Enjoying the 'Backdoor' - Anal Play

Many people think that only male homosexuals enjoy or engage in anal sex. A significant number of heterosexual men and women as well as gay women also enjoy some form of anal stimulation. It can be said with some degree of certainty that the anus is an erogenous zone. It is richly supplied with tactile sensation. Many of the nerves and some of the muscles share the same nerves as the genitals. In fact, stimulating the genitals in both men and women may cause contraction of the anus.Simulation of the anus is not considered erotic by everyone. Others will find that for esthetic or other reasons anal stimulation is unpleasant.

However, a study in the mid-1970s showed 8 percent of women included some form of anal stimulation as a regular part of sex. Another study in 1988 reconfirmed this finding. The same study found that over 25% of women had experienced anal intercourse at one time or another. Thus, it can be said that anal sex practice is very common.The techniques used for anal sex include anal intercourse, enemas, insertion of foreign bodies into the anus, and anilingus. Of these, the only technique that offers no danger to the recipient is anilingus. The use of anal orifices for sexual gratification may be complicated by several diseases, including venereal warts, syphilis, gonorrhea, AIDS, hepatitis, and other sexually transmitted organisms. These diseases will not be discussed here.

Anal Masturbation and Foreplay
Anal masturbation occurs when the participant either manipulates the anus or inserts small objects into the anus. It usually is performed as a part of genital masturbation, but may be done by itself. The most common method is to simply insert a finger into the rectum or to stimulate the rectum.

Manipulation of the anus is often used as a part of sexual foreplay and arousal. In this context, it is commonly used as an adjunct to intercourse. Knotted cords or small beads on a string have been inserted into the rectum and rapidly withdrawn during orgasm to make the orgasm more intense.An important part of anal sex is adequate lubrication.

Unlike the vagina, the anus and rectum do not produce any lubrication and, without it, anal fun can be quite unpleasant. There are a large number of lubricants on the market. It is generally best to use water-based lubricants, especially if using condoms or any latex toys. Petroleum jelly based lubricants will damage the latex and cause the condom to break or the toy to be permanently damaged. An inexpensive lubricant is KY Jelly. A little more pricey is one called AstroGlide that has the same consistency of a woman’s natural secretions when she is ovulating (when she is more sexually arousable).

Another consideration is cleanliness. The anus and rectum contain a large number of bacteria that are not friendly to the vagina and could cause other problems in the body. Penetration of the anus with fingers, penis, or toys requires thorough cleaning with soap and water before insertion into the vagina. Conversely, when switching from vaginal to anal penetration, thorough cleaning of the fingers, penis, or toys is not required.

In both anal foreplay and masturbation, it is extremely easy to lose control of small objects that are inserted - particularly if they are well lubricated and the individual is sexually aroused. Beads inserted anally should be connected to a long cord that has a large diameter ring attached to one end. The large ring will not remain outside the body to allow the string of beads to be removed easily. Likewise, any butt plugs, dildos, etc. should have a flanged end to prevent them from becoming ‘lost’ in the rectum. The flange acts to anchor the toy to the outside of the body and allows easy removal. Because toys with no flange can get pulled deeper into the rectum, items such as vegetables, flashlights, light bulbs, etc. should not be included in anal play.

Some of the problems associated with anal sex include a torn anus or rectum, retained foreign bodies (the dildo got stuck), and perforations of the rectum and lower bowel.

Anal Tearing
Toys inserted into the anus or intercourse can produce minor injuries to the area. These injuries can result in anal fissures (painful linear ulcers), torn hemorrhoids, abrasions, ulcerations, or bruises. One study found that 45% of anal injuries were caused by penile anal intercourse, 30% by fist intercourse, and 16% by foreign bodies. The other 9% had no specified cause.Treatment of uncomplicated or uninfected cuts, scrapes, and tears should include abstinence, sitz baths in warm water, stool softeners, and topical pain relief preparations. In any case, gentle stimulation should be mandated in future anal play.Tears in the anus and rectum seldom cause major problems. Most will show no signs of irritation or bleeding. If bleeding persists or deep lacerations have occurred hospitalization and surgery may be needed especially if the sphincter muscle is torn or if severe internal tearing has taken place.

Retained Foreign Bodies
Toys such as dildos and vibrators have be inserted for erotic anal stimulation. The only size limitation on the size of the object inserted into the rectum are the size of the rectum and the size of the imagination. Common objects include dildos, butt plugs, and vibrators, fruits and vegetables, bottles, softballs, baseballs, and rods of sundry materials. Truly bizarre items are occasionally inserted into the anus, including: gerbils and hamsters, and cement. Men outnumber the ladies in the reported retained foreign objects in the rectum. This may reflect a greater male aggressiveness or simply a different anatomy. Depending on the object, a retained toy, dildo, vibrator, or other object may require surgery to remove. If an object gets stuck while playing and simple finger probing cannot remove it, a visit to the emergency department is appropriate. It is never a good idea to insert something larger to go ‘fishing’ for the retained item. And, no, it will not pass during the next bowel movement!

Perforations
Perforation of the colon or rectum represents a potentially lethal complication of anal sexual activities. Perforations high up in the colon may result in infection of the abdomen. Signs and symptoms of this infection include rapid onset of abdominal pain, rapid heart beat, rapid breathing, fever and a rigid abdomen. A person with this type of complication needs intravenous antibiotics, massive intravenous fluids, and prompt surgery.

Potentially lethal anal/rectal sex activities

"Fisting"
A special note should be made of the "ultimate" technique of anal sex known as "fisting", also called "fist fucking," "handballing," or “fist fornication. In this practice, the hand and forearm are inserted into the rectum for erotic stimulation. It is apparently well known in the gay community, but is infrequently practiced. Willing participants tend to use drugs or alcohol to help them relax. These substances can cloud the appropriate response to pain and increase the risk for life threatening injuries.If thinking about fisting a partner, the key is to start slowly and use lots of lubricant. Insert one finger at a time and allow the anal sphincter to relax before inserting the next finger. To help ‘loosen’ things, after two or three fingers have been inserted, spread the fingers a little to ease the tightness of the anal opening. Stop or delay progressing to another finger if pain is severe or persists or bleeding is present.This is predominantly a male activity. Lesbians have been reported to insert a fist into the rectum for stimulation, but far more frequently insert fingers or a hand into the vagina of a partner. Rectal and vaginal stimulation with a hand may also occur in heterosexual relationships. The injuries that result from this activity may range from simple anal tears to life-threatening perforations of the colon. The threat to the person may be increased by delay in getting treatment.

Rectal Rodents
Another particularly dangerous activity arises from a hoax perpetrated by gay men in San Francisco. This purported sexually enhancing activity involves the insertion of a live small rodent (gerbil) into the rectum, often though a plastic tube. The theory behind this holds that as the rodent dies, the death throes of the animal will be erotic to the recipient of the rodent. Unfortunately, rodents tend to chew their way out of danger and can readily chew though the colon. The result can be disastrous. There is no way to “declaw” or make the rodent safe because rodents deprived of their teeth will rapidly die.

Simply stated, gerbilling is a no-no!

Enemas
Enemas may be used to cleanse the rectum prior to anal intercourse or manipulation, and may be a source of erotic stimulation in their own right. The arousal may be shared by those giving the enema and those receiving it. Additionally, intoxicating substances such as cocaine, coffee, alcohol, or hallucinogens may be put into the rectum during enema play. These substances are quickly absorbed and the speed of effects are similar to intravenous drug injection.The most obvious hazard of enemas is laceration or perforation of the anus or rectum by the enema nozzle. This may be caused by using a hard nozzle instead of a soft rubber rectal tube, an injection pressure that is too great, or insertion of the enema nozzle while the partner is sitting. The participant may use too great a volume of enema solution with potential rupture of the colon or water intoxication. Sadomasochists or naive users may inject irritating substances and cause a inflammation of the colon. Repeated enemas may cause the loss of important body chemicals such as potassium and calcium. Further, an overdose of water has even been seen in some people.

Another hazard deals with the temperature of the enema solution. A solution that is too hot (> 105 F) can cause burn injury to the colon or result in overheating of the body. A solution that is too cold runs the risk of hypothermia. If your partner stars shivering during enema play, the solution is too cold and needs to be warmed. Your partner also needs to be warmed!

Possible lacerations and perforations need to be seen and treated by the emergency department physician.