A while ago, I answered a question about wearing butt plugs for an extended period of time (read this column here). I received the question below as a follow-up to this column:
While I understand that 10- to 12-hour use of an anal plug is fine, my concern is with 24-hour use, removing only for defecating and hygienic necessities (or the occasional day off). Do the stretching, and more specifically the eventual incontinence issues, hold any true relevance? Additionally, are those concerns still relevant depending on whether the toy extends from the outside through the anus like a plug or is worn inside, for example, "on a string”?
I asked Mark P. Behar, PA-C, a physician assistant at Milwaukee Health Services Inc. and a volunteer at Brady East STD (BESTD) Clinic, to comment on this question.
Behar says, "Unfortunately, I do not have the answer to this question. There are no good research studies that evaluate the short- or long-term effects of using butt plugs.Therefore, I am compelled to extrapolate what we do know, and deduce what we would expect to be true.
"The usual physiologic condition of the internal and external [anal] sphincter [muscles] is to remain tightly closed, except for momentary defecation, anal stimulation during sex or medical examinations, when a cascade of nerve stimulation allows momentary relaxation.
"So what if a person uses a butt plug? Momentary and short-term use probably is not much different than bowel movements, anal sex, or medical procedures. Long-term use, however, probably is.
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"Imagine how your body habituates to the sensation of a mosquito walking on your arm. Initially, the tickle sensation is quite annoying.This probably is also related to your realizing that there is a bloodsucking insect on your body! In other words, there may be a cognitive component that overcomes the reflex scratch or swatting that comes almost automatically. After considerable time, this bug-crawling sensation loses the severity of its annoyance and is easier to tolerate. It may not even be noticed! You are habituating to the bug’s walking on your skin.Imagine also what happens to anyone who does not operate a set of muscles regularly, say, from an injury to an arm or leg. After the acute injury heals, the previously injured muscle will be very weak, and may require some time to get back to normal function.
"Let’s now return to long-term use of the butt plug. The anus is left in a constantly open position, instead of being tightly closed. Does this contribute to a habituation of the nerve-muscle reflex associated with voluntary sphincter control? Will this contribute to irreversible damage or bowel incontinence? Possibly, but we don’t know. But if we know anything about how the body responds to chronic stimulation, then I think I would read between the lines. Anything for short periods of time will probably be fine. But long-term use is probably not a great idea, and may contribute to chronic and irreversible changes in how the nerves and muscles ‘down there’ work effectively."
I would add to Behar's comments that the idea of using an internal plug that is connected only to a string on the outside like a tampon doesn't sound like a great idea to me. This design works in the vagina because the vagina is a closed, relatively short space, and things inserted into it aren't able to go past the cervix, which most women can touch with their fingers. The anus and rectum, on the other hand, have a tendency to pull objects further inside the body through involuntary muscle contractions, and objects are able to travel so far inside the body that a visit to an emergency room is necessary to remove them. With the plug-on-a-string scenario, there's no guarantee that the string itself wouldn't be pulled into the body or that the plug itself wouldn't travel dangerously far up the rectum. I've seen some examples of silicone plugs attached by a slender silicone cord to a cock ring, which would prevent the plug from traveling too far into the body while still not stretching the sphincter as much as a traditional plug might, but this still doesn't address the overall issue of whether long-term wear can cause permanent nerve or muscle changes.
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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.