Anal sex typically refers to sex involving anal penetration with a penis or strap-on. During anal sex, the person known as the top penetrates the anus of their partner, known as the bottom. This type of sex is sometimes called anal intercourse. However, anal sex can also refer to any form of sexual activity involving the anus, including analingus, anal fingering, and anal play with toys.
Here we’ll focus on the primary definition of anal sex. Information about the broader usage of anal sex can be found in our article on anal play.
How many people are having anal sex?
Studies show having anal sex is very common, especially among the LGBTQ+ population. Statista reported that from 2021 to 2022, an estimated 42 percent of Americans had tried anal sex. These findings were in line with research from the Centers for Disease Control and Prevention, which found that 36 percent of women and 42 percent of men had tried anal sex.
However, other studies suggest anal sex is far more common. In 2024, the International Union of Sex Workers surveyed 1240 sexually active adults across the United States. It found 65.6 percent of heterosexual people, 85.1 percent of bisexual people, and 88.6 percent of gay and lesbian people had tried anal sex.
Anal surgeon and Future Method CEO Dr. Evan Goldstein ran a slightly smaller study in 2019. Of the 880 American adults he surveyed, 72 percent said they’d had anal sex with 72 percent of male respondents reporting that they'd topped or bottomed during anal sex and 70 percent of female respondents reporting the same.
His team’s research also found more millennials had anal sex than any other age demographic. 73 percent of this group had tried anal sex, compared to 68 percent of both Generations Z and X.
While some people may try anal sex once and never revisit it or only do it occasionally, others make it part of their usual sexual routine. The Future Method study found the average American has anal sex 2.57 times a month. For straight people, this falls to 1.85 times a month. However, bisexual people typically have anal sex 3.05 times a month, while gay and lesbian people usually have anal sex 6.91 times a month.
Why do some people enjoy anal sex?
Anal sex can be very physically and psychologically satisfying for tops and bottoms.
“Fortunately, (almost) everyone has an asshole, which makes anal play universal, regardless of gender or sexuality,” Dr. Goldstein told Kinkly. “For those with prostates, it’s called the male G-spot for a reason – when stimulated properly, orgasms bring full-body euphoria. And due to the close proximity of your anus to the vaginal wall, cervix, and pelvic floor, even if you’re someone who wasn’t born with one, it’s still possible to find immense pleasure and even orgasm through anal penetration. A lot of women get off simply because the opening of the anus and the anal canal are sensitive, erogenous zones in and of themselves. What’s also incredible about anal orgasms is that they often feel like a whole-body climax rather than just being concentrated in the vagina or clitoris.”
Many bottoms also enjoy the feeling of fullness they get through anal penetration. Penetrating the anus squeezes the penis tight, which can be very pleasurable for tops.
While tops that don’t have penises don’t get the same physical stimulation during anal sex, they may find pegging a partner psychologically satisfying. This sex act subverts gender norms, which can be empowering. The top role is typically more dominant in anal sex, so it can appeal to anyone who enjoys taking control during sex. Similarly, some bottoms enjoy feeling vulnerable and submitting to their partner during anal sex.
While some people enjoy the physical sensations of anal sex, others enjoy it simply because their partner does. This is especially common among women, with 28 percent telling the International Union of Sex Workers that pleasing their partner was a key reason for having anal sex.
Anal sex has historically been taboo, which can add to its appeal. It can be thrilling to break social rules and have sex in a way that seems “dirty” or “wrong.”
“There’s a positive spin to the ‘taboo’ anal sex might still carry (primarily among heterosexuals), which is that it can bring you and your partner closer, and it can also help spice things up because it’s another way to be intimate with each other,” Dr. Goldstein added. “That was one of the reasons why I wrote my new book, 'Butt Seriously': to help tackle stigmas and taboos, as well as walking through the proper how-to of beginning (and perfecting) your anal game. Play on!”
Some women and others assigned female at birth may also enjoy anal sex because there’s a very small risk of pregnancy. If a woman knows her partner’s sexual health status, anal sex can be a relatively low-risk activity. This can relieve some pressure and help her focus on her own pleasure.
Does enjoying anal sex make a man gay?
Anal sex can be enjoyed by people of any gender and sexuality.
“I don’t think there’s anything gay about anal sex. We need to remove the ‘gay’ from anal sex and think more of sexual acts that create pleasure and can be enjoyed by anyone,” Dr. Goldstein stressed. “There are so many pleasurable nerve endings in your ass – why would you deprive yourself of some of the best orgasms you could possibly have? Unfortunately, there’s still so much stigma around anal sex and what it says about your sexual identity, and we fight every day to keep breaking down those barriers. The people and clients I know who are open about their sexual needs and desires often have the best sex lives (and this carries over into their overall health and wellness, too). If our sexual needs aren’t being met, this can wreak havoc on our lives. I see it all the time at my practice.”
It’s also worth noting that while many gay men enjoy anal sex, some don’t. Research also shows many people who identify as straight have tried anal sex. The straight men aren’t just topping either. According to Future Method, 10.4 percent of straight Americans have tried pegging. This indicates that many straight men enjoy taking the bottom role.
Positions for anal sex
People can have anal sex in many different positions. Doggy style, where the top positions themselves behind the bottom, who is on all fours, is one of the most common options because it offers such easy access to the bottom’s anus. Rear entry, where the bottom lies face down on their stomach, puts less pressure on the knees. Spooning is another popular relaxed option for beginners.
Reverse missionary, where the top lies down and gets straddled by the bottom, is another excellent option that gives the bottom more control. Couples can also have anal sex in the missionary position if they use a pillow or wedge to elevate the bottom’s bottom.
There are also several more advanced anal sex positions including:
Many of these positions can be adapted for group sex. For example, a third person could join in on doggy style by anally penetrating the person topping the person on all fours. Similarly, a third person could top a person who is topping someone in the missionary position.
Does anal sex hurt?
Anal sex can be uncomfortable for bottoms who aren’t used to this kind of sex, but it shouldn’t be painful, according to Dr. Goldstein.
“It’s a myth that anal sex is inherently painful. There is a lot of misinformation and lack of education on anal play, as well as the general stigma that still gets associated with anal play,” he said. “What I always tell my patients is: if you’re experiencing pain during anal play, then something isn’t right. There is a big difference between pain and discomfort. Anal sex is not something everyone explores, so, when you do something for the first time, it’s highly likely you may not find it enjoyable and it might even feel uncomfortable at first, but these two sensations are not the same as pain.”
Experiencing pain may be a sign that couples should go more slowly and use more lubricant. Penetration is easiest when the bottom is relaxed. Plenty of foreplay and penetration with fingers, small sex toys, or anal dilators can help them feel calmer. If pain persists, specialist healthcare providers may offer some solutions.
“At my private practice, Bespoke Surgical, we have pioneered studies that tell us which type of bottom you are,” Dr Goldstein explained. “Through anal manometry testing, we measure the strength and relaxing capacities of the sphincter muscles. With these results, we can figure out what work, if any, you need to do in order to reach your goals … Anal botox is an incredible substitute and has completely changed the game for those who want better, more pleasurable anal sex and haven’t been able to achieve it previously.”
Anal sex tips
These tips can make anal sex easier and more satisfying:
- Communicate with a partner to gain consent, establish boundaries, and ensure the sex is mutually pleasurable.
- Clean the anus with water and a washcloth, or an enema if concerned about feces.
- Start slow with analingus, anal fingering, or using anal toys or dilators before attempting anal sex with slow, gentle penetration from a penis or strap-on.
- Try beginner-friendly positions before moving on to more advanced options.
- Use plenty of commercial lubricant on the bottom’s anus and the top’s penis or strap-on and reapply it regularly to make penetration easier and reduce the risk of tearing.
Safety and anal sex
While women can’t get pregnant through anal sex, there is a very small chance of pregnancy if semen moves from the anus to the vagina. Although the risk of pregnancy is greatly reduced, the risk of tearing increases the chances of contracting and transmitting sexually transmitted infections. So, condoms are recommended. Tops should change condoms if they move from anal sex to vaginal sex or receiving oral sex or if they switch partners.
Additional measures, such as getting the HPV vaccine and taking pre-exposure prophylaxis (PrEP) to reduce the risk of HIV, can further reduce the risks.
The anus isn’t self-lubricating like the vagina is, so it’s important to use lots of lubricant. A well-lubricated anus is less likely to tear. Silicone-based lubricant is thicker and more effective, but water-based lubes also work. Both types are safe to use with condoms. Tearing isn’t just painful. Tears also provide entryways for bacteria living in and around the anus to enter the body and cause infection.
Cleaning up thoroughly after anal sex can reduce the risk of bacterial infections. It’s important to wash anything that came in contact with the anus, including the penis, hands, and any sex toys used with a mild soap and water.
Many people also clean themselves thoroughly before anal sex. While this habit can reduce the spread of germs, it can also carry some risks.
“Most people douche or clean out prior to anal play, and without the right solutions and methods, it can not only continue to be messy, but actually lead to irritation, bleeding, and just a general shitty feeling (no pun intended),” Dr. Goldstein advised. “The key is daily fiber supplementation and pre+probiotic use, which can lead to better bowel movements and yes, less douching. If you are going to douche, I want people to understand that less is more.”
There’s also a small risk of rough anal penetration perforating the bottom’s colon. Heavy or continuous bleeding from the anus are the most common signs. This is a serious injury that requires urgent medical treatment at the nearest emergency room.
Frequent anal sex may weaken the anal sphincter. Kegel exercises can strengthen the sphincter and offset any damage.
