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The anus is the outlet of the lower portion of the colon (i.e., the rectum). It is located in the fold between the buttocks and is the opening through which fecal matter is eliminated from the body. For many men and women, the anus also is a sexual organ.

Anal sex may involve the following:

• Insertion of the male sex organ (penis), fingers, or sex toys (e.g., vibrator, dildo) into the anus
• Stimulation of the anus using the mouth (called analingus), fingers, or sex toys
• Using an enema (introduction of fluid into the rectum through the anus) to provide sexual stimulation

Maintaining anal health is important for all men and women who practice anal sex, including heterosexual men and women, men who have sex with men (MSM), women who have sex with women (WSW), and bisexuals (people who have sex with both men and women). Anal intercourse is the primary method of sexual intercourse in men who are homosexual (i.e., gay).

Unprotected anal intercourse (i.e., sex without the use of a condom) is considered to be a high-risk sexual behavior. Sexually transmitted diseases (STDs), including HIV/AIDS, can be spread through anal sex. People who participate in any type of anal sexual activity should be sure to practice safer anal sex.

Safer anal sex involves using a latex condom for anal intercourse and a water-based lubricant for sexual activity that involves penetration of the anus. Also, the anus should be gently cleansed prior to anal sex and sexual partners should avoid contact between any object that has had contact with the anal area (e.g., fingers, penis, sex toy) and the mouth or vagina.

Anal sex can result in injury to the anus and surrounding tissue and can cause pain, increase the risk for infection (e.g., sexually transmitted diseases, methicillin-resistant Staphylococcus aureus [MRSA]), and impair function of the rectum and anus.

Anal intercourse can increase the risk for anal fissures (small tears in the skin of the anus) and can worsen hemorrhoids (enlarged veins in the anus). Men and women who practice anal sex also are at increased risk for anal cancer.

The anal area contains a number of nerve endings, and many men and women find stimulation of this area pleasurable. However, not every person enjoys anal sex. As with any aspect of a healthy relationship, open communication and respect regarding anal sex is important between sexual partners.

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