’t know if the anus is stretching too far and this could cause you
an injury. If it gets on the penis (assuming it’s a penis going in) then it’ll
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cause that to go numb too which will lead to reduced pleasure and
also delayed ejaculation/orgasm. So now we have a situation where
it’s less pleasurable for both parties, runs the risk of not feeling if it’s
too stretched, delayed orgasm so the act will be going on for longer,
further increasing the risk of trauma. So basically not a great idea.

Sex toys

As we said earlier, preparation is key. This also includes physically

stretching the anus a little to get it ready to accomodate whatever is
ultimately going to be going in. This may be a penis or a toy, or simple
a finger or two.

Now don’t panic, those aren’t medieval torture instruments you see,
they are sex toys, but actually they are quite advanced toys, so don’t
freak out.

Sex toys (and penises) come in all shapes and sizes, small, large, thin,
thick, short, long, straight, bent, curvy, bulbous, etc. The list is almost
endless. It’s important that you get the right toy for the right job. If
you are an advanced user then you will want different toys, but this
article is for beginners. Beginners are likely to want small toys. We are
mostly talking about butt plugs here, but there’s anal dildos too. We
don’t recommend using something which is not designed to be
inserted in to the rectum, mainly due to the risk of either trauma or
‘travelling’. This is where a toy can get lost inside the rectum and start
to work its way up the body. This won’t happen though if you have the
correct toys.

One of my colleagues Dr George Forgan-Smith has a great site on all

things anal related. It’s geared towards men who have sex with men,
but it’s applicable to anything anal. He has a great guide on butt plugs
so be sure to check that out if you have more questions, particularly
for more advanced users.

Butt plugs

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Basically butt plugs are designed to go in the butt. They are shaped
correctly, tapered, and have a wide base to avoid travelling. They
come pretty small to the very large, and come in different materials,
colours, and textures so make sure you get the right ones for you. The
easiest way to size them up is to put your finger in your bottom and if
it feels ok then that’s a reasonable size.

As a very rough guide most penises are about the same width as 2
fingers, so if you can take that ok then a penis is probably ok too. If
you are using toys, then size them up based on the dimensions on the
product. Depending on what you want from the plug then the size can
be adjusted. If you want to get used to having something in your bum
then start small with something small and comfortable. You don’t
want your first experiences to not be enjoyable. As you get more used
to the sensations then you may want to increase the size of the toys.

You can wear butt plugs at home or out and about, whatever takes
your fancy. They are very unlikely to just fall out unless they are too
small, and as long as you are wearing underwear then they won’t just
fall on the floor as you are walking along. Assuming you get a non
vibrating kind, nobody will know you have one in, so if that’s
something you want to do then go right ahead.

I’m ready for anal sex

Great. You’ve decided that you are ready to do the deed. So let’s talk
about what will happen. Assuming you have done all the above, you
are as prepared as you wanted to be, you are physically mentally and
emotionally ready to take something in your butt, then it’s time to get
started. If you are using a toy and not a penis then you will control the
whole thing yourself, so when you are ready then put that toy in. Go
slowly. Take it easy. It’ll be an odd feeling as we discussed above, but
shouldn’t hurt. If it does then stop.

If it’s penis-in-anus sex then it’ll be a little different. You will have a
partner to also take into account.

Infection
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Infection

First things first. Let’s talk safety. We already discussed pain above,
but we need to talk infections. Anal sex has a higher chance of
contracting STIs including blood borne viruses like HIV and hepatitis.
This is both if you are giving or receiving so it’s very important to think
about using a condom. Condoms should be put on the penis before
lube and lube goes on top. That’s very important. Lube under the
condom will cause it to come off.

Before embarking on any sex but particularly for anal sex it is a good
idea to get an STI check with your GP. You could have an STI even if
you don’t have any symptoms. The majority of people don’t have
symptoms so it’s a good idea to get a check. It’s easy, but for a full
proper check it’s recommended to have rectal swabs as well as the
other tests. I’ve lost count of the number of people I’ve picked up
asymptommatic STIs just from rectal swabs.

Assuming you and your partner don’t have any STIs and you are
happy and confident to not use a condom then you don’t have to.
Although the risk of bacterial infection following anal intercourse is
very low, for the giver it’s important to consider the risk of urinary
tract infections and prostatitis (infection in the prostate). There are
steps you can take to reduce the risks, including good cleaning (as we
said above, although douching actually can increase the risks), having
a wee after sex to physically expel any faecal matter (poo), and having
a good wash afterwards. If you get any symptoms of infection (e.g.
pain, discomfort doing a wee, or discharge then see a doctor as soon
as possible).

You don’t have to use a condom if you are happy and confident not to
but it’s always worth thinking about the risks.

Positions

Another question I often get asked about anal, what position should
we do it in?

Well I’m going to bust a myth here, there’s no position that’s just for
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anal. It’s not mandatory to do it doggy style. There are however
positions that may be more comfortable to receive in. The best
position is one that you are happy and comfortable and relaxed in,
but otherwise positions which ‘open’ the anus and rectum will be the
most comfortable.

For example the fetal position (on your side knees up to your chest)
with the giver lying behind you in a spoon position is typically the
easiest, at least for beginners. This does depend a little on penis size
(more on that later) but typically its the best beginner position.

Depending on you and your partner, or rather your trust in them, you
may feel it’s better to be in control of the penetration so you can take
it as slow as you like. ‘Girl-on-top’ can be a good position for this (men
can go on top of course as well if having sex with another man). It
makes it easy to control the penetration and stop your partner
thrusting too deeply. As the anus is very close to the vagina pretty
much any position can be used for anal sex.

Be gentle

For those who are giving, do not just shove it in. It can be difficult for
the giver to resist the temptation to push it all the way in. The anus
and rectum are typically ‘tighter’ than a vagina and so the sensation to
the giver can be a little overwhelming. It’s super important that you
resist that temptation and just go slow. If you thrust it in and go right
down all the way straight away you will cause deep trauma to your
partner, both physical, mental and emotional. Take it slow, damn slow,
and ease it in. Let them accomodate. Give them time. It’s very
important.

It’s not a sprint or race to the finish line

Once you are both much more versed in anal then you can set your
own pace and do what feels right, quick or slow.

Penis size

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So we had to talk about this at some point. If you are using toys
instead then just use an appropriate size toy for what you can take.
For penis size though this is a different story. I’m not going to get in to
the whole ‘size matters’ debate (other than to say it really is the
stroker not the poker), but we all know that penises come in all
shapes and sizes. Some are short and fat, some long and slender,
some are straight whilst others are curved. There’s no ‘correct’ penis
shape or size.

For reference the average penis size is around 5 inches long and 4.5
inches round (circumference). Some penises are large and this may
cause you to be concerned about taking this in your butt. Don’t worry.
All it means is that you need to be much more prepared and practice
with toys first. Eventually if it’s something you want to do with the
right person and the right practice then you’ll be able to take it and
enjoy it. Trying without any kind of practice is likely to cause you
problems though. If you are the giver and have a large penis please
think about what that thing might be doing to whoever you are giving
it to and just take your time.

Ok. i’m definitely ready now. what do we do?

If you are both prepared and ready, then go for it. Do your foreplay.
Get the lube. Use fingers. Use your toys. When ready for that final
penetration then get in position. If spoon position then line up
whatever is going in with the anus and gently push. Whoever is
receiving can push back gently. If ‘girl-on-top’ or something similar
then whoever is on top should line the penis up with their anus and
sit down gently on it.

It’s often easier if the receiver tries to open up their anus and rectum a
little. The easiest way to do this is to basically try to do a poo. This is
essentially the same action and should open up the anus and rectum
a little. Remember when we said you should try to poo before anal
play? This is where you don’t want to actually be doing a poo. Now
don’t push too hard or force it – you aren’t actually trying to expel
whatever is going in, just trying to open up a little to help.
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Butt plugs are fairly simple to go in, they are tapered and so it
stretches as it goes down, but a penis and most dildos are bulbous at
the end so the biggest stretch will come at the start. After this initial
stretch once the head of the penis/dildo is actually in it’ll feel like it
‘pops in’ and then the stretch will go down and it’ll feel easier. Ok this
is where I have to say the next feeling you get will probably freak you
out. It’ll feel like you need to take a huge shit. That’s normal. Trust
me (I’m a doctor) that’s normal. You won’t actually need to take a huge
dump on your partner so don’t panic. It’ll feel weird, but soon that
feeling will go and you should just get a pleasant fullness.

Keep going

Once you are ready to and used to the feelings then start to get that
penis/dildo in you some more, to the point you are happy. Most of the
time the rectum can take an entire penis right down to the base,
though this may depend on the length of the penis. Be careful with
dildos as you don’t want them to get lost inside the rectum and then
‘travel’ up the bowels.

Eventually you will want to start moving it in and out a bit, just like
vaginal sex. Go for it. Just do what feels good at this point, and enjoy
yourself. Remember it’s not a race, but if you want to go at it hard and
fast and it feels good then go right ahead. As with any kind of sex, it’s
not just about one act in isolation, so make sure you or your partner
are stimulating your entire body and mind whilst also have anal sex.
Although some can, very few people will have an orgasm purely from
anal intercourse so play with your other bits.

It’s perfectly fine to play with your other bits during anal sex, in fact it’s
definitely a good idea as you are much more likely to have a good
time. Anal sex is about all those engaged in the act having a good
time, not just whoever is doing the giving. Pro tip: If you are wanting
your partner to be receptive to anal sex and do it more often,
ensuring they have a good time is far more likely to work than if they
have a terrible time.

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Semen

So everybody is having a great time. It’s starting to get to that time.

Ejaculation is appproaching. (assuming you have a penis involved).
What do you do? Well you have 3 options

Pull out (gently please) and come somewhere else

Come inside a condom if you are using it
Come inside your partner’s ass

Any option is fine. What I would suggest though is discuss it with your
partner before hand so that you all know what’s going to happen and
no surprises. Again please don’t do anything ‘unexpected’ thinking
you’ll get away with it, you will just piss off your partner and
guarantee they never have anal with you again. Plus it’s a form of
sexual assault.

You don’t need to worry about being ejaculated inside your rectum,
and indeed many people find it feels very nice, but there are some
risks. We already discussed the risks of STI but also there’s a risk of
pregnancy. I know that sounds really strange, but there is. Although I
couldn’t find exact numbers, it’s estimated that quite a number of
unintended pregnancies comes from anal sex. There 3 main reasons
this can happen:

Semen on fingers going near/in the vagina

The penis coming out and accidentally going inside the vagina
Semen leaking from the anus after anal sex which goes down
towards and into the vagina

Well yes but I didn’t think you could have sex by having it in the bum bum!

Lily Allen (British singer/songwriter)

Anal sex is not recommended as a form of contraception.

Afters

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So we are done. We’re all bummed out. We’ve hopefully had a great
time but what do we do now? Well just like you would with any other
kind of sex. When ready, get up, have a wash – there’s probaby lube
all over your bum and toys/penis. There may also be poo on your toys
or penis. Don’t panic, it’s going to happen. If they have been inside
your ass then they aren’t going to come out smelling like roses.

Just have a wash with soap and water (toy cleaning stuff for toys). I’d
suggest do a wee – generally good advice after sex to reduce the risk
of UTI, but also for anal in particular as it’s just that little more dirty,
plus for whoever has the penis that went inside the best thing is to
have a wash and do a wee to physically expel any matter which might
be making its way up.

Depending on your experience level you may be quite sore and feel a
little stretched out, that’s normal. Semen (if ejaculated inside) may
leak out a little. If you do a poo after it’ll probably come out. You may
do a lot of farts. There’s probably been a fair bit of air pumped up
there during the sex so don’t worry. They will probably be wet farts
and semen may come out a bit, again normal. It’ll settle down.

Just like if you have semen in your vagina after sex, you may get some
leaking out a little as the day goes on, again this is normal so don’t
panic.

Don’t worry, you won’t be shitting yourself all day after anal. The anus
closes up again fairly quickly after anal. It’s not like in the [porn]
movies where they stay open and it looks like they could pass a
bowling ball out of their ass – unless you are in to gaping but that’s not
really a beginner’s topic.

I hated it

Ok so you just didn’t like it. It was weird, unpleasant and

uncomfortable and you aren’t keen to repeat it. You really didn’t like
it. That’s ok. Not everybody enjoys it.

You need to tell your partner though (assuming it wasn’t self play) so
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they are aware. Speak to them so that they can understand what you
didn’t like. There may be something you can work on, or it may be
that it’s just never going to happen for you, and that’s OK.

Whatever you decide your partner should understand and go

along with it.

I loved it

Great. You’ve now expanded your sexual repertoire. Tell your partner.
You don’t need to be coy about it, especially given the fact you just
had their cock up your butt.

When you do it again is entirely up to you. You may want to go again

stright away, that’s fine, do what you want. You may want to wait and
do it at a later point, that’s ok. You may want to make it a regular
occurence or a spontaenous thing, whatever works for you and your
partner.

Whatever you decide your partner should understand and go

along with it.

Coercion

Ok sorry but we need to talk about this. If your partner is pressuring

you into anal sex and you really don’t want it then you need to tell
them. Be frank and honest and say ‘no. I don’t want it’. They should
understand. If they persist then be firmer and say something like ‘look
I know you want to try it, but I really don’t, please just accept that’. If
that still is not enough then you need to be asking yourself if you are
safe in this relationship and whether you need to leave it or get some
help.

Please speak to somebody if you are unsafe. There will be support

lines you can call for confidential advice, usually free. 1800 RESPECT is
the number to call here in Australia, and there are services like White
Ribbon, Reach Out and Lifeline that can help too, or of course speak
to your local GP who can help.

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If you are in an emergency situation please call the police and
make yourself safe.

Hopefully though all has gone to plan, it was a pleasurable experience

and everybody had a good time. If you want to take your anal play
further in the future then go right ahead, just do it safely.

When done right, anal sex can be an extremely enjoyable, pleasant

experience for all those involved. If you do it correctly then you will
find it can be extremely intimate and pleasurable and can and should
be enjoyed to its fullest extent, but that means doing it correctly.

Dr Suresh is a GP and Skin Cancer Doctor in Kenmore, Brisbane.

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Social media is pervasive in modern society but can social media be
used in medicine? Is has huge flaws but also huge potential for good
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Health Promotion

SNAP – Alcohol and the French Paradox

By Dr Suresh Khirwadkar / January 27, 2020
Dr Shawn Hsia discusses alcohol and the French Paradox
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