Hygiene and Health

There is always Hygiene and Health to consider. So let's consider it now. We could also add comfort and peace of mind.

At the foot of this page is a link to a page dealing with HIV Risk factors. This is an important enough subject to link to here as well. It is a chart compiled by Dr Christian Martin, an incomplete chart. HIV is a separate subject, a vital subject, one that concerns all sexually active people. It is not one I am going into here.

This page deals with simple hygiene and simple health matters.


Yes. Normal hygiene, which includes the need to actually be clean when enjoying anal adventures, and normal health such as ordinary infections. For sexually transmitted diseases you just need to research on the net with any good search engine.

So let's start with hygiene.

Almost everyone' first reaction is that the anus and the rectum are dirty and smelly places. I mean just look at what comes out, right?

In part they are right. If that was your own first reaction, heck I'm not going to disagree with you. Shit smells. Faecal matter is the dead and decayed product of digestion. It contains a good selection of bacteria which you don’t particularly want to ingest, and it doesn’t smell too clever. Mind you, there are some folk who get off on that! To each his own, I guess. Just not around me, OK?

So we need to deal with total cleanliness.

Frankly sex is most enjoyable when there are no inhibitions. And being inhibited about any part of your body or your partner's body is a shame. If cleanliness and hygiene is one of those inhibitions, we're going to remove that one straight away.

Remember at the bottom of the page on self exploration? The page I talked about an internal bath?

Yep. This is where we look at the concept

An enema.

Now I don’t particularly want to confuse this with the apparently therapeutic fad of colonic irrigation, though this cleans you out too! I've always reckoned that colonic irrigation is done by the monied classes who have a servant do everything for them. "Take a shit for me, please!"

An enema is a simple, repeatable, cleansing operation either done solo, or, if less inhibited, with your partner. It is not in place of taking a dump. So take one. Before the enema I mean. And take as complete a dump as you can. No point in making the enema do more work that necessary.

While you are doing that, read on. No, print this off, dummy! Unless you have one of those online bathrooms with a webcam! If so, I reckon you're already so far ahead of me that you are in fits of laughter.

You are going to need some simple equipment. Ideally you need to visit the pharmacy and get an enema kit, but you might also be a tad shy. It’s easier than asking for condoms! So, let's see what we need.

An enema is an anal washout. It is done by introducing water slowly and gently into the anus with some sort of device, and keeping it there for as long as fifteen minutes before allowing it to leave. And an enema kit is designed to do this.

The kit is like a hot water bottle, with a tube long enough to hang on the hook you have on the bathroom door, and a slim nozzle to insert into the anus to allow the water to trickle in. It contains about two litres of liquid. Two litres is about 70 fluid ounces. A US pint has 16 fluid ounces, an imperial pint has 20 fluid ounces.

If you don’t have a kit, you'll want to improvise. You know the shower heads on a flexible hose on the bath taps? Well, unscrewing the spray head usually reveals a simple small outlet which you can place against but not inside your anus. If using this method you will have to guess the flow rate. Do be very careful of the temperature!

What we are aiming to do is to introduce this two litre volume of body warm water with soap (shampoo but not dandruff shampoo) added into your already empty rectum over a period of about 20 minutes. Yes, that long. We are not aiming to hose you down with so much pressure that you can brush your teeth in the flow. In fact, if you did that you would injure yourself inside. Sometimes the obvious needs to be said.

Now it feels very strange. Very. Especially as you are quite likely to get sudden abdominal cramps at least a couple of times as the fluid goes in. Try to relax them away. They will pass. They just mean that the liquid is doing its work. Maybe passing some obstruction (extra shit) which will be washed out when it comes back down again. If you are using the bathtaps, turn them off until the cramp passes. If the kit, just relax through it.

You will feel full before the full volume is inside. That's normal. Relax again and it will all go gently in.

Now the fun starts. You are going to try to hold this slippery water inside you for as long as possible. I bet you can't do it. The anus leaks! Do not under any circumstance try to answer the front door or the phone at this stage, or you'll be redecorating the walls and replacing the carpet.

Sit on the throne, and let roar.

And when Niagara is done, let it roar again. Coz it will.

If you want, repeat with plain water and rinse. If not, then heck, you are so empty you could eat from the inside anyway. All that is left is to wash the external area to remove splashing, to dry it and to enjoy your new cleanliness.

Sound disgusting? Well, yes, a bit. But it can be erotic. Well, if not, why on earth did you get erect during the process?

Now your partner can literally kiss your arse almost with impunity.

The Downside of Enemas

I am going to quote verbatim, some correspondence on globalcyberclinic.com (the site seemed to be defunct when we checked on 12 October 2016) where the topic of douching etc was discussed. I think it has some major value here as a counterpoint. All copyrights are acknowledged.


Ref Medscape.com 7th August 2002

Douching Common Practice Among Women at Risk For HIV

By Karla Gale

NEW YORK (Reuters Health) Jul 31 - Among women at high risk for HIV infection, douching is a common practice, according to results of a multicenter study. Therefore, those who design trials of vaginal microbicides need to address the impact of this practice on the safety and effectiveness of the products, investigators report in the July issue of Sexually Transmitted Diseases.

Dr. Beryl A. Koblin, of The New York Blood Center in New York, and associates recruited 623 women in 1995 from Chicago, New York City, Philadelphia and southeastern New England. The study was conducted as part of the Vaccine Preparedness Study, by the HIV Network for Prevention Trials.

The subjects were considered to be at high risk based on their behavior over the previous year. Such behaviors included injection drug use, prostitution, having at least five male sex partners, diagnosis of a sexually transmitted disease, or being in a relationship with a man who was seropositive for HIV or at high risk. At a 24-month followup visit, subjects responded to questions regarding douching and risk behaviors.

Only 5% of subjects had never douched, whereas 70% reported having douched in the past 6 months. Reasons for douching including cleansing after menstruation or after sex, to prevent infection and to prevent pregnancy. More than 60% had previously been informed that douching is not healthy, including 68% of those who had done so within the previous 6 months.

"Within that group of women, those who have multiple partners were more likely to be douching," Dr. Koblin told Reuters Health. She noted that women who persisted in douching may be unlikely to stop based only on further educational messages.

Future trials of microbicides "must include women who normally douche, or else the trials would miss the people at the highest risk," Dr. Koblin added. Not only could douching change how the product would act in the vaginal environment, it "could affect safety, if it caused any abrasions or other kinds of disturbances," she maintained.

Sex Transm Dis 2002;29:406-410.

Reply 1:

Do you know of any similar studies among gay men that relate douching or enemas with HIV incidence??

Frankly I doubt that douching/enemas after sexual activity would be beneficial. I have the reverse feeling by intuition, but it would be valuable information, I think.

Reply 2:


I can’t find any studies linked douching & incidence of HIV or STIs.

However as you are aware the rectum does not produce lubrication like the vagina but only a small amount of mucus. Therefore, rectal penetration should always require a lubricant. If the rectum is douched on a regular basis this can irritate the rectum causing it to tear easer, dry out, leading to constipation and weaken natural immune defences.

So I believe that regular douching would actually increase the transmission rate of all infections not just HIV.

Tony G

Reply 3:

To get this clear, do you mean the ACT of douching, or things like soap which are often used in (eg) an enema solution thta may cause rectal harm?

Many gay men like "inner cleanliness" before penetration, and this extra infomration wil be useful for us all.

Reply 4:

I must first make it clear that this is my own opinion & can find little to support it with reference to the transmission of infection.

Prior to working in Sexual Health I worked in an oncology environment. Part of my many tasks (to any nurse reading the word task will give you an idea of how long ago I’m talking) was to prep bowls prior to surgery using high bowl wash outs & enemas, if this task was used to often on the same person it lead to inflammation & in some cases infection, i.e. normal commensal bacteria are not aloud to do it job.

We are all aware that vaginal douching is not recommended. For the same reasons the act of rectal douching for the purpose of "inner cleanliness", would dependant on the frequency, lead to adverse effects, including cleaning away any commensal bacteria, mucus & drying the bowl out, leading to constipation & rectal fistulas on top of this the risk of tearing during sex would increase.

I’m not saying all men should not douch, what I am saying is everything in moderation.

I will keep an eye out for any information one way or another & I will ask a friend of mine who works with male sex workers to see if he has any insight into it.

Tony G

Reply 5:

Typical Ive just found the following which supports my previous post at:

gayquestions.com/health/questions/08_01_cleanbutt.shtml (the site seemed to be defunct when we checked on 12 October 2016)

Question: How can I really get my butt clean (inside and out) before I have sex with my boyfriend or dosn't it really matter?

Erik Replied:

What a great question! I want to first thank you for having the courage to actually ask this question. My suspicion is that lots of guys out there wonder about this same issue...but it can be an embarassing thing to talk about.

Your question comes in two parts. The first part I want to address is "does it really matter"? Most experts tell us that it is usually uncommon for fecal matter to be present in any significant amount on or just inside the anus (a healthy person's fecal matter is generally stored deeper inside the digestive track). That said, however, more most people the thought of ANY feces being present during anal sex is not an appealing one. So in response to this part of the question...scientifically, it may NOT matter...but personally, you and your partner(s) have to make that call.

The second part of your question deals with IF you want to clean, how to go about doing it. Cleaning the outside of your butt can be as simple as a shower or bath or a washcloth with warm water (and optional mild soap). Some guys even use baby wipes to clean themselves; and others find it helpful to keep the area around their anus clear of hair to make it easier to clean. Cleaning the inside is a bit trickier...and can be a bit more dangerous, as well. The most popular way guys have found to clean out is through douching or enemas. This means using a device of some kind to push water up inside your rectum and then expelling it to "rinse out." You can actually buy small handheld enema bottles at any pharmacy or grocery store (the most popular brand is "Fleet") or you can improvise and use the bottle that comes in a woman's douching kit, an ear syringe (often found with baby products), or even a turkey baster! (Be as creative as you like!) While this method is very effective, it does bear some risks. Frequent or improper anal douching can lead to constipation, irritation in the lining of the rectum (which can increase risk for HIV/STD), or damage to the rectal walls. Here are few tips to make it a little more safe:

Less is more. You don't need to use a LOT of fluid.

DON'T use over the counter douches designed for women. The fluid in these can irritate your rectum.

Don't put chemicals (i.e. soap, rubbing alcohol, astringents, etc.) inside yourself. A little bit of lukewarm tap or distilled water should suffice.

Don't do it too often and don't do it repetitively. If you find yourself douching out your rectum 3 times a day every day....you are going to experience problems!

I hope that answers your question.

If you have any further information, don't hesitate to ask!

Thanks a bunch!

Erik Libey
Gay Health Coordinator

And More which could once be found at mindprod.com/gglossdouching.html (the site seemed to be defunct when we checked on 12 October 2016)


Cleaning out the rectum with water preparatory to anal sex. The disadvantages of douching include:

It removes mucous from the anal lining. This makes it more susceptible to infection, especially HIV.

Too much flow, too much heat or too frequent douching can irritate the bowel.

It is of no use in safe sex. Douching after sex usually just pushes semen or blood further in.

The bacteria in the rectum usually cause no problem for the inserting partner, especially if they use a condom.

Unless you allow a couple of hours prior to sex for any water to drain, you can end up with an embarrassing flow of possibly dirty water.

If you are overly vigourous, you will flush bacteria from the large intestine where they cause no trouble back into the small intesting, where they do.

The advantages of douching include:

It eliminates embarrassing odour or mess.

Some people will be quite offended if you do not.

And even more at: gayquestions.com/health/questions/03_02_douche.shtml (the site seemed to be defunct when we checked on 12 October 2016)

Question: I was wondering is it safe for a guy to use a douche? Or is their another way to clean him self? Cuz my boi is big on keeping himself clean and I just want to know it is safe for him to use b4 I let him use it....

Erik Replied:

The question you pose is actually a very common one...and a great one to ask. First of all, I can reassure you and your boyfriend that wanting to "keep clean" is completely normal. One of my favorite authors in the gay health field, Daniel Wolfe, wrote a piece on this subject and said "From toilet training on, we've learned that even our own shit is dirty." And that's definitely the truth! So the question becomes...what can we do about it?

Well first off I should point out that with the exception of just prior to bowel movements (and one generally knows when those are), very little fecal matter should really be present in the area just inside the anus/rectum. For a person whose stools are healthy, feces usually pass with little or no trace. Still some people don't want to chance it. And for these individuals, there are some options. Rectal douching or enemas have been used by gay men for decades to clean up prior to anal sex....and have been controversial in terms of "to or not to" and "do's and don'ts" for as long!

There are a number of products available at your corner grocery store or drug store that you can use ranging from a turkey baster (...don't laugh...guys use them) to the douche bags designed for vaginal douching in women. The two best options, however, are an enema bottle (these are small flexible plastic bottles with a narrow nozzle that can be refilled/re-used and are usually fairly inexpensive. One name brand to look for is "Fleet.") or an ear syringe/bulb (the type designed to clean a baby's ears and nasal canals...usually found in the baby products). Both of these items are reasonably priced, reasonably sized, and designed in a way that can minimize discomfort but maximize ease of use.

Although douching is generally not a serious health risk, there are some important points to consider.

  1. First of all, never put anything inside yourself but lukewarm water. It is unnecessary and potentially unhealthy to put soap or cleaners or vinegar or ANY other chemicals/substances into the solution. Water will do the trick just fine.
  2. Only a small amount of water should be used. It is not necessary to "overfill" yourself...and doing so could cause complications such as poor drainage, blockage, and constipation.
  3. Douching should not become a daily routine. Many experts contend that douching or enemas too often can cause bowel problems.
  4. Be aware that douching INCREASES RISK OF INFECTION WITH HIV/STD'S because it not only can cause minor abrasions (a nozzle is, after all, being forced up the anal canal) AND it can also rinse away naturally protective cells on the mucous lining of the rectum.

All in all, as a general rule....douching, like so many other sexual choices we make, has its pros and its cons. And every individual needs to weigh those issues and decide if it is appropriate for them.

Erik Libey
Gay Health Coordinator OR Gay Health Consultant

Hope this helps, now that I really have started to dig it seems that anal douching is not recommended, for even more info go to Google type anal douching in search engine & watch it all appear.

Tony G

Reply 6:

That set of answers was awesome by the way.

How, given all this information, does the Colonic Irrigation Industry" justify itself?

I must admit I have always felt that thsi is mainly a method for those with too much extra cash to pay someone to take a crap for them, but they do claim therapeutive powers by irrigating, and this irrigation sounds like a "plumbed in enema".

From the answers here it seems that the drawbacks outweight any likeloy therapeutic benefit

Reply 7:

Hi I never really thought about it to be honest, until your question & it appears we both learnt a lot in the process.

As for the Colonic Irrigation Industry, I agree it does seem that the drawbacks outweigh any likely therapeutic benefit. But you can guarantee that they all have some obscure research paper to back up any claims that they make.

Tony G

Interesting stuff. It seems that one is both right and wrong. BUT one can never be too well informed. I think the choice of to douche or not to douche is highly personal

Which leads us to health.

Even after an enema, and most certainly before it, the rectum contains a myriad of bacteria which are designed to deal with digestion.

These bacteria are not designed to go into your mouth, nor are they designed to go into your partner's urethra.

Well the former was pretty damn obvious.

The latter less so.

From experience, I can tell you that an infection of the urethra, urethritis, is no picnic. It is kind of like pissing razor blades. And believe me you need to piss more often. It sucks. Bigtime.

Even if you are a virgin and your partner is a virgin, and you are neither of you HIV+, nor have you had any possibility of HIV exposure, please consider using a condom. A good condom. One which is not past its expiry date. And use the right lube. One which doesn't dissolve the condom you've bought.

Yeah, using a condom is like sunbathing in a body stocking. Urethritis is worse than sunburn. It can lead to bladder infection, glans infection, foreskin infection (if you are lucky enough to still have a foreskin), and even such total disease of the urethra to mean that it has to be surgically replaced.

So wear one.

And otherwise, use a good simple antibacterial soap to wash all the toys and body parts that you use after you have had fun.