Anal sex has always been a highly controversial subject, and the controversy that surrounds it looks set to continue because evidence is accumulating that this practice may sometimes lead to anal cancer.Indeed, the most anal cancers seem to be linked to infection with HPV'.This is human papilloma virus, which is readily spread from one person to another during sexual contact. The Society also states that 'having anal sex is a risk factor for anal cancer in both men and women'. The risk is greatest if you have had numerous partners.
What is it?
Anal sex means sexual activity involving the bottom – in particular, the type of intercourse in which the penis goes into the anus. It's often referred to as 'rectal sex'.Anal sex is now known to carry considerable health risks, so please read our advice carefully.Our impression is that during the 21st century anal sex has become rather more common in heterosexual couples, partly because they have watched 'blue movies' in which this activity so often occurs.Often, it is presented as something that is both routine and painless for women. In real life, this is not the case. Anal intercourse is often very painful, particularly the first few times.
Other types of sexual activity which involve the anus include:
►'Postillionage' – which means putting a finger into the partner's bottom.
►Insertion of 'butt plugs' – which are sex toys that dilate the anal opening and create a sensation of fullness.
►Use of vibrators on or in the anus (please see cautionary note below).
►'Rimming' – which is oral-anal contact; this carries a significant risk of infection.
►'Fisting' – which means putting the hand into the rectum; this activity is rare among heterosexual couples.
Taboos and infection:
There are taboos surrounding the various types of anal sex – and particularly anal intercourse.These may arouse strong feelings of moral indignation, guilt and anxiety.But research shows that, whether we like it or not, the anal area is equipped with many erotic nerve endings in both men and women.So it's not surprising that many couples (including a lot of heterosexual ones) derive pleasure from some form of 'bottom stimulation'. Most sexual activities carry a risk of transmission of sexually transmitted diseases (STDs) ranging from gonorrhoea and herpes to hepatitis Band HIV. Anal intercourse carries a high transmission risk.
Is it safe?
Anal sex, if practised with care, is possible for most couples.The main health risks, which affect both heterosexual and homosexual couples are described below.
►Human immunodeficiency virus (HIV): There is no doubt that anal intercourse carries a greater risk of transmission of HIV – the virus that can cause acquired immunodeficiency syndrome (AIDS) than other sexual activities, particularly for the receptive partner.
►Human papilloma virus and warts: this virus can be transmitted during anal intercourse and that may lead to anal warts.
►Hepatitis A (infectious hepatitis): this is a viral infection that can cause jaundice. Hepatitis A is not usually a life-threatening illness, although sufferers can feel quite ill. It can be transmitted by oral-anal contact.
►Hepatitis C: is a cause of progressive and sometimes fatal chronic liver disease. Hepatitis C may be transmitted by anal intercourse, although this seems to be a rare occurrence. Sharing of equipment for intravenous drug use is a far more important risk for transmission.
►Escherichia coli (E. coli): may sometimes cause mild to severe, or even (very rarely) fatal, gastroenteritis. It is one of many viruses and bacteria that can be transmitted by oral-anal contact. Some E. coli strains (uropathic E. coli) can also cause urinary tract infections (UTIs), ranging from cystitis to pyelonephritis – a serious kidney infection. E. coli very readily crosses the short distance between the female anus and the female urinary opening, so causing a urinary infection. Anal intercourse can facilitate this transfer, particularly if it is immediately followed by vaginal intercourse.
►There are other, safer sexual practices that can be exciting and rewarding, but many couples may still wish to try the anal route.
►The use of condoms and water-based lubricants, such as K-Y Jelly, will offer some protection.
►Oil-based lubricants, including Vaseline, may cause condoms to split, as will over-energetic thrusting without adequate lubrication.
►Specially toughened condoms designed for anal intercourse may offer more protection.