Can anal sex impact my pelvic health?

What you need to know about anal sex and your pelvic health

When people hear about sex, most will automatically think about vaginal sex. However, we need to make sure that individuals and their clinicians or healthcare providers remember that sex is many things to many people.

We need to facilitate open conversations so that any questions, concerns or issues can be shared. Anal sex is rarely discussed routinely and that is worth challenging!

There are often questions around whether anal sex can lead to injury of the structures that support anal continence (called sphincters) and the fact is, that there is very little evidence on this either way.

As of December 2023, the only report that we can use to guide us is a study of 4,000 patients in the UK that found a 5% rate of anal incontinence in men as a baseline figure, increasing to 10% in men who engaged in anal sex. There was a 33% rate of anal incontinence in women, increasing to 45% in women who engaged in anal sex. These numbers suggest that anal sex may be linked to higher rates of anal incontinence but one study does not allow us to take a firm view on this.

It is possible that anal sex has a high risk of trauma to the lining of the anus, and this may lead to a higher risk of transmission of sexually-transmitted infections.

Some of the key factors that are likely to make anal sex less traumatic for the pelvic floor, and therefore less likely to cause continence issues, include:

  • good communication between partners
  • consent
  • using condoms and a water-based lube
  • going slow
  • having a safe word and being ready to stop

If you have any issues with your bowel control, or any aspect of anal health, do see a pelvic health physiotherapist or your doctor. It may feel difficult for you to discuss, but clinicians are used to these situations and will help you to feel more comfortable.

Always see your doctor if you have unexplained bleeding from your bowels or a persistent change in bowel habits.

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