I've been on a roll for the past few weeks with questions related to anal sex. This situation isn't unique to my column; when I saw Dan Savage speak at Northwestern University a couple of weeks ago, he received so many queries related to butt play that he quipped, "There are a lot of dusty vaginas in this town." Although anal sex is not actually more common than other types of sexual activity [see the fascinating Indiana University national sexual behavior study for statistics on this], I think sex educators tend to get more questions about it because there's less reliable information about anal sex out there.
A case in point: the fact sheet on the use of lubricants during anal sex that was released last week by IRMA (International Rectal Microbicide Advocates). According to this fact sheet, many commonly used water-based lubricants can cause damage to anal tissue when used during sex, which in turn could lead to higher rates of sexually transmitted infections. This damage appears to be related to the fact that some water-based lubricants tend to have a lower concentration of water-soluble ingredients than cells in the anal area; therefore, when lube comes into contact with the cells of the rectum, it sucks water out of these body cells and makes them shrink. When cells are damaged like this, it's more likely that a bacteria or virus can infect the body.
IRMA does not have any specific lubricants that they recommend using or avoiding; instead, they state that more research on the effects of lubricant during anal sex is needed. While one's first reaction to this news might be, "OK, if water-based is bad, I'll use silicone lubricant instead," we don't have any research that shows whether silicone lubes cause the same type of damage or not.
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So what to do? I would NOT recommend discontinuing the use of lubricants during anal sex. Butt play without lube can be downright painful and perhaps even more damaging than butt play with lube. If you notice that your lubricant causes burning or irritation, don't ignore it; try switching to one with fewer chemical ingredients. Since the main issue here is that lubricants may increase the likelihood of sexually transmitted infections, condom use during anal sex becomes even more important. The bottom (tee-hee) line: Keep using lube, and be extra-consistent about condom use.
This reminds me of the flap over the spermicide nonoxynol-9 during the late ’90s and early 2000s. Researchers had initially hoped that N-9 might be as toxic to HIV as it is to sperm and thus could be used as an HIV prevention tool. However, studies showed that N-9 was extremely damaging to cell tissues, and thus could actually increase the rate of HIV infection rather than decrease it. Since then, condoms with N-9 have almost disappeared from the market (although N-9 is still used in contraceptive devices like the Today Sponge and with diaphragms).
We'll never know what unexpected discoveries researchers will make about sexual health. Our job as responsible sexual citizens is to accept that sex comes with some risk, stay informed, and make the best choices we can with the information we have.
Want Laura to answer your questions in SEXpress? Send them to laura@shepex.com. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.
Laura Anne Stuart has a master’s degree in public health and has worked as a sexuality educator for more than a decade. She owns the Tool Shed, an erotic boutique on Milwaukee’s East Side.
