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Psychosexual: Tips for managing pain in anal sex

15.06.23 5 minute read

I want to have more anal sex, but I keep feeling pain. What can I do to help?

Step 1 – What types of sex are best for your arousal?

People sometimes believe that they should be able to have anal sex, and particularly penetration, regardless of the circumstances. This just isn’t true. The circumstances in which we’re having sex, like who it’s with, what types of sex and what’s going on around us are crucial to reflect on to make sure it’s a situation that actually turns us on rather than off. Read more here about understanding and connecting to your Conditions for Good Sex.

Step 2 – Giving your body a different experience of penetration

Kegel Exercises 

These exercises are designed to strengthen the pelvic floor muscles that run from the front of the pelvis to the base of the spine, underneath the pelvic bone. Contractions of these muscles help to produce pleasurable sensations during anal sex, but can also be involved in spasms and tightening which can make penetration painful or for some, impossible.

Like any other muscle in the body, the pelvic muscles can be trained to become stronger and more flexible. If you do not regularly use or stretch muscles they tend to become tight and less supple overall. Lack of exercise, pregnancy, being overweight and the menopause can all contribute to a weakening of the pelvic muscles. By practicing these exercises, we can learn to notice whether these muscles are relaxed or tense, and to have a greater sense of control over relaxing them when sex begins.

Getting Started

To find your pelvic muscles, contract your anus, as though you are trying to stop the flow of urine when you are peeing  or hold back a bowel movement . Initially, you might find yourself contracting your stomach or thigh muscles too, but with practice you will be able to isolate only the pelvic muscles.

Once you have found them, squeeze and then release the muscles to get used to the sensations of tensing and then relaxing.

Regular Practice

At first, begin by squeezing and releasing the muscles fifteen times. This should be done at least twice a day, and you can do this without anyone noticing (e.g. whilst sitting at work, watching TV or driving)

Once you feel comfortable gradually increase the number of contractions until you can comfortably do about 50 in one go.

At this point, instead of releasing the muscles immediately (short Kegels), hold the contractions for 3-5 seconds (long Kegels). You can then practice both long and short Kegels a couple of times a day, alternating between both.

For most people, it will take at least a month (sometimes longer) to notice any changes to the pelvic muscles, but with practice you will start to see differences. You will start to notice that you have greater strength when contracting the muscles, and have more control over relaxing them (with a greater awareness of the differences between these states).

Practicing Penetration

This strategy is designed as a way of introducing penetration (if you choose to) in a slow and gradual way, at your own pace.

Using fingers or a small sex toy, the idea is to teach the muscles of the anus to relax and to  slowly get used to having something inside. Sex toys or dildos can be used for both vaginal and anal sex. They can be bought online from a range of retailers and come in different shapes and sizes. It is advisable to start with something small, gradually increase the size if you want to as you gain confidence.

Alternatively you can use your fingers, starting with the smallest (or even just the tip of a finger) and building up to two or even three fingers. This is about the same size as a penis.

Whatever you use, the aim is start with the smallest form of penetration and to gradually increase the size. If you would like to have sex with penetration by a penis, then you can slowly continue until you can comfortably and easily insert something that would be close to the size of a penis.

Preparation, Preparation, Preparation

We cannot stress too highly the importance of preparation before attempting any form of  penetration. If you start before your body is ready and you feel comfortable it may cause pain, be an unpleasant experience and make it less likely that you will want to continue to practice in the future.

You should take time to

  • Feel relaxed. Perhaps take a bath, listen to some music or read a book. Basically, anything that will increase your chances of feeling calm and comfortable.
  • Start with other forms of arousing touch. Spend time getting your body in the mood for sex. This might be by touching other parts of your body, stimulating your genitals or  thinking about a sexual fantasy or experience.
  • Find a position that is comfortable for you. Many people prefer to be lying on their backs, but take time to find a position that works for you.
  • Maximise lubrication. It is important to remember that the anus does not produce its own lubrication. It is vital to use plenty of lubrication every time you attempt penetration, in  order to maximise comfort and enjoyment. You can never use too much lubrication!

Step by Step

Starting with a small sex toy or finger (you could even use just the tip of a finger to start with), try gently inserting it inside as far as you feel comfortable. It may take several attempts before you are able to insert it in all of the way.

If it feels uncomfortable, painful or just does not seem to be able to go in, this is a sign that the muscles in your anus have tightened. They have learnt to do this to protect you from pain so you need to do something to relax them. Perhaps try some less intrusive stimulation to regain a sense of arousal, change position or use the techniques you have learnt in the Kegel exercises to relax the muscles again.

Do not move on to a larger sex toy or finger(s) until you feel completely comfortable with the smaller size first. Once you can easily insert this, try to gradually increase the amount of time you keep the small sex toy or finger inside yourself. The idea is to keep this inside until feelings of anxiety have subsided (which can take several minutes). This way you can start to break the association of penetration and anxiety/ pain, and instead build a new association between penetration and feeling comfortable and aroused.

Building Up

For some people, being penetrated by a small sex toy or finger is enough and they have no desire to move onto anything larger. For others, increasing the size of the sex toy or number of fingers will be both pleasurable and bring them closer to replicating sex with a partner (i.e. bring the size closer to a penis or larger sex toy). When you can insert the smallest sex toy or finger with little or no discomfort, you can move onto the next size up (by using a larger sex toy or by increasing the number of fingers). At each stage, take time to feel comfortable and relaxed, and to extend the amount of time you can manage to keep it inside the anus.

Only move on to the next size when you are happy that you can use the current size easily and comfortably.

Regular Practice

Try to practice every day. To begin with sessions should last about 10 minutes each time, with this time increasing as you feel more comfortable. It can take many sessions to build up to the largest dilator or 2 or 3 fingers so don’t worry if it feels like it is taking some time. Most important is that you move at your own pace and that you practice regularly no matter how quickly you progress through the stages.

Involving a partner

When you have worked through the stages outlined above, and you feel ready, you may wish to try penetration with a partner.

It is important for your partner to know when you are sufficiently turned on so that you can be sure that the internal changes that make sex feel comfortable have taken place. They should take the lead from you about when to start penetration and by what (penis/ finger/ sex toy etc.) They should go slowly and stop, slow down or withdraw if you ask them to.

It is recommended that at first, you allow your partner to penetrate you slowly and gently. Once they are inside, take time to stay in this position and get used to the sensations. As with the exercises above, it is important for them to stay inside for long enough for you to feel relaxed, and to get feel comfortable the feelings of penetration.

When you feel that you are relaxed and that having your partner penetrate you feels comfortable, you can incorporate movement (if you want to). It doesn’t matter which of you is moving or the positions you chose to explore, the point is to stay relaxed and to focus on the sensations that are increasing your arousal. It is important to communicate with your partner about what is working. It is also important that whoever is being penetrated is in charge of how much movement, when to stop and when to resume.

Getting additional support

If after a period of practising the techniques outlined above, you feel there is no improvement in your difficulties with anal sex, you might want to speak to you GP. You can explore getting a referral to a psychosexual therapist in your local area, or you can contact us for advice on how to get support from here.