Anal sex: how safe is it really? What are the risks of anal sex?

Anal sex is a taboo subject – often even between partners. Yet every couple has the right to experiment and discover what they enjoy, and sex involving anal penetration is a form of intimacy that many people find pleasurable.

There's no shame and nothing wrong in wanting to try it – and that desire shouldn't be judged either. What matters, though, is that you're well informed, because anal sex does carry some higher risks than vaginal sex. Find out how safe anal sex is and how you can protect yourself so that the experience is as enjoyable as possible.

What is anal sex

When we talk about sex, we usually mean vaginal sex. Sexual contact isn't limited to vaginal penetration, however. There are dozens of forms of intimacy that couples can choose from, all of which can bring pleasure to both partners. One of these is sexual contact involving anal penetration.

Anal sex refers, as the name suggests, to sexual activity in which the anus is penetrated by the penis, the fingers or by sex toys. Thanks to the many nerve endings around the sphincter, this area is highly sensitive, and stimulating it can give partners a great deal of pleasure.

Myths about anal sex

Because anal sex isn't as intuitive as vaginal sex, and because many cultures have spread prejudices about it over time, it's a controversial topic surrounded by plenty of speculation. Much of it is false or only partly true – so let's clear a few things up:

Myth: Only gay people have anal sex 

Anal sex isn't just for same-sex partners. Couples can choose sex involving anal penetration regardless of the partners' gender – with the penis or with sex toys. Yes, heterosexual couples can have anal sex too, and the practice in which the female partner penetrates her partner's anus is known as 'pegging'.

Conversely, not all gay couples have anal sex either – some people simply don't enjoy this form of intimacy, whatever their sexual orientation.

Myth: You can't get pregnant from anal sex 

This isn't purely a myth, but only partly true. It's true that pregnancy can't occur from anal intercourse alone, or from ejaculation into the anus. But any form of unprotected sex in which semen comes close to the vagina can lead to pregnancy.

The likelihood of becoming pregnant after unprotected anal sex is lower. Even so, there's still a chance that semen could reach the perineal area and travel from there into the vagina, which can result in pregnancy.

Statistics suggest that around 8% of couples who practise unprotected anal sex experience an unplanned pregnancy.

Myth: You're less likely to catch a sexually transmitted infection from anal sex 

Quite the opposite: with anal sex, the risk of contracting sexually transmitted diseases is just as high or even higher. Because the tissue of the anus is very delicate and easily injured, the risk of pathogens entering the body increases. Generally speaking, the person being anally penetrated faces a higher risk of infection than their partner.

The risks of anal sex

Anal sex carries some higher risks than vaginal sex. That doesn't mean you should be afraid or avoid anal sex because it's dangerous. It simply means you should be aware of these risks and how to avoid them, so that you can protect yourself.

Anal fissures

Anal fissures are common after anal sex. Because the tissue of the anus is very delicate, inserting any foreign object – including the penis or sex toys – can cause injury. These small tears can cause severe pain, itching, irritation and bleeding.

Infections 

Because of the risk of anal fissures, anal penetration also increases the risk of sexually transmitted infections. According to specialists, anal sex is the sexual behaviour carrying the highest risk of HIV transmission from an infected partner.

What's more, bacteria and viruses from the anal area can more easily reach the vagina during anal sex, increasing the risk of vaginal infections. Among the infections that can be transmitted are gonorrhoea, chlamydia, syphilis, E. coli, hepatitis B and C, and parasitic infections.

Bowel perforation 

Although it's rare, there is a risk of perforation of the large intestine. It presents after anal intercourse as heavy, persistent rectal bleeding and abdominal pain, and requires immediate emergency treatment.

Tips for safe anal sex 

As mentioned already: the fact that anal sex carries certain risks doesn't mean you should avoid it altogether or be afraid of this form of intimacy. Practised safely and with everyone's consent, anal sex can be a source of pleasure and new sensations.

Here are a few tips for exploring this experience safely:

• Talk to your partner. Always make sure you both want the same thing, and respect your partner's wishes. Just because someone has agreed once doesn't mean they'll want to every time. Always keep talking to avoid pressure, confusion and misunderstandings.
• Use a condom. It protects against sexually transmitted infections. Also change the condom after anal penetration before moving on to vaginal penetration – this reduces the risk of transferring bacteria and causing vaginal infections.
• Use lubricant. Unlike the vagina, the anus doesn't self-lubricate. Use a water-based lubricant before penetration to reduce friction and with it the risk of anal fissures.
• Be patient. Like any form of intimacy, anal sex can become more enjoyable with experience. So be patient and stop as soon as pain or discomfort arises, or if either partner doesn't want to continue. Take things step by step, and only carry on when you both feel ready.

Complications associated with anal sex 

The risks of anal sex – for women as well as men – can develop into complications if ignored. If any of the following signs appear, see a doctor as soon as possible for diagnosis and treatment:

• Irritation and pain after penetration
• Bleeding due to anal fissures or haemorrhoids
• Disrupted bowel movements because of the pain

Frequently asked questions about anal sex 

We want to be as open as possible and leave no question unanswered. That's why we've gathered the most common questions about anal sex and answered each one in turn.

Can I have an orgasm from anal sex?

Like any form of sex, anal sex can bring pleasure and lead to orgasm. The nerve endings of the clitoris extend into the anal area, which is why anal stimulation can feel very good. Bear in mind, though: whether anal or vaginal sex, most women can only reach orgasm if penetration is accompanied by clitoral stimulation.

Should anal sex hurt?

No. This misconception stems from the idea that anal sex is 'against nature'. Of course, you may feel some discomfort or an unfamiliar sensation during anal penetration, especially at first. But the truth is: anal sex shouldn't be painful.

Pain is a signal that something isn't right. It might mean you need lubricant, that there are anal fissures or irritation, or simply that the pelvic floor or rectal muscles are tense and you need to relax.

Do I have to use a condom?

It's recommended that you always use a condom during anal sex, to prevent the spread of bacteria and sexually transmitted infections, and also to make sure there's no risk of an unwanted pregnancy.

Is bleeding after anal sex normal?

Light bleeding after intercourse can indicate injury, while heavy bleeding accompanied by severe pain may even point to a bowel perforation. One thing is certain: bleeding is not normal. If it doesn't stop or is accompanied by other symptoms, see a doctor immediately.

Can anal sex cause cancer?

Anal sex can increase the risk of contracting HPV, which in turn can contribute to the development of cancer.

Can anal sex cause HIV?

Anal penetration itself doesn't cause HIV. However, unprotected anal sex increases the risk of HIV transmission if one of the partners is already infected. It's considered the sexual practice with the highest risk of transmitting the human immunodeficiency virus. So always protect yourselves with a condom to avoid infection.

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