Sexual Health

Is Anal Sex Safe? Here’s What You Need to Know (But May Not Want to Ask)

Q: Can you get pregnant from anal sex?

No, anal sex can’t directly cause pregnancy . There’s no connection between your anus and rectum and your reproductive system. But keep in mind: If a person ejaculates during anal sex, the semen can sometimes leak toward their partner’s vagina. Though it’s rare, this can lead to pregnancy. Using a condom can help contain semen and prevent pregnancy.

Written by Sarah Gupta, MD | Reviewed by Sophie Vergnaud, MD

Updated on June 17, 2026

Drazen_/E+ via Getty Images

Key takeaways:

Anal sex is generally safe, especially when you use condoms and lubricant.
Anal sex can increase your risk for sexually transmitted infections (STIs), especially HIV.
Anal sex may increase the risk of anal leakage in both men and women, especially in certain situations.

Chances are high you’ve heard about — or tried — anal sex. It’s pretty common in the U.S. But whether or not you’ve tried it, you may be wondering if anal sex is safe. After all, even though your butt is a sensitive (and even pleasurable) area, it’s not technically designed for sex.

Anal sex is widely accepted as safe, especially when you use protection. But it can come with some risks too. Here’s what you need to know.

Is it safe to have anal sex?

Anal sex is generally considered safe, especially when you use condoms and lube correctly.

But just like other types of sex, anal sex does come with some risks, including sexually transmitted infections (STIs), anal cancer, and anal fissures. There’s also some evidence that some people who have receptive anal sex (meaning a penis or other object is inserted into their bottom) may be more likely to have problems with anal leakage later on.

Let’s take a closer look at the risks involved in anal sex, as well as what you can do to make anal sex as safe as possible.

Can you get HIV from anal sex?

Yes, the biggest health risk with anal sex is HIV (human immunodeficiency virus). You’re more likely to spread — or get — HIV from receptive anal sex than from any other type of sex (like vaginal or oral). This is because the skin in your anus is somewhat thin, which can make it easier for viruses to enter your body.

Can anal sex cause cancer?

No, anal sex can’t cause cancer on its own. But anal sex can increase your risk for anal cancer if you get human papillomavirus (HPV).

HPV is an STI. Certain types of HPV can cause cancer in your mouth, cervix, vagina, and anus. HPV is the number-one cause of anal cancer.

But keep in mind: In most people, HPV will go away on its own within 2 years without ever causing health problems. And there’s also a vaccine that can protect you against some types of HPV.

Can you get an STI from anal sex?

Yes: Just like any type of sex, anal sex can spread STIs. This can lead to an infection in your butt, genitals, mouth, or your skin.

In fact, anal sex has a higher risk of spreading some STIs than other types of sex. This is because the skin in and around your anus is thin and delicate, so it can more easily get infected.

STIs that can cause an infection in your bottom include:

Herpes
HPV
Gonorrhea
Chlamydia
Syphilis

Can anal sex cause anal leakage?

Anal leakage (incontinence) is when stool, gas, or liquid accidentally comes out of your bottom.

Pregnancy and digestive disorders can cause anal leakage. Receptive anal sex can also increase the risk of anal leakage in both men and women. This risk may be higher if you:

Don’t use enough lube during anal sex
Experience emotional discomfort during anal sex
Have overactive pelvic floor muscles
Engage in high-intensity sexual activities like BDSM or anal fisting
Have anal sex more than once a week
Use drugs during anal sex

Pelvic floor physical therapy can potentially help prevent and treat anal leakage caused by anal sex.

Other potential risks of anal sex

Here are some other possible risks of anal sex:

Irritated hemorrhoids: Hemorrhoids are swollen blood vessels in your anus. Anal sex doesn’t cause new hemorrhoids. But it can make them feel worse if you already have them. This can also make anal sex more painful.
Skin tearing: Anal sex can cause anal fissures. These are tears in the skin in your anus and rectum. They’re often small and heal on their own. But other tears can be deeper or get infected. The best way to prevent them during anal sex is to use lube and to go slow.
Rectal prolapse: This is when part of your intestine turns inside out and slides out through your anus. There isn’t any evidence that anal sex does, or doesn’t, cause rectal prolapse. It’s not clear what causes rectal prolapse. But it’s more common in women, older adults, and people with chronic constipation or diarrhea. If anal sex does cause prolapse, the risk is probably very small.

How to have safer anal sex

As with all types of sex, you can take steps to make anal sex as safe and enjoyable as possible. Educating yourself is one of the best things you can do to prepare.

Here are some other tips that can help you get ready for anal sex:

Have a condom ready. Using a condom or other barrier can protect you and your partner from STIs — including HIV. There’s even a brand of condom that’s now FDA authorized for anal sex.
Use lots of lube. Your anus can’t naturally lubricate itself, so you’ll always need lube to have anal sex. Lube can make penetration easier and more pleasurable. And it reduces the chance of injury.
Use the right type of lube. Choose a plain, water-based or silicone-based lube. Massage oils, or oil-based lubricants, aren’t a good choice because they can damage condoms. And avoid numbing lubricants. They can make it harder for you and your partner to be aware of what feels good — and what hurts.
Communicate with your partner — both before and during sex. Before having sex, talk with your partner about whether they may have an STI, especially HIV. Get tested if needed. And during sex, check in with your partner regularly. If you’re feeling uncomfortable — or experiencing pain — think about taking things a little easier. With anal sex, it’s always a good idea to go slow and pay attention to your body.
Before you have sex, get vaccinated for HPV. The HPV vaccine can protect you from getting HPV-related anal cancer in the future.
Talk to your primary care provider about pre-exposure prophylaxis (PrEP). PrEP is a medication that can help prevent HIV in people who are sexually active.
Practice good hygiene when changing to a new activity. If you’re having anal sex and want to switch to vaginal sex, take a minute to put on a fresh condom. You should also wash whatever body parts or objects you were using — like your penis, hands, or any sex toys.

Are there side effects from anal sex?

Yes, anal sex can cause side effects. If you have receptive anal sex, your bottom may feel a little sore afterward. You may also notice a bit of bright red blood when wiping after using the bathroom. Both of these things are normal and should stop in 1 to 2 days.

Here are some tips to try if you’re sore or have any bleeding:

Take a warm bath with Epsom salts. This is often called a “sitz bath.”
Take some ibuprofen (Advil, Motrin) or naproxen (Aleve) to help with inflammation.
Use over-the-counter (OTC) lidocaine cream to temporarily help with pain or irritation.
Use a stool softener, like Metamucil, to make bowel movements easy and soft.

And most importantly: Give yourself time to heal. It’s a good idea to wait to have anal sex again until your side effects are gone and you’re feeling back to normal.

When to see a doctor after having anal sex

See a healthcare professional if you have bleeding, swelling, or pain that lasts for more than 1 to 2 days. This is especially important if your symptoms are getting worse or if you have a fever.

Ongoing anal pain can be a sign that you have one of the following:

Hemorrhoid with a blood clot
Large or infected anal fissure
Anal abscess
STI
Fungal infection
Anal cancer

And if you’re sexually active, be sure to keep up with your regular STI testing — including rectal testing if you have anal sex.

Frequently asked questions

It’s hard to say if anal sex feels good or not. That’s because sexual pleasure is different from person to person. For some people, anal sex feels good. For other people, it doesn’t. And for some people, anal sex even feels bad or painful.

No, anal sex can’t directly cause pregnancy. There’s no connection between your anus and rectum and your reproductive system.

But keep in mind: If a person ejaculates during anal sex, the semen can sometimes leak toward their partner’s vagina. Though it’s rare, this can lead to pregnancy. Using a condom can help contain semen and prevent pregnancy.

No, you don’t need to douche or use an enema before anal sex. It’s totally normal — and safe — to run into a little poop during anal sex. Just make sure to wash up with soap and water afterward. That said, some people do like to rinse out their rectum before having anal sex, either with an anal douche or enema.

It’s not a good idea to use Vaseline (petroleum jelly) during anal sex. It can damage condoms and cause skin irritation. In general, it’s best to stick with a “personal lubricant” product for sexual activities, especially since these are regulated by the FDA.

The bottom line

Anal sex is generally considered safe. But, like all types of sex, anal sex can put you at risk for sexually transmitted infections (STIs) — especially HIV. It may also increase your risk of having anal leakage.

Taking steps to practice safe anal sex can protect you from STIs and from other health risks that come from being sexually active. This means using condoms and lube every time you have anal sex. Also, consider taking pre-exposure prophylaxis (PrEP), and communicate with your partner. Finally, get tested regularly for STIs.

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Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

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References

American Cancer Society. (2025). Anal cancer causes, risk factors, and prevention.

Anal Cancer Foundation. (n.d.). What is the HPV vaccine?

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

Is Anal Sex Safe? Here’s What You Need to Know (But May Not Want to Ask)

Key takeaways: