Anal Health 

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This sheet is designed to provide anal health information.  Problems in this area are common for many people. 

Anal Sex

Blood-borne viruses (BBVs), including HIV, and sexually transmissible infections (STIs) can be passed on very easily through anal sex – more easily in fact than during any other type of sexual activity.  When taking the necessary precautions however, anal sex can be both safe and enjoyable.

Condoms and dams provide protection against STIs (a dam is a thin latex square held over the anus during oral sex).  Never use a condom or dam more than once, and always a new condom if switching between the vagina and anus, or between partners. If you are going to insert your finger into someone’s anus, it is advisable to wear a latex finger cott (a glove for a single finger) to reduce the risk of tearing and the exchange of body fluids.  If you are going to insert more than one finger it is advisable to wear a latex glove.  Gloves are more readily available than finger cotts and can be purchased from most pharmacies and some supermarkets.

As the anus doesn’t produce any lubrication of its own (unlike the vagina or mouth), it’s important to use plenty of water-based lubricant when having anal sex to reduce discomfort, the risk of skin tearing and prevent condom breakage (oil-based lubricant breaks down the latex in condoms and dams).  Symptoms such as pain in the rectum (the lower part of the intestine, leading to the anus) or discharge from the anus can be signs of an STI.  If you are experiencing any of these symptoms you should discuss them with a doctor.

As with any sexual activity, having anal sex is a personal choice.  If it is something you don’t feel comfortable with, don’t allow yourself to be pressured to take part, as there are lots of other ways to enjoy yourself and your body.

Anal Fissures

An anal fissure is a break in the skin at the opening to or just inside the anus, and can be caused by constipation, anal sex, or the use of fingers and toys during sex.  Anal fissures can cause irritation, which can lead to anal itchiness and scratching, and also pain when defecating (pooing). Treatment depends on how extensive the fissure is, the reason the fissure developed, and how it is affecting you. Some creams are available over the counter from pharmacies, however it is recommended you consult with a doctor first, especially if there is any bleeding, as sometimes infections can be mistaken for a fissure.

Open anal fissures are a point of entry for infections and therefore can increase your chances of contracting an STI or BBV.  You can reduce the risk of getting an anal fissure by:

• asking sexual partners not to wear rings and cut their fingernails if they are going to put their finger in your anus, to avoid tearing and the exchange of body fluids.
• knowing your limits when it comes to anal sex, and only going as far as your body feels comfortable with.
• using lots of water-based lubricants to avoid skin tearing
• having a high-fibre diet, to avoid constipation.

Anal Itching

Anal itching is a problem for some people and can be caused by a variety of factors such as different foods (chillis, tomatoes, caffeine and some dairy foods), allergic reactions (to soaps, oils, creams, latex, lubricants and detergents) and physical causes (haemorrhoids, sweat, worms and anal fissures). Sometimes no reason can be found for the itching.

Once people start to scratch their anus it is often difficult to stop. The skin around the anus becomes increasingly irritated and can be more sensitive to everyday products like toilet paper. It is important to talk with a doctor about the itching and try to determine why it is happening. In the meantime avoid applying products that contain alcohol and perfumes as they may irritate the area more. You may want to stop using these products or eating certain foods in an attempt to see if the itching lessens. Do this for about one month then start to gradually introduce these products back into use one at a time, monitoring your reaction to them.

Haemorrhoids

Haemorrhoids are like varicose veins and are actually inflamed and enlarged veins in the rectum. Internal haemorrhoids originate inside the rectum but can often protrude outside the rectum as they enlarge.  External haemorrhoids are enlarged veins under the skin next to the anal opening.  Haemorrhoids can be the result of activities such as heavy lifting, a chronic cough, or chronic constipation, all of which increase the pressure on the veins. 

Although anal sex doesn’t cause internal haemorrhoids, it can irritate them and cause bleeding, thus creating a point of entry for BBVs.  As anal bleeding can be a symptom of something more serious, such as colon cancer, you should see a doctor if bleeding occurs.

Prevention of constipation is one of the best ways to reduce the pain and problems associated with haemorrhoids, so try and gradually increase foods in your diet that are high in fibre such as fruits, vegetables and unprocessed grains like whole-grain breads and bran cereal.  Drinking at least two litres of water a day also helps. If this isn’t enough to prevent constipation you may need to introduce a natural fibre supplement such as Psyllium husk or a commercially produced fibre supplement such as Metamucil. Diarrhoea can also irritate haemorrhoids, so it is important not to go overboard when managing constipation.

Douching and Internal Cleansing

‘Douching’ (or an enema) refers to a powerful jet of water or medicated solution used to clear the anus of faeces. Also known as internal cleansing, douching is not a recommended practice as it can lead to damage of the rectum, which increases the risk of contracting an STI or BBV.  For this reason, other activities such as colonic irrigation are also not recommended.

Reference: Brent, B. (2002). The Ultimate Guide to Anal Sex for Men. Cleis Press Inc, USA.

Practising safe sex reduces the risk of contracting HIV and other sexually transmissible infections (STIs).

Page last updated Thu, 07 Jan 2010 15:37