As with any sexual topic, what is “normal” really is in the eye of the beholder. Anal sex involves inserting the penis through the anal sphincter. The anal area has a lot of nerve endings and, for some, is very erogenous. It is estimated that 5-10% of sexually active, heterosexual women engage in anal sex. For these couples it is “normal”. That being said there are unique health risks to be aware of and precautions to be taken.
The anus is a tighter entrance and lacks lubrication that is present in the vagina. This combination increases the risks for tears. Commonly these are small tears throughout the skin or thin mucosa. Adequate lubrication can help decrease this. On rare occasions, significant trauma can occur if the colon wall is perforated.
Beyond the pain the tears cause, they significantly increase your risk of contracting an STD (such as HIV, hepatitis or herpes). Studies have shown a 30% increased risk of HIV infection compared vaginal intercourse. HPV also increases the risk of anal warts and anal cancer. For women who regularly practice anal intercourse it is not unreasonable to do a rectal pap smear in addition to the routine cervical pap smear.
Aside from STD-type infections, the anal area has a high count of bacteria from feces. This puts partners at increased risk of infection. Likewise, vaginal or oral sex after anal penetration increases risk for infection. If you notice a discharge or pain in the days after engaging in anal sex, you should be evaluated by your physician.
The anal sphincter is a muscle intended to keep stool inside. Over time, penetration of the sphincter can lead to weakening or damage to the muscle. This can lead to problems with gas or stool incontinence. Just like the vagina, the anal sphincter can be strengthened with Kegel exercises.
It is also important to realize you can still get pregnant practicing anal sex. Sperm can find their way into the vagina and to a readily awaiting egg.
So bottom line – yes, anal sex is OK if it is consensual, but take the following precautions:
- Wear condoms to prevent STD and pregnancy
- Use copious lubrication to decrease pain and trauma
- Avoid vaginal or oral sex after anal intercourse
- As with any sexual practice, if it is not enjoyable, tell your partner and stop.