Ask the Doctors: Anal Sex and Incontinence

Can you tell me if there is any association between anal penetration and incontinence.  Would stretching the muscles cause a laxity later in life?

Thanks for your great question!

The pelvic floor muscles commonly known as Kegels or PC (short for pubococcygeal) muscles are a significant part of the system that keeps our innards inside us, allows for stronger feelings of orgasmic contraction, and assists in containing bowel and bladder. Keeping these muscles exercised and flexible is valuable for all these reasons, and so it’s a great idea to exercise them whether or not anal penetration is going to be part of your life. (I’ll explain how to do it below.)

However, anal penetration in general isn’t a risk for incontinence. Done correctly, anal penetration does not hurt, because the muscles that keep the anus closed are flexible. They expand to accommodate a finger, toy, penis, whatever — you do not stretch them forcibly, which would hurt the bottom (that is, the person being penetrated) and which might indeed lead to real damage. This is the point at which incontinence might conceivably be a later outcome — if permanent damage were to result from penetration where the bottom was not allowed to relax, but was penetrated without that step.

This by the way, is why Good Vibrations does not sell “anal-ease”-type of products, that numb the anus. The anus should never have to be numbed — if penetration is painful, the person either has an underlying medical condition that should be addressed, like fissures, or they are not yet relaxed enough to be penetrated.

So here is some basic information to help facilitate that relaxation. First, Kegel exercises. To find this group of muscles, a person can stop a stream of urine in mid-flow, and once you know which muscles to tighten to do that, continue tightening in repetitions of ten or twenty. Serious “Kegelers” sometimes do a few hundred a day! Make sure to relax as well as tighten — when you lift barbells, you don’t just curl, you also release. In fact, there is a barbell to help with this process: Betty’s Barbell, intended to assist with PC muscle exercise.

Next: Dr. Jack Morin, in his great book Anal Pleasure and Health, pointed out that people who desire comfortable, pleasurable anal penetration can usually achieve it: they are more likely to be able to successfully relax those muscles that generally keep the anus tightly closed. People who don’t wish to do it because they’re afraid, being pressured, or for some other reason are more likely to be hurt due to insufficient relaxation.

Also, anal penetration must be done with enough lubricant to make the bottom comfortable. Spit won’t do it: water-based or silicone lube is preferable. And of course many people choose to use condoms if anal intercourse is in the cards.

I hope this is helpful! Correctly done, anal play can actually enhance anal health: Dr. Morin notes that it can improve hemorrhoids, for instance. Improperly done, there are definitely some health and safety problems — one great reason to learn to do it right, but the other good reason is enhanced pleasure.

We’re dedicated to getting you the information you need about sex, pleasure and your health. If you have any questions, please email our staff experts, Dr. Carol Queen and Dr. Charlie Glickman, at! For product-related questions, please email or call our customer service staff at

Dr. Carol Queen

Carol Queen has a PhD in sexology; she calls herself a "cultural sexologist" because her earlier academic degree is in sociology: while she addresses individual issues and couple's sexual concerns, her overarching interest is in cultural issues (gender, shame, access to education, etc.). Queen has worked at Good Vibrations, the woman-founded sexuality company based in San Francisco that turned 35 years old in 2012, since 1990. Her current position is Staff Sexologist and Good Vibrations Historian; her roles include representing the company to the press and the public; overseeing educational programming for staff and others; and scripting/hosting a line of sex education videos, the Pleasure-Ed series, for GV’s sister company Good Releasing. She also curates the company's Antique Vibrator Museum. She is also the founding director of the Center for Sex & Culture, a non-profit sex ed and arts center San Francisco, and is a frequent lecturer at colleges, universities, and community-based organizations. Her dozen books include a Lambda Literary Award winner, PoMoSexuals, and Real Live Nude Girl: Chronicles of Sex-Positive Culture, which are used as texts in some college classes. She blogs at the Good Vibes Magazine and at SFGate's City Brights bloggers page and contributes to the Boston Dig. For more about her at

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