anonymous on August 29, 2011

Are there any negative side effects of anal sex in men?

I'm a homosexual man and I've been in a very successful relationship for two years. I sometimes ejaculate inside my partner during anal sex. I would like to know if that’s okay, or if there are any negative side effects? We’re in great health and live a healthy lifestyle.

answered by Annette Fuglsang Owens, MD, PhD on August 29, 2011

What a great question. It is obvious that you care both about your own health, and that of your partner.

Yes, there is some risk involved in anal sex. For example, as with any sexual activity, if you or your partner has a sexually transmitted disease (STD), it’s possible to transmit the infection through anal sex.

Also, anal sex can result in tearing the skin or other damage to the anus or rectum if not enough lubricant is used…and open skin increases the risk of spreading STDs and bacterial infections. Remember, the rectum and anus do not produce any natural lubrication during arousal.

The lining of the anus and rectum is quite delicate and rich in blood vessels, so it’s easy to scratch or even tear. Therefore, it’s recommended to never insert anything into the anus that doesn't have a smooth surface. And make sure not to insert anything that might slip away from you, since it may become very difficult to retrieve again…a potentially dangerous situation that has brought people to the emergency room.

Hemorrhoids can be irritated by anal sex, too…so if your partner has hemorrhoids, that could be a concern as well.

The good news is that semen ejaculated into the anus is harmless, and easily absorbed into the receiver’s body. After all, male ejaculate simply consists of water, semen, fructose (a form of sugar), and secretions from the glands, prostate and testicles. So if you’re in a mutually monogamous relationship in which you’ve both been tested and cleared of any STDs or other infections, it’s fine to perform anal sex without a condom and to ejaculate inside your partner during anal sex. You can learn more about STD risks, testing and prevention in our Expert Guide to STD Basics.

Finally, to be on the safe side, I would encourage you and your partner to see your doctor for an anal Pap smear. This test screens for any unusual cells that could become cancerous. Keep in mind that, if you or your partner have the human papillomavirus (HPV), it can be spread through anal sex…and there are specific types of HPV that can cause cancer.

Thanks so much for your thoughtful question, and I wish you and your partner continued health and fulfillment together.

Related info:

Annette Fuglsang Owens, MD, PhD

Dr. Owens is an AASECT-certified sexuality counselor. Her areas of expertise include the medical aspects of human sexuality and sexual problems, as well as the impact of STDs ⎼ and other diseases, illnesses and disabilities ⎼ on sexuality. Dr. Owens was educated at the University of Copenhagen in Denmark.

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