sexual health Archives

Preparation: What Actually Matters

Safe anal sex for gay men starts with preparation, and the preparation conversation is often more complicated in people’s heads than it needs to be in practice. The main concern for most men is cleanliness. The practical answer is: the rectum does not permanently store faeces. The lower rectum is generally clear unless a bowel movement is imminent. For most men, a shower, emptying the bowel before play, and avoiding a meal 1-2 hours before is sufficient preparation for sex without penetration beyond the lower rectum.

For more thorough preparation or deeper penetration: a simple anal douche or bulb syringe with lukewarm water is the most common approach. Fill, insert gently, release, and repeat until the water runs clear. Use lukewarm water only, never soap, never tap water at significant pressure, never enemas with additives. The rectum absorbs water and compounds introduced into it.

Douching: How to Do It Correctly

A bulb syringe holds about 150-200ml of water. This is enough to clean the lower rectum. Fill with lukewarm water, insert the nozzle gently with a small amount of water-based lube, squeeze slowly, retain briefly, and release over the toilet. Repeat 2-3 times until the water is clear.

Do not use a full enema bag with high volume. Do not add soap or other compounds to the water. Do not douche immediately before sex as the tissue needs a short recovery period after water contact.

Over-douching disturbs the rectal microbiome and can make the tissue more vulnerable. It is not something to do multiple times per day.

Lube: The Most Important Variable

The single factor that makes the biggest difference to comfort and safety in anal sex is lube quality and quantity. The anal canal does not self-lubricate. Without sufficient lubrication, microtears occur in the delicate tissue. Microtears increase STI transmission risk and cause pain.

Use more lube than you think is necessary. Apply it to both the penetrating partner and the external anal area. Reapply during the session if there is any sensation of drag or friction. There is no such thing as too much lube for anal sex.

For lube types and which to use in different situations, see the Manatomy lube guide for men.

Protection and STI Risk

Receptive anal intercourse has the highest per-act STI transmission risk of any sexual activity, including HIV, gonorrhoea, chlamydia, and syphilis. Condoms, when used consistently and correctly, significantly reduce transmission risk for all of these.

PrEP (pre-exposure prophylaxis) is available in Australia and is highly effective at preventing HIV transmission when taken as directed. It is not a replacement for testing and does not protect against bacterial STIs. Regular STI testing (every 3 months for men with multiple partners) is part of practising safe anal sex in the full sense of the term.

Positions for Comfort

Positions that allow the receiving partner control over the depth and pace are most comfortable for first-time or less experienced anal sex.

Riding: receiving partner on top, controls all movement and depth. This position gives the most autonomy to the person receiving and is often recommended for firsts.

Missionary with elevated hips: pillow under the lower back changes the angle and can reduce strain. The Inflatable Fuck Pillow is designed for exactly this purpose, allowing the angle to be set precisely.

Doggy style: the angle can be very comfortable but gives the penetrating partner more control, which is worth factoring in.

Pain: What Is Normal and What Is Not

Some sensation during anal sex is normal. Pain that causes you to want to stop is a signal to stop. The distinction between the mild stretch of penetration and actual pain is worth paying attention to rather than pushing through.

If penetration is consistently painful: more lube and slower approach. If discomfort persists, try a different position. If pain is persistent across multiple sessions regardless of preparation, talking to a doctor about whether there is an underlying anatomical reason is worthwhile.

After-Sex Care

Post-sex, the anal tissue has been stretched and stimulated. A gentle warm wash is sufficient. If there is minor bleeding, this is usually a minor tear and typically resolves within a day. Significant bleeding warrants medical attention.

Rest is natural after extended anal activity. For solo toy use, see the butt plug guide and dildo guide for care-specific information.

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Normal Variation in Scrotal Anatomy

Ball health for men starts with reassurance on variation: the scrotum and testicles vary considerably between individuals in size, shape, position, and texture. One testicle hanging lower than the other is normal. A testicle that is slightly larger than the other is common. The texture of the scrotal skin varies significantly between men and changes with temperature.

Understanding what is normal for your own body requires regular attention. Noticing when something changes is easier if you have a baseline of what your normal feels like.

Testicular Self-Examination

Regular self-examination, once a month, after a warm shower when the scrotal muscles are relaxed, is the most practical way to stay aware of your testicular health. The technique is straightforward:

Hold each testicle gently between your thumbs and forefingers. Roll it slowly between your fingers. You are feeling for the general shape and size, any hard lumps or nodules on the surface of the testicle itself, and any noticeable change from previous examinations.

The epididymis, a soft, slightly lumpy structure at the back of each testicle, is normal and commonly mistaken for an abnormality by men doing self-examination for the first time. Familiarise yourself with this structure so you are not alarmed by it.

When to See a Doctor

Reasons to see a doctor that do not require waiting for a routine appointment: a hard lump on the surface of the testicle itself (not the epididymis), a noticeable change in the size or shape of a testicle, a dull ache or heaviness in the lower abdomen or groin that persists, a sudden sharp pain in the scrotum (particularly in younger men under 35, this can indicate testicular torsion, which is a time-sensitive emergency).

Testicular cancer is the most common solid cancer in men aged 15-45 in Australia. The survival rate when caught early is above 95%. The reason early detection matters so much is that testicular cancer is highly treatable when identified early.

Ball Stretching and Testicular Health

Men who engage in regular ball stretching often ask about the health implications. The honest summary: the sensation of discomfort during normal stretching sessions is surface-level and associated with the scrotal skin, not the testicles themselves. The testicles are not being stretched.

Ball stretching that produces pain inside the testicle itself, a dragging sensation in the lower abdomen, or significant discomfort that does not resolve after removing the stretcher is different from the normal surface pull of the skin, and those symptoms warrant medical attention.

Normal sensations during ball stretching: a pulling, outward pressure on the scrotal skin, some achiness in the area during a longer session, temporary increased scrotal looseness after a session.

Abnormal sensations to stop for immediately: any pain felt inside a testicle, groin pain that feels like it originates internally, sudden sharp pain, numbness or colour change in the skin.

Testicular Temperature and Fertility

Testicular function is temperature-sensitive. Sustained heat exposure reduces sperm production temporarily. This is relevant for men using ball stretchers for extended periods (particularly in warm weather), and for men who sit with a laptop on their lap for hours. The effect is temporary and reverses when normal temperature is restored.

For men who are actively trying to conceive, moderating heat exposure to the scrotum during that period is a reasonable precaution.

External References & Resources:

Medical Self-Examination Guide: Healthy Male’s Step-by-Step Guide on How to Check Your Balls (Funded by the Australian Government Department of Health)

Testicular Cancer Statistics & Support: Cancer Council Australia’s Testicular Cancer Information

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Tag: sexual health

Safe Anal Sex: A Practical Guide for Gay Men