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ASK THE SEXDOC Questions about Anal Sex #2

ESSENTIAL SAFETY INFORMATION ABOUT ASS PLAY: Because of the anatomy of the anal sphincter (circular muscle), objects that get narrower as they go in can be rapidly taken into the rectum. Make sure that you have an ironclad grip on the object or that it gets wider further down so it won't slip in all by itself.

11/25/98 Q: Hello (again) Dr. Fitz, This question relates to an earlier question that you answered for me. Thank you for your advice and your web site. Because of it, I have been able to openly discuss my "issue" with my wife, albeit as embarrassing as it was for my first few attempts to do so. Our inhibitedness in discussing sexual topics now is almost null and void thanks to the encouragement I received from your advice. I need to preface my question first by describing the current state of my situation. I enjoy being stimulated with anal penetration by use of a dildo tremendously. So much so, that I can have multiple "orgasms" by being stimulated in this manner. The reward for this to me is so pleasant that I engage in this activity during and for masturbation at least twice if not 3 times per week. I don't necessarily ejaculate in the normal sense when anal stimulated orgasms occur, although a few drips of semen leaks out or is massaged out via the repeated penetrations of the dildo during some of these orgasms. I have yet to have successfully orgasmed and ejaculated by this means solely, although I manually stimulate my penis in the usual way often to achieve the full ejaculating orgasm normally associated with "completing" masturbation. I am not gay and typically enjoy viewing heterosexual pornography during these sessions. (Often times I'll suck on another dildo getting my lips and tongue involved in sexually oriented sensations to heighten my arousal as well.) I have recently been able to gain some acceptance from my wife to participate in my desire for anal stimulation during a few of our sexual encounters. She is still uncomfortable in handling and using a dildo on me, but is willing to insert a finger or two during oral sex or during our sexual encounters in the bathtub. I am going to let time ease her inhibitedness with this as I realize that rushing her into this is not going to make it any easier for her to grow comfortable with it. Anyway, after all of that, here is my question. Because I enjoy being stimulated with anal penetration and as frequently as I do, my body (or more specifically my lower digestive tract or lower intestine) has gotten very used to having bowel movements "encouraged" via dildo penetrations. Therefor, previous to my engaging in this activity, I have to, in the interest of convenience and cleanliness, flush my lower intestinal system of all fecal matter. To do this I usually connect a hose to the bathroom sink and use this to give myself enemas into the toilet until I am completely 'clean'. (flush, rinse, expel, repeat, etc.) What I would like to know is if I am causing some health risk to myself by doing so, especially as frequently as I have grown accustomed to. Am I negatively affecting my nutritional requirements, or at other health risks, etc? (This is a concern that my wife also expressed when I discussed this with her.) The only side effects that I have noticed is that it takes me about 3 or 4 days until my BM cycle becomes regular again, as I assume is normal to expect after emptying ones bowels of the matter for the next few potential movements. (This does not bother me physically nor is it uncomfortable.) Any feedback you have about this will be greatly appreciated. Thanks again for creating this open and encouraging environment for our sexuality knowledge transfer! B

A: Dear B,

Please keep in mind that I am a psychotherapist, not a medical doctor. These comments have been gleaned from years of dealing with patients who engage in a wide variety of sexual behaviors and who report what their medical doctors say, as well as tons of reading in the scientific (as well as anecdotal) literature.

Please also see the question about wearing a butt plug for an extended period of time on this anal 2 page.

I will comment on your questions, then volunteer what I think is a a win-win suggestion.

Having enemas too often weakens (makes them lazy through lack of use) the pelvic muscles that push fecal matter out of the rectum, thus creating a cycle of dependence on enemas (not good).

Using a tube connected to the bathroom faucet is also potentially a problem: there is too much pressure.

As I have commented elsewhere, the anus is full of nerve endings and many people find that anal stimulation is unique and immensely enjoyable. And, also as I have commented elsewhere, prostate stimulation can be exquisite for some.

Usually, and I must emphasize "usually", all that needs to be cleansed is the rectum. To go 3-4 days without a bowel movement after an enema, I infer that you are, in actuality, giving yourself a colonic, rinsing up through the rectum to the sigmoid, the descending, transverse, and ascending colons as well!

I am ignorant of the health risks or nutritional effects associated with flushing the contents of the large intestine -- any medically informed readers are invited to e-mail to me what the effect is -- but I have read in numerous places that you can suck electrolytes into your rinse water if the rinse is less saline than your cell fluids. And, you can dehydrate yourself if your colonic rinse is more saline than your body.

May I suggest: First, a high fiber diet. Tons of fruits and vegetables. Added fiber -- metamucil is gross, I have been told, but Rexall Showcase International (the multi-level marketing arm of Rexall) makes an excellent product. If you want to buy the Rexall product (Bios Life 2) wholesale, let me know and I will put you in touch with someone who can enroll you.

Second, that you time your anal stimulation activities for right after a bowel movement. If you get enough fiber, you will be able to have a regular pelvic muscle bowel movement daily. So, have the bowel movement, use an enema bag 3-4 feet above your waist, take about a pint to a quart into your rectum, stop the influx of water, evacuate, repeat 1-3 more times (until you expel clear water) taking no more than a pint to a quart, then wash and dry your butt, and assume the position for anal play. Do put several folds of towel under your mid-section because you might have a little more wetness, but it shouldn't be much.

A few details. If you anally pleasure yourself 2-3 times a week, and you flush as you do now, and you say it takes 3-4 days before you are in a position to have a bowel movement, I conclude that you are always flushing before anything solid can get to your rectum. Hence, the weakening of the pelvic muscles from non-use.

The semen "leaking" out during prostate stimulation is actually caused by internal pressure on the seminal vesicles, the cigar-shaped tubes that hold the liquid from the prostate when it mixes with the sperm from the testicles. During a usual ejaculation, it is the pelvic muscles involuntarily contracting that squeeze the seminal vesicles causing them to suddenly squirt semen into the urethra and out of the penis.

I am surprised that your wife is OK with inserting one or two fingers, and not OK with a dildo! More than one woman has commented that she'll use a dildo because she doesn't want to get shit under her fingernails (or that her fingernails are too long or too sharp)! Some (both inserter and insertee) are more comfortable if the inserter is wearing a latex examining glove -- much less expensive from a medical supply house than from your local drug store, by the way.

Contrary to prevailing heterosexual knowledge (ignorance), in dominant-submissive gay relationships, it is more often the dominant partner who makes the submissive partner penetrate him, so he (the dom) gets the prostate stimulation.

I suggest that you and your wife focus on what is pleasurable to each of you. From time to time, not necessarily every love-making session, take turns. For 15(?) minutes you tell her exactly what to do to provide you with maximum pleasure, then for the same amount of time make it clear that you won't touch her unless she gives you specific, articulate, precise, behavioral instructions. There is no more anything homosexual about her penetrating you with a dildo, than there is if you lick and finger her clitoris (which many lesbians enjoy doing to each other). It is the gender of the parties, not the activity, that makes sex homosexual!

And finally, more than one heterosexual couple has concluded with enthusiasm that it is an immense turn on for both when she straps on a dildo, lubes it and his ass up, and fucks him with wild abandon. The pressure needed to push into him results in an equal and opposite pressure back on her labia and clitoris from the base of the dildo. Because she wants -- responds to -- rhythmic pulsing on her clitoris, she becomes more than self-motivated to change the direction of the thrusting rapidly. ONE NOTE: The cheap dildo harnesses are a waste of money! Elastic straps are OK for boxer shorts, but they are not robust enough for the pressure of simulated penile thrusting (especially given the greater resistance of the anus relative to the vagina). I suggest leather straps with "O" rings for continuous adjustment (as opposed to holes in a buckle, like a belt -- one setting can be too loose while the next is too tight). Many leather fetish stores are staffed with unembarrassed employees who use the products they sell, so they can advise you of the pros and cons of different products. Make Sure that the harness you select is compatible with the dildo (flared base to fit into the harness). And before you leave the store, make sure that you know how to install the dildo into the harness. Some are "counter-intuitive" to put it mildly!

So, B, a milestone will be for your wife to strap on a harness and service your backdoor. Please let me know your comments on this and let me know what happens.

And remember: never insert anything into the vagina that has been in any rectum without thorough washing with a bactericidal soap!

Q: Can someone have an orgasm by anal masturbating? If so, how can one achieve this?

A:  The answer is gender-related. I have known women who can have an orgasm from mental concentration alone, from squeezing their thighs together (very common), from bicycle, horseback and motorcycle riding (in the last case, especially if there is a golf ball sewn into the seat), from nipple stimulation alone, and from anal stimulation ranging from gentle pulsing externally to anal intercourse (with penis or dildo). Clitoral and G-spot stimulation is taken for granted (although there are women who cannot achieve orgasm from any of these methods without intervention).

I have never known a man to achieve an orgasm from mental concentration alone (nocturnal emissions don't count), but orgasm can be achieved by prostate stimulation. The easiest way to the prostate is via the rectum, which means going through the anus (see the second question below). I suspect that you can condition the body to associate anal stimulation with prostate stimulation but I speculate that you'd need a lot of stimulation on the anus to do that. Do any male readers achieve orgasm from anal stimulation alone? -- just the anus, not also the prostate? Please let me know.

Q: What is the largest safe dilation of the average anus without causing permanent stretching? I have seen 4" diameter objects as well as plenty of examples of a gaping hole where the sunburst ought to be. Also, what is the greatest depth?

A: I doubt that there is any literal answer I could give that would be of much operational value. How large do you want to go? What you see in still pictures are people who will stretch their anus to accept unusually large objects, in return for money or alleged fame. Still pictures of gaping holes are shot IMMEDIATELY after a large object was removed. Watch an anal sex porno flick and switch to extreme slo mo (slow motion) to see the milli-seconds after the object comes out of the anus. It takes about one second for the anal sphincters to close, but if that moment gets caught on film, the still photo shows a gaping hole with the implication that that is the way it stays. The greatest depth (see also comments elsewhere on my "anal sex" pages) is also a function of individual differences, and the answer is "until discomfort (of the recipient) or resistance (when inserting the object) is felt.

Q:  What is the best way to stimulate a man anally? How do you stimulate the prostate?

A: It is very individualistic. The basic answer is to experiment and evaluate. What one man likes will be different from what another enjoys. The goal is neurological stimulation. Try outside touch, insertion of objects with different textures, and objects of different diameters. Some men enjoy outside touch only and cannot stand any dilation or insertion. Some men prefer a completely smooth dildo; others like the feel of "ribs" or simulated "veins". Some like only a minor dilation (1/2"), others get off on the sensation of significant stretching. In case you didn't know (and I know that some who read this are going to regret it), there is a practice called "wristing" or "fisting" in which a hand is inserted into the rectum, up to the wrist. Different strokes for different folks ....

The prostate is located approximately behind the pubic bone. If your fingernails are short and your fingers are long, with your male lover on his back, insert your well lubricated middle finger and pushing gently up, make a "come here" finger movement. A latex examining glove works well for smoothness of insertion and for the squeemish. If you fail the finger/nail test, purchase a smooth small vibrating dildo, and put the tip where the tip of your finger would be. Your lover should be able to give you feedback as to where and what kind of motion feels best. Also experiment with timing Some men report that when their partner is stroking their penis (with hand, mouth, or vagina), if the dildo is inserted after they are quite aroused, that it feels best and results in an explosive orgasm.

Q:  Is it safe to wear an anal plug for an extended period of time? Which is best for prolonged stimulation? Is it safe to wear one to work for 3-4 hours at a time?

A:  Most of the literature refers to this as a "butt plug". If you've never seen one, search the web or order the Adam & Eve catalog (link from my home page). Comfort is affected by both internal pressure and by tissue contact where the flange -- the flared part that keeps the plug from slipping completely inside the rectum -- touches the anus. If you use a water-based lubricant, it will either be absorbed through the skin or evaporate, in both cases becoming dry. Then you can irritate exterior anal tissue and the inside of the buttocks. Anybody out there go to Summer Camp and get butt rash? If you use a petroleum-based lubricant you will deteriorate the latex of the plug. Some of my patients swear by Albolene, which is a make-up remover. Buy the smallest quantity you can (major chain drug stores, etc.) in the unscented version. It's a white cream that liquifies at room temperature and it spreads like wildfire. The universal first use mistake is to use too much. Albolene is made of Mineral Oil, petrolatum, paraffin, and other stuff. It won't evaporate, and it's a great skin cleansing and makeup remover.

What is best for prolonged stimulation is a matter of individual preference. Some butt plugs vibrate; others can be inflated internally. CAUTION: The butt plug is a popular item because it is stimulating. In addition to stimulating sexually, it is also stimulating to the gastro-intestinal tract, and may promote peristalsis -- the ripple contractions of gut muscles that move the food product from the throat to the rectum and out the anus. So after some time (varies dramatically from person to person) there might be the need for a significant bowel movement. If you're at work for 3-4 hours wearing a butt plug, and you don't have a private bathroom, it could really stink up the place removing the plug and evacuating your rectum. Plus, how do you explain the wash-up at the sink to the person standing next to you? (Oh, ... just doing the dishes ...) Or you just wrap up the plug in tissue and carry it around with you for the rest of the day? (Smelly). Experiment at home or in some privacy before trying this in public.

Q: Isn't "Erotic Enema" an oxymoron? How can anyone derive pleasure from giving or receiving an enema?

A:  People get eroticized in many different ways. And while there is some one to one correlation between childhood experiences and adult turn-ons, it is often obscure and may not appear related. For example, only some people whose caretaker wore a rubber apron while they were being bathed as a child find the smell of hot rubber now erotically energizing. The anus is densely packed with nerve endings, which can transmit signals. If you were immensely praised for bowel control, you might associate the pleasure of strong parental praise with the pleasure of "holding it and letting it out when you want".

There are, for some people, simply feelings of cleanliness. If what comes out is dirty, smelly, and disgusting, what better way to rid yourself of the dirt you contain than flushing it all out?

There are overtones of B&D (bondage and discipline) and S&M (Sadism and Masochism) in enemas for some people.

And some people do not consider it a stretch of the imagination (although some readers of this certainly will) that there is some symbolic implication for both genders in childbirth. Inserting the nozzle is symbolic penetration and intercourse; the inflow is symbolic ejaculation; the swelling of the abdomen with the enema solution is symbolic pregnancy; and the expulsion is symbolic delivery. Some readers right now will be saying -- Gheeeez, sexdoc, give me a break! Folks, I don't make this up -- I just report it.

There is also for some a sense of pressure internally on the prostate for men and the G-spot for women -- which is reported as quite pleasurable.

All of my words on this topic are incomplete. For those who really want to know more, click on the banner below ( Beth Tyler has assembled the most complete Web site on this topic that I know of. CAUTION:  If you are queasy about this, DON'T GO THERE. And if you do go, please come back to ASK THE SEXDOC.

Beth's Banner GIF

Starting around May 1, 1998 the Sexdoc began to answer questions about aspects of erotic enemas for Beth's members ("enemates"). You are welcome to peruse the Q/As there by linking here Beth's Q/As but you won't be able to get into the "Inner Sanctum" of Beth's site without becoming one of her members. Click on the above banner to check that out.

Q:  What is the maximum length a dildo can be safely inserted into the anus?

A:  For much more of an answer than this question asks, but indeed for a wealth of information about the large intestine in humans, including how one gets a "high colonic" enema tube way, way, way, up into the human body, I suggest that seriously inquiring minds see the klismaphilic (enema lovers) e-sig (that's an Electronic - Special Interest Group if you didn't know):

But I digress. First I want to clear up some common wording contradictions. The opening into the vagina is called the introitus (where the inner-most part of the labia meets the outer-most part of the vagina). The opening into the rectum is called the anus. I find it curious that we refer to vaginal sex (referring to the internal organ) but not "rectal" sex. Similarly, the term "anal intercourse" (referencing the opening, not the internal organ) is universal but I'll bet only 1 in 1,000 would know what I was talking about if I referred to "introital sex". Curious, huh.

The inquirer who submitted the above question goes on to ask: "Can you provide any information on how deeply an 18" long but slim (1 1/2" diameter) and very soft and flexible dildo could be inserted slowly and safely into the anus?

Please note that the one and one half inches is DIAMETER. THE SEXDOC DOES NOT CONSIDER 1 1/2 INCHES IN DIAMETER TO BE SLIM. There is such confusion over the length of the average erect penis (5"), that I want to go on record immediately letting all you out there who want to "measure up to be average" that 1/2" in diameter is slim. 3/4" begins to be somewhat uncomfortable at first insertion, thus needs anal dilation first. One inch is about the upper limit most folks feel comfortable is still erotic -- a noticeable sense of being stretched but not painful when you are accustomed to it. Above one inch and we're getting into SM and theatrics (porn movie) territory. For what I infer is raw sensationalism you can find "anal sex" web sites showing very large objects in the anus, but I have never had a non-SM patient report that inserting anything larger than one inch in diameter was routine ass play.

3/25/99 A reader who wishes to challenge this writes:

I take issue with your answer of:
"Above one inch and we're getting into SM and theatrics
(porn movie) territory. For what I infer is raw sensationalism you can
find "anal sex" web sites showing very large objects in the anus, but I
have never had a non-SM patient report that inserting anything larger
than one inch in diameter was routine ass play. "

Having played around in this area for the last four years - not
obsessively or self injuriously - I would agree that 1.5" diameter is
not slim but it certainly isn't as huge as you make it out to be.  In
fact, I can insert that size with relative ease and little discomfort.
It's when I go to 1.75" that it takes a bit of time (30 sec.) and a
small bit of initial discomfort.  I do question whether such a slow
progression of increasing sizes makes one gradually adapt to the point
where the original pleasant sensation of slight stretching is lost and
one needs to go to something bigger.  In any case, your 1" max size for
non S/M et al is plainly wrong.  Look at the anal sex toys ie dildos,
vibrators and butt plugs; they will generally be at a 1.5" diameter.

The Sexdoc responds:
Just because YOU can easily accept up to 1 1/2 inches in diameter doesn't mean that the vast majority of the population can (without discomfort).

Yes, there are PLENTY of sex toys that are bigger, but they are sold to a minority of players -- those who wish to threaten that diameter without going through with it, and those, like you, who derive pleasure from the larger diameters.

There is room for diversity here, and I have talked with many dozens of people, men and women, who engage in a variety of ass play.  The majority find up to about an inch OK, and more than that uncomfortable.

Can you accept that maybe you don't have a broad enough sample of players to draw on?

If you recall the answers page and/or date on which I answered that question I'd appreciate it if you'd let me know so I can post your e-mail and my reply to that Q/A.

Your reaction?


He replies:
What's the URL of your sex advice site.  Believe I stumbled on it when doing
a search on "Albolene" and forgot to bookmark it.   Going now to the Good
Vibrations anal sex toys site, I am reminded that, in fact, there are a
number of items with less than a 1.5" diameter.  Most everything below 1" is
characterized as "slim".
You have piqued my interest in this "normal" diameter issue.  I may have to
look around the web for some place to do a survey to see if you are right.

Found it.  The address is:
There are no dates and the response in question is at the bottom of the
You are NOT authorized to use my name. Initials are okay but neither my
first nor last name.

The Sexdoc again responds:
Thanks for the page reference.  The first names you see on my web page are all fabrications.  Often, a writer will volunteer that he or she wants me to use initials or a "pet name" so they can tell the friends they want that they were the author.


I will be curious, open, and receptive to what you find out about diameters.  Please let me know.

End of 3/25/99 insertion (text, not ...)

There are two major considerations here: If you stretch the anus too far, you can cause encopresis, which means involuntary bowel movements. And, if you shove something too far into the bowel and it doesn't curve and turn passing through the connections between segments of the colon (sigmoid, descending, transverse, ascending), you can puncture a hole in the lining causing fecal matter to escape into other body cavities not designed to handle that material. That is life threatening.

So the literal answer to how deeply a soft and flexible dildo can be inserted is: until the recipient reports discomfort (which will feel weird because there are no "pain nerves" in the bowel tissue itself) or the inserter feels more resistance than the resistance felt during the first several inches. It would be immensely informative for you to do it to yourself several times so you will know as both inserter and recipient, what it feels like.

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