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The anus and its health

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1-     What is the anus?

The anus consists of two types of muscles. The first, external and controlled at will by the person, hence it helps in the voluntary control of the inner digestive system. The second type is unaffected by the person’s will but by several involuntary factors such as the person’s comfort. This factor affects significantly pain when having sexual intercourse. If the person is uncomfortable while having anal sexual intercourse, his anus will not be relaxed and hence he will be in pain upon penetration.

The membrane of the anus cells is extremely thin and this makes the anus more susceptible to sexual infections that travel faster into the blood.

The anus also contains blood sacs knows as hemorrhoids that naturally exist inside the anus.

There is no natural lubricant in the anus when having sexual intercourse (in contrast to the natural vaginal moisturizer during vaginal sexual intercourse), and thus it is important to water-based lubricants for anal sexual intercourse.

2-     Rectal enemas

Enemas are used to clean the anus from stool before anal sexual intercourse.

Enemas are used for psychological comfort before having anal sexual intercourse to rid the rectum of stool.

Frequent use of enemas can lead the digestive system to become dependent on them to let stool out, hence leading to problems of constipation. They can also cause anal fissures under high water pressure or if not used with care.

Therefore it is important to be careful when using enemas:

  • Do not use it frequently
  • Make sure the water used is neither too hot nor cold
  • Make sure the water pressure is not high
  • Do not share enemas with others to avoid transmission of infections
  • Apply water-based lubricant to the enema probe to avoid discomfort or injury

3-     Anal fissure

Anal fissure is a wound in the anus that leads to pain at two times: directly after letting the stool out and two hours after that. The wound could cause some bleeding after bowel movements. It is important to consult a doctor if one of those symptoms occurs.

Anal sexual intercourse can lead to a fissure in the anus in two cases:

  • If the intercourse is not using a lubricant
  • If the intercourse involves harsh pushing

This is where the importance of using water-based lubricants arises when having anal sexual intercourse.

It is worth pointing out that anal sexual intercourse does not lead to hemorrhoids that involve the sacs of blood surfacing out and swelling. However, it is important to avoid anal sexual intercourse in the presence of hemorrhoids.

4-     Anal infections

  • Infections transmitted through sexual fluids

These infections include hepatitis B, HIV, syphilis and herpes. Condoms can protect against such infections.

  • Infections transmitted through touch

These infections get transmitted even with the use of a condom.

Human pappilomavirus (HPV) is transmitted through touch and is highly contagious. HPV exists frequently and in several kinds, but only one kind leads to warts. A person may be carrying the virus and can transmit it even if he shows no symptoms. The virus starts as one wart and then spreads and multiplies to several warts. It is important to consult a doctor as soon as a wart appears on the genitals, anus or thighs.

Lice on the genitals can also be transmitted through intercourse even if the colony is from one hair to another.

  • Other infections

There are naturally occurring bacteria inside the anus that can lead to urinary infections if they can reach the urinary tract of the person penetrating. A condom will minimize this risk.

Oral-anal intercourse or rimming should be performed with the awareness that it can lead to some infections such as hepatitis A or parasitic infestation.

Graciously translated by LebMASH volunteer translator: Patrick

Dr. Omar Harfouch - Anal Health session LebMASH



  1. […] Lebanese Medical Association for Sexual Health gave a presentation on Friday the 2nd of December 2013 about anal health to the Whispers project that attends to the […]

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