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Joseph Terlizzi , a New York-based colon and rectal surgeon, for the lowdown on how gay and bi men can prepare, how to do the deed, and how to stay safe post-coital.
Check out his expert advice on how to make anal sex more pleasurable:. While maintaining anal hygiene is important, people tend to be too fastidious when it comes to cleaning up before anal intercourse.
Common mistakes I see patients make include using chemical wipes the perfumes and preservatives make them irritating and wiping too much friction can lead to abrasions. This causes the skin around the anus to become inflamed, leading to thickening and ultimately itching or discomfort with sex.
So forget the harsh scents and chemicals — before sex, simply clean the outside of the anus well in the shower or bath with plain water or a very gentle soap. Fiber helps bulk up stool and decreases liquidity, further minimizing the chance of a mess. In general, men should consume grams of fiber per day, and women should consume grams of fiber per day.
While enemas may seem like a logical way to avoid an embarrassing interaction, I strongly advise against them. Enemas increase your risk of acquiring infections, including gonorrhea, chlamydia, hepatitis and even HIV. Additionally, among subjects who performed 50 or more enemas in their lifetime, there is a trend for increased risk of anal dysplasia which can lead to anal warts and anal cancer. If you just read this paragraph, rolled your eyes, and still plan to use enemas, there are steps you can take to mitigate the risks.
Second, keep in mind that after the enema is about 1. Ensure that there is no soap in the enema, as this can cause more irritation.
Most importantly, only use a small volume of water you can try the little bulbs that are sold in drug stores to clean out your ears. If you try to clean high up, the water will mix with the stool. This can fill the rectum with liquid stool, running the risk that you will have a messy experience. Toys present an excellent way to prepare and relax before intercourse, but they can easily cause trauma if used incorrectly, and even spread infections if shared. Passing them back and forth between partners without thoroughly washing them can spread STIs.
Opt for softer latex toys that are much less likely to cause trauma than ones made with more rigid materials. Rimming can provide some lubrication and helps the anus relax before sex. That said, rimming can put both partners at risk for STIs, so be careful.
Dental dams may be used as a protective barrier to minimize the risk of infection, but can obviously be awkward to use. Condoms are the best barrier against STIs, though their efficacy can vary depending on the type of infection. Condoms are unfortunately less effective for STIs like herpes, HPV, and syphilis, which can be spread by skin-to-skin contact. Even if you are consistently using condoms, PrEP can serve as a valuable backup if you are at even a minor risk for HIV exposure.
It is very important that you get your PrEP from a healthcare professional who is comfortable prescribing the medication, who you can find by using our Lighthouse doctor search function.
I have heard of individuals getting Truvada on the streets and this is a terrible idea. Second, it is important that your doctor checks your kidney function and other lab tests every few months. This reflex is more pronounced in uncircumcised men, and will make bottoming more painful and difficult. Gently allow penetration to the point of minimal discomfort. Within a minute, the sphincter will relax and the penis can be slowly inserted fully.
After anal sex, shower normally with a gentle soap. Clean the outside of the anus very gently — do not attempt to scrub. Do not use enemas, including soap suds or Fleets. Get tested for STIs every three months if you are having anal intercourse with more than one partner, and every six months if you are monogamous. You can easily find a gay-friendly or gay-identifying doctor through Lighthouse to avoid negative discrimination or stigma.
When bottoming hurts, it could be that your anus is anatomically too tight or you are unable to relax, which is oftentimes a psychological response. Many people have had negative bottoming experiences in the past or simply have a fear of the unknown, rendering them unable to relax their anus and enjoy safe and pain-free anal intercourse.
Some people are simply tighter than others — and some penises are larger than others — which can make anal intercourse more painful. For either problem, I suggest trying dilators. Available in medical supply stores, dilators provide a safe and secure way to become more comfortable with anal sex.
Start small, leave the dilator in place for 10 minutes three times a day, and use the same size for a week. Dilators help with psychological fears by preparing you more for what to expect, giving you total control over your body, and erasing any fear or embarrassment in the eyes of a partner.
Physically, they allow the sphincter to accommodate a penis over time and should help bottoming get easier. If for any reason anal sex remains painful or you notice the appearance of lumps, bleeding, or an ongoing itch, see a healthcare professional immediately for a thorough anorectal examination.
Despite the fact that both men and women have been engaging in anal sex since the ancient Greeks and probably long before that , there remains, in many circles, a stigma attached to it. Because when it comes to bottoming — or any part of your sex life — no subject should be taboo. Interested in learning more? Make an appointment with Dr.
Terlizzi today. Noor, S. Archives of Sexual Behavior 43, — Schmelzer, M. Safety and effectiveness of large-volume enema solutions. Appl Nurs Res 17, — Richel, O. Politch, J. Rodger, A. JAMA , — Podnar, S. Clinical elicitation of the penilo-cavernosus reflex in circumcised men.
BJU Int. Read Next. Everything you wanted to know about bottoming but were too afraid to ask. Getting Down to Business Now for the fun part. Step 1: Foreplay. Step 2: Condoms. Step 3: Penetration. Post-Coital Cleaning After anal sex, shower normally with a gentle soap. If you are unable to enjoy anal intercourse, there could be a few factors at play.
Physically, they allow the sphincter to accommodate a penis over time and should help bottoming get easier If for any reason anal sex remains painful or you notice the appearance of lumps, bleeding, or an ongoing itch, see a healthcare professional immediately for a thorough anorectal examination. Find Bottom Friendly Medical Support Despite the fact that both men and women have been engaging in anal sex since the ancient Greeks and probably long before that , there remains, in many circles, a stigma attached to it.