QUESTION
I was wondering what you could tell me about anal sex and tearing that could happen. I have even heard you can die from it.

ANSWER
Severe tearing of the anus is certainly a serious health problem. Tearing can cause an infection or abscess and if untreated may lead to further complications. Death would be very rare and in more than 15 years of clinical practice I have not heard of or read about anyone dying from an anal tear from consensual anal sex. But if both partners are careful, use lots of lube and go slow—with the bottom (receptive partner) in control of how fast penetration happens, there is no reason that any tearing at all should occur. Of course, if one experiences long-lasting pain and/or bleeding, he or she should see a doctor immediately.

To make anal sex as safe and enjoyable as possible, start slowly and use a condom with lots of lube. Again, proceeding gradually will minimize rectal trauma. Inserting one lubricated finger and gradually adding a second finger is a good way to relax the anal sphincter. Anal beads also serve this purpose quite well.

Remember that pain is your body’s warning signal. So relax and enjoy anal sex while remaining conscious of that internal monitor.

See a similar question: http://www.sfcityclinic.org/drk/menshealth23.asp.

To your health,
Dr. K