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Should I use an enema?

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Annie asks:

I know vaginal douches should be avoided at all costs, but if I'm considering anal sex, should I invest in an anal douche? I've seen a couple on (trustworthy) sex toy websites under the "sexual health" section, and they seem to be considered a good idea by users. But are they safe to use? And, er...how do you use them?! I'm pretty self-conscious, so I want to be assured everything's clean. And finally, should I invest in a specialised anal lubricant, or stick to my usual? Thanks so much.

Susie replies:

Anal douche is more commonly referred to as an enema. Enemas are solutions that are injected into the lower bowel to induce defecation through one means or another. There are many different kinds of enemas, those including things such as milk and molasses, fleet, cone, etc.

Using an enema before anal sex is more than anything a personal preference. That in mind there are a lot of things that will help you along the way in both deciding and knowing exactly what information is most important pertaining to this.

The anus and rectum aren't the bowel, and the bowel is where feces is stored. These are just the passages where the fecal matter passes. While there can be trace amounts present, which yes may have a scent, that's all that's there. Yes, some of those traces may sometimes show up on a condom/penis/fingers/toys when engaging in anal play, but consider it about the same level of matter/scent that you'd find when you have intercourse at the very end of your menstrual period.

With this understanding you can see that in general anal douching is not all that needed. If you defecate prior to sex, you might have less of a problem provided your stools were firm enough to leave completely.

On this same line, for some people the use of an enema prior to any type of anal sex play makes the experience less enjoyable. Enemas can cause some mild irritation which becomes more severe during penetration (especially considering an enema can remove the natural coatings that protect the lining of the rectum.)

All this in mind, if you’re still planning to use an enema then there’s only two that you should be considering at all. The fleet enemas come already in a bottle and are a saline-type formula with a cap for easy insertion into the rectum. Once placed into your body you simply squeeze all of the liquid out of the bottle.

The better enema to use though is generally what’s called a cone enema. The bag and cone can be purchased at a drug store (or some giant eagles sell them as well.) Feel the water with your elbow like you would check for a kids bath (because your hands are not as sensitive) and fill the bag as directed on the instructions with warm (but not too warm) water. After you’ve added the water let the valve go slowly to allow the water to flow down the tube – this will prevent a lot of air from entering your body which will cause not only gas but can cause cramping. You’ll also want to be sure to use lubricant on the cone before inserting to prevent tearing. Additionally, you’ll probably want to use some disposable gloves as well to avoid the mess.

After inserting the cone you hold the bag at a higher level and allow the water to drain. If you experience cramping or a very uncomfortable fullness without much water, stop the flow with the valve and wait a few minutes for your body to become accustomed to the water before continuing. Once the water is drained or you feel like you’re completely full, stop the water and hold the cone in place for at least a minute to allow the water to settle, and then pull the cone out. Remember that anything you put into your rectum is absorbed into the body quickly so no additives. Additionally, you don’t want to do this right before anal sex, rather a few hours before at least to lessen immediate discomfort.

What it comes down to though, as mentioned above, is that it’s not all that necessary. Especially considering that it’s suggested to always use a condom for anal sex (and always switch that condom if you’re going to change from anal sex to any other type of sex as the bacteria can cause innless and infections easily.), and enemas don’t lessen your chances of infections spreading.

If you choose to engage in anal sex, you might want to start with manual penetration (you partner puts on a latex glove with some lube and inserts fingers), or maybe a toy safe for anal play (butt plugs or something small with a flared base).

As for lube, your regular water-based lube should be fine. However, many people prefer to use a thicker lubricant like KY Jelly. The important thing is it has to be safe for condoms. You absolutely need to use condoms during anal sex because infection risks can run high.

written 19 Sep 2007 . updated 27 Jan 2014

Information on this site is provided for educational purposes. It is not meant to and cannot substitute for advice or care provided by an in-person medical professional. The information contained herein is not meant to be used to diagnose or treat a health problem or disease, or for prescribing any medication. You should always consult your own healthcare provider if you have a health problem or medical condition.