Practicing safe anal sex is not as intuitive as safe vaginal sex, so Cosmopolitan.com spoke with five doctors about how to keep your back door healthy when you do it in the butt.
1. Don't have anal sex if your anus isn't clean and your bowels are still full. "Right before you have anal sex, make sure you empty your bowels, and then get in the tub or shower and do some good cleaning to the area with antibacterial soap," says Karen Elizabeth Boyle, M.D., FACS. Because there's less lubrication and the hole is less elastic, you're more likely to get tiny tears in your skin during anal sex, so keeping the area as clean as possible is best for preventing infections.
2. Don't use the same condom if you switch between vaginal and anal sex. "If you're having anal sex and want to switch to vaginal sex, you should change the condom in between," says Alyssa Dweck, M.D. "Women are susceptible to infection if the rectal bacteria gets in the vagina." Basically: Change holes, change the condom.
3. Don't think that just because you can't get pregnant, you don't need to use condoms. Those little tears in the skin you can get during anal sex make it even more likely that you'll get any STIs your partner might have, because they'll have direct access to your bloodstream, explains Jennifer Gunter, M.D. But it's possible to protect yourself. "Unless you're in a monogamous relationship and you're positive your partner doesn't have any STIs, you should always use condoms," she says.
4. Do not use anal toys that don't come with an easy way to get them out. Dr. Boyle says that every emergency room doctor has dealt with an item stuck in a butt: soda bottles, cue balls, vaginal vibrators, and so on. "The anus naturally contracts, and can actually pull up the item into the rectum," she says. "The item could also break once inside the rectum and bowel, which could cut a hole in the bowel, requiring invasive surgery." If you want to use a sex toy, butt plugs and anal vibrators are designed for your butt and are usually bigger around the bottom, so they're less likely to go all the way into your rectum and get lost.
5. Don't have anal sex just because your partner wants you to. Michael Krychman, M.D., states the obvious but important thing to remember which is, like with all sexual acts: "Don't feel pressured to engage in something you're not comfortable with." It's bad for your mental health.
6. Don't do it dry. "Dry anal sex is uncomfortable, and can promote rips and tears," says Dr. Dweck. Vanessa Cullins, M.D., recommends "a little dab of water-based or silicone lube on the anus," which not only makes you less likely to tear, but also increases your pleasure.
7. Don't forget to wash in between vaginal and anal play if you're not using condoms. If you're monogamous and not using condoms, penis going from the anus to the vagina could potentially increase risk of infection," Dr. Dweck says.
8. Do not take muscle relaxant drugs to help you loosen up. "People sometimes use certain drugs like amyl nitrate ('poppers') to make anal intercourse more comfortable or easier to do, but do not use them," Dr. Boyle says. "There is no medical evidence to support that drugs help make anal sex better, plus it's a very strong drug with serious side effects, like dangerous changes in blood pressure." Foreplay is the best way to relax and loosen up before anal sex.
9. Don't assume your anus can't get herpes, or that STIs can't be transmitted during anal sex. "It sounds simple, but it's true," says Dr. Dweck. "Herpes is just as transmissible during anal sex as during vaginal sex."
10. Don't have anal sex if you have hemorrhoids (or if you're going to, be extremely careful). "Lots of people have hemorrhoids, but disturbing them during anal play could cause bleeding so just be mindful of that," Dr. Dweck says.
11. Do not use a numbing cream or jelly like lidocaine to help reduce pain during anal sex. "When the anal skin is numb, you might not feel significant injury from vigorous activity, so you might overlook a serious injury to the anus," says Dr. Boyle. Use plain, water-based or silicone lubricants only.