Anal sex can be enjoyable for all parties involved if done correctly and safely. It’s very important that all parties understand what is happening, agree and consent, and are prepared properly. Dr Suresh gives the ultimate beginner’s guide to anal sex.

It’s not something we should be ashamed of

Anal sex. Anal intercourse. Bumming. Butt fucking. Whatever you want to call it.

That taboo topic. The subject that we just never talk about. The thing that good people just don’t do. It’s disgusting and horrible and just gross. Right?


Many people do it. From all walks of life. All colours and creeds. All races and religions. We live in the ’50 shades’ generation, which whilst in my opinion are awful, badly written books, at least they had the benefit of shining the spotlight on sex and allowing some people to bust out of their shells a little.

It’s estimated around that 40% of people have tried anal sex

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As a GP a lot of what I do is talk about sex. It just comes up so much in all sorts of issues. If I had to guess I’d say probably at least 1 in 10, if not more of my GP consultations involve something to do with sex.

Anal often comes up and people usually have lots of questions about it. It does usually take them a little while to open up about it, and lots of prompting, but once those flood gates open then usually the questions just come pouring out.


Define normal. I actually rarely use the word. I don’t like it in medical consults. Nobody is ‘normal’. We are all individuals and we do what we do. I prefer the words ‘usual’, ‘often’ or ‘commonplace’. So is anal sex commonplace? Absolutely. It’s estimated around 40% of people have either tried or are are regularly having anal sex. That’s almost 1 in 2 people. That sounds pretty ‘normal’ to me. Now some do it once and never again, some do it all the time as the sole form of sex. Some do it by themselves, some do it in groups.

Sex is complicated and yet wondrously simple at the same time. If you enjoy it and it’s safe, nobody gets hurt, then keep doing it.


Most of the time when discussing anal sex with my patients if they actually are already doing it then they know some of the answers anyway, (although they always learn a thing or two) but this is probably the question I get asked the most.

The answer is: not really if done correctly. If done incorrectly, if forced, or rushed, it’ll hurt a lot and be a deeply unpleasant experience for those involved.

If it hurts then something is wrong. You should stop. Do not continue thinking it’ll get better. However we do need to talk about the pain. Sometimes differentiating our sensations can be difficult, and what you may perceive as pain could be the sensation of the anus (butthole) stretching. The anus isn’t really designed to accomodate objects for a long time and so that stretching can be a very odd sensation and for some quite unpleasant to begin with. Some people really like the ‘stretch’ and are in to ‘stretching’ but that’s an advanced topic.

Once the initial discomfort of the stretch is gone then anal should be very pleasurable. If it hurts then something is wrong and there could be a cut or tear and you should stop. If it just feels too damn tight and the stretch is too much for you to take then you should stop and spend some time training your butt to accomodate objects (see below).

You will feel full. That’s normal. You are putting things in your ass. That fullness can be very disconcerting the first time you experience it. It’s an odd sensation to get used to, but you will. The fullness can also become very pleasurable in time.

When done right, anal sex can be an extremely enjoyable, pleasant experience for all those involved. It can be extremely intimate and pleasurable and can and should be enjoyed to its fullest extent, but that means doing it correctly.


To answer this we need to set the scene. Almost quite literally. Anal is not just something you can jump straight into. It usually needs to be prepared for, the atmosphere correct, the mood right, everybody understanding what’s going on and prepared for what’s to come.

Before anything else, preparation is the key to success


Yep. Preparation is key. The real art of anal is in the preparation. As we said it’s not something you usually just jump into, although it can be spontaenous, unplanned and still be amazing for those involved.

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Well the first step is probably a shower or a bath. You don’t have to, but cleaning is is pretty important. It’s not the cleanest of areas so washing is not a bad idea – it’ll make you feel better about it, whether you are giving or receiving.

To wash it’s generally advised to use non fragranced soaps or cleansers as fragranced products can sometimes sting that area. Give the area a good clean but dont’ scrub, you don’t want a raw anus if you are about to receive a penis or toy.

The giving party should also wash. Same deal. Don’t scrub. If it’s penis-in-anus sex then the giver should wash thoroughly as above. If you are using a dildo or vibrator then clean it using the appropriate cleaner for the toy. Soaps can sometimes damage these products so use the right stuff. If you aren’t sure check the manufacturer advice.


Ok so we are talking about anal sex and putting things in the butt, we kinda need to talk about poo. One of the top concerns patients have when talking about anal sex with me is the mess. They are worried they are going to get poo everywhere. I’ll just say this now, it doesn’t really happen.

It’s a good idea to try to open your bowels before receiving anal penetration to reduce the mess but also it’s not going to feel great getting a finger, penis or toy in your butt if it’s full of poo. You don’t need to take laxatives or do anything special, just try to do a poo. Make sure you clean afterwards.


What’s douching. It’s the process of cleaning inside the rectum (in this case). There’s plenty of products on the market that make it easy, but is it needed?

There’s actually no evidence that rectal douching is of any benefit when it comes to anal sex. It may make it cleaner inside which you would think would be a good thing, but there’s actually some evidence that anal douching can actually increase the risk of getting infections and having problems with anal sex. Word of warning: it can be a messy process.

It’s not needed and anal sex isn’t actually very messy, but if you want to do it then make sure you get the right products.


Foreplay is very important. The easiest way to enjoy anal is to be comfortable, relaxed and prepared. We’ve already discussed the physical preparation, but what about the mental, emotional prepation?

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You don’t need to have smooth jazz on repeat to enjoy sex

As we said earlier setting the mood is important. This doesn’t mean putting some jazz or Barry White on the record player is needed, it just means emotionally and mentally being prepared and ready to have sex. Now this goes for all sex not just anal, but it’s even more important for anal sex. Unlike the vagina the anus doesn’t really relax as much and accomodate inserted objects easily, so the most important thing is to be relaxed and willing.

Foreplay is important for all parties whether they are giving or receiving. It allows the receiver to physically be more accomodating, to be more much more engaged and willing for sex, to be much more in the mood. It will enable a much easier orgasm for the receiver if it’s comfortable and not hurting them, and as we know orgasm isn’t just purely physical. In fact most females in particular need emotional and mental stimulation during foreplay and sex as well as physical to achieve orgasm. If males are receiving then this will also enable a much better orgasm due to reduced pain and increased feelings of intimacy with their partner.


Rimming, giving a rimjob, getting a rimmer. To give it its medical term – analingus. Mouth and tongue on asshole. That’s right, this refers to putting a mouth or more appropriately putting a tongue on to or in to your butthole. Basically it’s licking your asshole. Don’t freak out. Lots of people do it. It can be very pleasurable and an extremely intimate act between willing partners. Just make sure you are clean first as this is much higher risk for getting a gastro infection.


We discussed cleaning and douching already. Now we are talking physically getting the anus ready for insertion.

You can’t have too much lube

It goes hand in hand with emotional and mental foreplay, so please don’t forget those parts, but we also need to discuss physical foreplay.

As we said already the anus isn’t as accomodating as a vagina when it comes to penetration, but it can be ‘stretched’ a little. This will ultimately allow for a much easier insertion. Depending on your experience and frequency of anal sex this could either be fairly easy or more difficult. Those that are new to anal play may struggle a little to get the anus physically ready to be penetrated so do take your time. Start with lube. Lots of lube. You can’t have too much lube.


Lubrication is one of, if not the most important things when it comes to anal sex. It’s necessary. It’ll make it far easier and far more enjoyable for both parties, and without it it’s going to be bloody painful, maybe literally.

If you are wondering if you have enough lube then you definitely don’t have enough

The anus is not self lubricating like the vagina. It needs help. Saliva is not the best lubrication and not recommended because it doesn’t work well enough and doesn’t last long enough and neither are things like water (e.g. bath/shower), moisturisers, cooking oil, butter etc. Particularly oil is often a bad idea because whilst it’s very lubricating it is extremely messy and often causes the rectum to contract and squeeze a lot which won’t be pleasant.

Get a proper lubricant, either water or silicone based. Silicone based lubrication tends to be better for penis-in-anus sex because it is typically a bit thicker and lasts much longer, but can be bad for silicone based toys (you should use water based with those). WebMD has a good guide on lubes so check it out if you have more questions about that.

As we said you simply cannot have too much lube. If you are wondering if you have enough lube then you definitely don’t have enough so use more. The more the merrier. Ideally lube should be applied to the anus, inside the rectum using a finger, and whatever is going in to the butt as well.

Some luricants come with fragrances or flavours in them, or are ‘2 in 1’ products like massage oil / lube. Whilst you can use these for anal play, they generally aren’t recommended because they can cause irritation and stinging on the anu or cause the anus and rectum to contract. They also tend not to last very long. You don’t want the lube running dry half way through.


The other thing that I’d suggest is that you stay clear of any lubricant or product with any numbing agent in it. You might think it would be a good idea to numb your bum a little because it’ll hurt less, but if you do anal right then it shouldn’t hurt much if at all. Numbing creams/lubes are a bad idea because whilst they can reduce the pain you might feel, they can cause you go to really quite numb and not feel anything. This will vastly reduce the pleasure you get from anal sex but also runs the risk that if you can’t really feel what’s going on then you won’t know if the anus is stretching too far and this could cause you an injury. If it gets on the penis (assuming it’s a penis going in) then it’ll cause that to go numb too which will lead to reduced pleasure and also delayed ejaculation/orgasm. So now we have a situation where it’s less pleasurable for both parties, runs the risk of not feeling if it’s too stretched, delayed orgasm so the act will be going on for longer, further increasing the risk of trauma. So basically not a great idea.

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As we said earlier, preparation is key. This also includes physically stretching the anus a little to get it ready to accomodate whatever is ultimately going to be going in. This may be a penis or a toy, or simple a finger or two.

Now don’t panic, those aren’t medieval torture instruments you see, they are sex toys, but actually they are quite advanced toys, so don’t freak out.

Sex toys (and penises) come in all shapes and sizes, small, large, thin, thick, short, long, straight, bent, curvy, bulbous, etc. The list is almost endless. It’s important that you get the right toy for the right job. If you are an advanced user then you will want different toys, but this article is for beginners. Beginners are likely to want small toys. We are mostly talking about butt plugs here, but there’s anal dildos too. We don’t recommend using something which is not designed to be inserted in to the rectum, mainly due to the risk of either trauma or ‘travelling’. This is where a toy can get lost inside the rectum and start to work its way up the body. This won’t happen though if you have the correct toys.

One of my colleagues Dr George Forgan-Smith has a great site on all things anal related. It’s geared towards men who have sex with men, but it’s applicable to anything anal. He has a great guide on butt plugs so be sure to check that out if you have more questions, particularly for more advanced users.

Basically butt plugs are designed to go in the butt. They are shaped correctly, tapered, and have a wide base to avoid travelling. They come pretty small to the very large, and come in different materials, colours, and textures so make sure you get the right ones for you. The easiest way to size them up is to put your finger in your bottom and if it feels ok then that’s a reasonable size. As a very rough guide most penises are about the same width as 2 fingers, so if you can take that ok then a penis is probably ok too. If you are using toys, then size them up based on the dimensions on the product. Depending on what you want from the plug then the size can be adjusted. If you just want to get used to having something in your bum then start small with something comfortable. You don’t want your first experiences to not be enjoyable. As you get more comfortable with the sensations then you can get a bit bigger to start to stretch the anus and get it used to bigger objects.

You can wear butt plugs at home or out and about, whatever takes your fancy. They are very unlikely to just fall out unless they are too small, and as long as you are wearing underwear then they won’t just fall on the floor as you are walking along. Assuming you get a non vibrating kind, nobody will know you have one in, so if that’s something you want to do then go right ahead.


Great. You’ve decided that you are ready to do the deed. So let’s talk about what will happen. Assuming you have done all the above, you are as prepared as you wanted to be, you are physically mentally and emotionally ready to take something in your butt, then it’s time to get started. If you are using a toy and not a penis then you will control the whole thing yourself, so when you are ready then put that toy in. Go slowly. Take it easy. It’ll be an odd feeling as we discussed above, but shouldn’t hurt. If it does then stop.

If it’s penis-in-anus sex then it’ll be a little different. You will have a partner to also take into account.

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First things first. Let’s talk safety. We already discussed pain above, but we need to talk infections. Anal sex has a higher chance of contracting STIs including blood borne viruses like HIV and hepatitis. This is both if you are giving or receiving so it’s very important to think about using a condom. Condoms should be put on the penis before lube and lube goes on top. That’s very important. Lube under the condom will cause it to come off.

Assuming you and your partner don’t have any STIs (you can have even if you don’t have symptoms so consider getting an STI check) and you are happy and confident to not use a condom then you don’t have to. Although the risk of bacterial infection following anal intercourse is very low, for the giver it’s important to consider the risk of urinary tract infections and prostatitis (infection in the prostate). There are steps you can take to reduce the risks, including good cleaning (as we said above, although douching actually can increase the risks), having a wee after sex to physically expel any faecal matter (poo), and having a good wash afterwards. If you get any symptoms of infection (e.g. pain, discomfort doing a wee, or discharge then see a doctor as soon as possible).

You don’t have to use a condom if you are happy and confident not to but it’s always worth thinking about the risks.

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Another question I often get asked about anal, what position should we do it in?

Well I’m going to bust a myth here, there’s no position that’s just for anal. It’s not mandatory to do it doggy style. There are however positions that may be more comfortable to receive in. The best position is one that you are happy and comfortable and relaxed in, but otherwise positions which ‘open’ the anus and rectum will be the most comfortable.

For example the fetal position (on your side knees up to your chest) with the giver lying behind you in a spoon position is typically the easiest, at least for beginners. This does depend a little on penis size (more on that later) but typically its the best beginner position.

Depending on you and your partner, or rather your trust in them, you may feel it’s better to be in control of the penetration so you can take it as slow as you like. ‘Girl-on-top’ can be a good position for this (men can go on top of course as well if having sex with another man). It makes it easy to control the penetration and stop your partner thrusting too deeply. As the anus is very close to the vagina pretty much any position can be used for anal sex.

For those who are giving, do not just shove it in. It can be difficult for the giver to resist the temptation to push it all the way in. The anus and rectum are typically ‘tighter’ than a vagina and so the sensation to the giver can be a little overwhelming. It’s super important that you resist that temptation and just go slow. If you thrust it in and go right down all the way straight away you will cause deep trauma to your partner, both physical, mental and emotional. Take it slow, damn slow, and ease it in. Let them accomodate. Give them time. It’s very important.

It’s not a sprint or race to the finish line

Once you are both much more versed in anal then you can set your own pace and do what feels right, quick or slow.


So we had to talk about this at some point. If you are using toys instead then just use an appropriate size toy for what you can take. For penis size though this is a different story. I’m not going to get in to the whole ‘size matters’ debate (other than to say it really is the stroker not the poker), but we all know that penises come in all shapes and sizes. Some are short and fat, some long and slender, some are straight whilst others are curved. There’s no ‘correct’ penis shape or size. For reference the average penis size is around 5 inches long and 4.5 inches round (circumference). Some penises are large and this may cause you to be concerned about taking this in your butt. Don’t worry. All it means is that you need to be much more prepared and practice with toys first. Eventually if it’s something you want to do with the right person and the right practice then you’ll be able to take it and enjoy it. Trying without any kind of practice is likely to cause you problems though. If you are the giver and have a large penis please think about what that thing might be doing to whoever you are giving it to and just take your time.


If you are both prepared and ready, then go for it. Do your foreplay. Get the lube. Use fingers. Use your toys. When ready for that final penetration then get in position. If spoon position then line up whatever is going in with the anus and gently push. Whoever is receiving can push back gently. If ‘girl-on-top’ or something similar then whoever is on top should line the penis up with their anus and sit down gently on it.

It’s often easier if the receiver tries to open up their anus and rectum a little. The easiest way to do this is to basically try to do a poo. This is essentially the same action and should open up the anus and rectum a little. Remember when we said you should try to poo before anal play? This is where you don’t want to actually be doing a poo. Now don’t push too hard or force it – you aren’t actually trying to expel whatever is going in, just trying to open up a little to help.

Butt plugs are fairly simple to go in, they are tapered and so it stretches as it goes down, but a penis and most dildos are bulbous at the end so the biggest stretch will come at the start. After this initial stretch once the head of the penis/dildo is actually in it’ll feel like it ‘pops in’ and then the stretch will go down and it’ll feel easier. Ok this is where I have to say the next feeling you get will probably freak you out. It’ll feel like you need to take a huge shit. That’s normal. Trust me (I’m a doctor) that’s normal. You won’t actually need to take a huge dump on your partner so don’t panic. It’ll feel weird, but soon that feeling will go and you should just get a pleasant fullness.

Once you are ready to and used to the feelings then start to get that penis/dildo in you some more, to the point you are happy. Most of the time the rectum can take an entire penis right down to the base, though this may depend on the length of the penis. Be careful with dildos as you don’t want them to get lost inside the rectum and then ‘travel’ up the bowels.

Eventually you will want to start moving it in and out a bit, just like vaginal sex. Go for it. Just do what feels good at this point, and enjoy yourself. Remember it’s not a race, but if you want to go at it hard and fast and it feels good then go right ahead. As with any kind of sex, it’s not just about one act in isolation, so make sure you or your partner are stimulating your entire body and mind whilst also have anal sex. Although some can, very few people will have an orgasm purely from anal intercourse so play with your other bits. It’s perfectly fine to play with your other bits during anal sex, in fact it’s definitely a good idea as you are much more likely to have a good time. Anal sex is about all those engaged in the act having a good time, not just whoever is doing the giving. Pro tip: If you are wanting your partner to be receptive to anal sex and do it more often, ensuring they have a good time is far more likely to work than if they have a terrible time.

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Not this kind of semen


So everybody is having a great time. It’s starting to get to that time. Ejaculation is appproaching. (assuming you have a penis involved). What do you do? Well you have 3 options

  • Pull out (gently please) and come somewhere else
  • Come inside a condom if you are using it
  • Come inside your partner’s ass

Any option is fine. What I would suggest though is discuss it with your partner before hand so that you all know what’s going to happen and no surprises. Again please don’t do anything ‘unexpected’ thinking you’ll get away with it, you will just piss off your partner and guarantee they never have anal with you again. Plus it’s a form of sexual assault.

You don’t need to worry about being ejaculated inside your rectum, and indeed many people find it feels very nice, but there are some risks. We already discussed the risks of STI but also there’s a risk of pregnancy. I know that sounds really strange, but there is. Although I couldn’t find exact numbers, it’s estimated that quite a number of unintended pregnancies comes from anal sex. There 3 main reasons this can happen:

  • Semen on fingers going near/in the vagina
  • The penis coming out and accidentally going inside the vagina
  • Semen leaking from the anus after anal sex which goes down towards and into the vagina

Well yes but I didn’t think you could have sex by having it in the bum bum!

Lily Allen (British singer/songwriter)

Anal sex is not recommended as a form of contraception.


So we are done. We’re all bummed out. We’ve hopefully had a great time but what do we do now? Well just like you would with any other kind of sex. When ready, get up, have a wash – there’s probaby lube all over your bum and toys/penis. There may also be poo on your toys or penis. Don’t panic, it’s going to happen. If they have been inside your ass then they aren’t going to come out smelling like roses. Just have a wash with soap and water (toy cleaning stuff for toys). I’d suggest do a wee – generally good advice after sex to reduce the risk of UTI, but also for anal in particular as it’s just that little more dirty, plus for whoever has the penis that went inside the best thing is to have a wash and do a wee to physically expel any matter which might be making its way up.

Depending on your experience level you may be quite sore and feel a little stretched out, that’s normal. Semen (if ejaculated inside) may leak out a little. If you do a poo after it’ll probably come out. You may do a lot of farts. There’s probably been a fair bit of air pumped up there during the sex so don’t worry. They will probably be wet farts and semen may come out a bit, again normal. It’ll settle down.

Just like if you have semen in your vagina after sex, you may get some leaking out a little as the day goes on, again this is normal so don’t panic.

Don’t worry, you won’t be shitting yourself all day after anal. The anus closes up again fairly quickly after anal. It’s not like in the [porn] movies where they stay open and it looks like they could pass a bowling ball out of their ass – unless you are in to gaping but that’s not really a beginner’s topic.

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