The Ins and Outs of Gay Sex (4 page)

Figure 1.
2:
Anal Sex

If insertion causes you pain, then his penis must be withdrawn and your muscle allowed to rest before any further attempts are made.
Often intense pain means your muscle has gone into spasm (abnormally tight contraction), and it may be anywhere from hours to days before it relaxes again.
Persistent insertion through a closed muscle can tear your anal canal (cause a fissure) or rupture your sphincter.
(See
Chapter 2
.
) Blood may or may not be present, and you might require medical attention.
For anoreceptive intercourse to be safe, it must be pain free.

Since most of us are size queens, patients often ask what they should do to accommodate an unusually large penis.
Well, occasionally you can’t.
And again I advise common sense:
If it hurts, don’t do it.
But try we must, so here are some easy rules to follow.
First and foremost, your partner’s length is not usually the problem, but his girth may be.
Your rectum is long enough to accommodate just about any penis, but it may not be able to stretch comfortably to accommodate his width.
Once his penis gets past your sphincter muscles (about three inches into your rectum), you’re usually home free.
Even if he gets thicker at the base, your buttocks keep you from descending all the way down on him.
Again, I don’t advise multiple-finger insertion as a means to “predilate” your sphincter because you can end up with a nasty tear.
Rectal dilators, sold in surgical supply stores, typically come in a set of four graduated sizes (diameter, not length).
They are blunt tipped for easy insertion.
Lie on your side and start with the smallest one (usually smaller than your finger).
Lubricate it well with a water-soluble solution and insert it by applying gentle, constant pressure against your opening until you feel your sphincter relax.
Then push it the rest of the way in.
Leave it in for about five minutes and then, if you’re up to it, progress to the next-larger size until you’ve used all four.
This provides you with a stepwise sphincter dilation so that, it’s hoped, you can accommodate your partner.
Incorporate these dilators into foreplay, working up to the largest size before your partner attempts penetration.
If you use them hours before a date, your sphincter may regain its strength before you climb into bed.
Don’t worry about needing the
dilators forever.
Once you can take your partner, you probably won’t need the dilators any longer—or at least not until your next boyfriend.
Inserting dilators can be a real turn-on for a partner.
If he wants to help, that’s fine, as long as he lets you guide him.
You don’t want him ramming the dilator in before you’re ready.

If you feel very tight—perhaps you never had anal sex before, had recent anal surgery, or are frightened from previous bad experiences—you will need to take more time.
Dilators are also very helpful for men in this situation, but instead of rapidly moving up from smallest to largest size, use one dilator (start with the smallest) for ten minutes three times a day.
And no, you don’t have to do it on your lunch break.
Try it once in the morning before work, after work, and before bed.
Each week progress to the next-larger size.
It will take a month, but in the end you’ll be rewarded.

Expect more difficulty and discomfort if you have a very tight sphincter.
If it hurts when you first get the dilator in, don’t pull it out.
That will only further aggravate your muscle spasm.
Wait ten minutes.
By then your sphincter will have relaxed and pulling it out should be easy.
If you do have pain, ask your doctor for a mild topical anesthetic to coat the dilator.
Once it’s in, the medicine will numb your sphincter.
Don’t use an anesthetic for anal sex, because it decreases sensations and you won’t experience as much pleasure from anoreceptive intercourse as you otherwise would have.

What do you do if the dilators are still not big enough?
Thank the Lord for your good fortune, and then ask for the next-larger set.
Dilators come in many graduated sizes, and you should be able to find some that will approximate your partner.

I am often asked if a dildo is just as good.
Many men find them more arousing and prefer the soft feel of latex to the
hard plastic of most dilators.
The answer is an equivocal maybe, and again, common sense applies.
If you have a scar from surgery that you are trying to stretch, you may need the firmer plastic or a medical dilator.
Men tend to buy large dildos, but if it’s almost as large as or larger than your partner, it can cause as much damage as he can.
Start out with something small, midway between your finger and your partner, that you can accommodate without much difficulty.
You want muscle relaxation without spasm.
I also prefer the graduated sizes provided by medical dilators.
Unless you buy several dildos, this benefit of progressive dilatation won’t happen with a single dildo.
As with a penis, coat your dildo with a water-soluble lubricant.

What if all this fails, and you still cannot accommodate your partner?
Well, I’m sorry to report that occasionally anal intercourse is impossible.
For gay men, anoreceptive intercourse is steeped in psychological overtones, and limitations other than physical may prevent penetration.
I have had couples in my office pleading to “make him relax so we can fuck.”
Many times the couple is talking to a surgeon when they should be talking to a therapist.
With patience, a gentle approach, and counseling, you may be able to overcome the problem.

Just a word about positions.
Be creative, and as long as it gets in and doesn’t hurt, it’s fine.
Once you relax and your sphincter accommodates your partner, move to any position you choose.
Medically speaking, if you are prone to rectal problems such as hemorrhoids, then a position with your face down puts less pressure on your anal area.
When you’re on your back with your legs in the air, your hemorrhoids may swell with blood and bleed.
You may be able to relax your sphincter better in certain positions, while others may afford deeper penetration.
Experimentation is not only fun, it helps you find the optimal position for both you and your partner’s enjoyment.

I know you’ve read it already, but it’s so important you’re going to read it again:
Your partner must be in control.
Your penis can hurt him seriously if he isn’t ready to take it.
Foreplay is great.
While it may heighten his desire for anal sex, physiologically it doesn’t do anything to relax his sphincter.
So when you’re ready to put it in, do whatever he asks.
If he wants you to wait or take it out, listen to him.
By persisting, you’ll cause more damage, and he may never let you back in again.
Many men, even with proper sphincter relaxation, still experience some pain when you first get all the way in.
Some find it tolerable, while others will ask you to pull out and let them rest.
Your penis has just acted like a dilator, and coming out prevents his sphincter from going into spasm.
No doubt he’ll let you back in, and because his muscle is already stretched, you’ll both have an easier and more enjoyable time.

If your penis is especially long, you may come to a point in penetration that gives your partner pain.
Your partner feels the head of your penis stretching the curve in his colon.
While you probably won’t push through, you can injure him and cause bleeding.
If those last few inches make him uncomfortable, hold back.

Always use a condom.
STDs pass both ways, and an anus is the highest-risk place for STDs.
He can easily infect you with anything lurking in and around his anus.
I caution you to assess your risk of catching something from each new partner before sticking it in.
You may decide that something less risky (masturbation or even oral sex) might be a wiser choice.
(See
Chapter 10
.
) Some men abandon condoms if both partners are HIV positive.
Again, I strongly advise against this.
There are plenty of other STDs to catch that you may not already have.
By not using a condom you also increase your chances of picking up a more resistant strain of HIV than what you already have.
(See
Chapter 5
.
)

As soon as you ejaculate, withdraw your penis while keeping a firm grip on the end of the condom.
If you wait to pull out, you will start to lose your erection and semen can seep through gaps in the condom at the base of your shaft.
This allows STDs out or in, depending on who has what.
By holding on to the condom as you withdraw, you prevent it from being left inside.

What if your partner says no to anal sex?
That is always his prerogative.
Certainly talk about it, exploring feelings as you try to discover reasons for his objection.
If he says it hurts, try a course of dilators.
Always be mindful of nonverbal cues.
(Gritting his teeth while you’re poised to enter is not a good sign.
) He may be afraid to tell you he doesn’t want to do it, and persisting can ruin a good relationship.
If he refuses, find other ways to satisfy yourself or move on.
If the relationship is important, sex therapy and couples therapy are often beneficial and may solve your problem.

And last, just because you’re the top doesn’t mean that someday your partner won’t ask you to be the bottom.
Again, you can always refuse, but you might just like it.

Gay men who practice anal sex or stimulation tend to assume erroneously that all anal-related problems are caused by their sexual practices.
This could not be further from the truth.
(See
Chapter 2
.
) If you do develop an anorectal problem, I urge you to contact your physician, for although it may be related to sex, it probably isn’t.
Besides mentioning your symptoms, tell your doctor that you’ve had anal sex.
If you cannot admit this without embarrassment, find a different doctor!

There are numerous, though thankfully infrequent, complications related to anal sex, but most are infectious and will be covered in subsequent chapters.
(See Chapters
2
,
3
, and
5
.
) Several complications do need to be discussed now.

BLEEDING
   Bleeding is probably the most common complication you’ll experience during or after anal intercourse.
Of course, if you notice it during sex, your partner should immediately withdraw his penis and terminate intercourse.
Bleeding also occurs prior to anal sex from finger manipulation, and anal sex should not be attempted until you heal.
Painless bleeding most often results from hemorrhoid trauma (see
Chapter 2
) and stops on its own.
Most men know if they have hemorrhoids, but if your bleeding persists for more than a day, see your physician.
Bleeding associated with pain is more significant and usually signifies a tear (fissure) in the lining of your anus.
(See
Chapter 2
.
) This tear usually sends your sphincter into spasm, which may not subside until the fissure heals fully.
Persisting in anal sex can deepen the tear, causing injury to your sphincter muscle.
Fortunately, tears usually heal on their own with stool softeners (medications that lubricate your stool for easy passage) and temporary abstinence from anal sex.

PAIN
   Pain is a very nonspecific symptom after anal sex and is often the first sign of infection (most notably herpes and gonorrhea).
Typically, pain begins a few days after intercourse, once the infection has had time to incubate and take hold.
Although you may notice a discharge or blisters around your anal opening, most often you will notice nothing at all.
(See
Chapters 3
and
4
.
)

Severe pain, with or without bleeding, during intercourse or immediately after may signify damage to your sphincter muscles.
These muscles can tear when stretched too much or too quickly.
Injured muscle bleeds, but the blood can remain trapped where you won’t see it.
Instead, you might notice swelling and pressure accompanying the
pain—similar to a bruise from a torn muscle in any other part of your body.
Treatment includes muscle relaxants, pain relievers, stool softeners, and sitz baths (bathing the area in warm water).
Although most muscle injuries are minor and resolve without long-term complications, some doctors believe they weaken the sphincter muscles.
Repeated injuries cause cumulative damage and, in later life, may lead to incontinence (an inability to control your bowel movements or gas).