Anal douching safety tips for gay men who bottom
Anal douching isn’t something we talk about much in our community and we aren’t given many opportunities to learn about it. My high school coach taught sex ed. He said “Keep it in your pants, boys. Keep it in your pants.” Surprisingly, he never covered anal douching. Yet, we are all supposed to somehow know all about it. And, we succumb to societal pressure to pass white glove tests at all times of the day. #bottomstruggles.
At Magnet, we are asked a lot about how to douche safely. In a perfect world, we wouldn’t douche at all. But to be real, no one wants to leave a crime scene on their partner. There isn’t much research on regular anal douching before sex but we do know some things. Below, I’ll give you the low-down on what we know about what’s safe to do—and what you should avoid doing if you douche.
Use the right water.
Tap water is fine if you aren’t using it every day. If you douche too often with tap water, you can cause an electrolyte imbalance that using normal saline would prevent. Avoid it if you can but it’s not always easy to do so. And absolutely do not use olive oil, bleach, alcohol, or anything else that you find under your kitchen sink. These will cause significant harm to your butt.
I know you aren’t running a cooking show at home to make your own normal saline. And sometimes your big top daddy is coming over too soon to run to the store to get a Fleet’s. So what about tap water?
Using the right type of liquid to clean out your butt is important. Your body maintains a delicate balance of electrolytes to function normally. If you use the wrong liquid, you can cause imbalances that harm your body. One of the safer liquids to put up your butt is called “normal saline.” This is a water mixture that has the right amount of a sodium electrolyte to match what is in your body. You can get this stuff in a saline Fleet enema or you can also make normal saline at home by combining a half teaspoon of salt with a cup of water.
And while you are pouring the water, be sure to check the temperature. I can’t over-emphasize this one. The mucosal lining of your intestines and colon is much more sensitive to temperature than the skin on the outside of your body. You may be able to tolerate a hot shower, but you’ll burn your insides if you use that same temperature in an enema. Test the water temperature first with your hand and turn down the temperature until it feels lukewarm. Then turn the temperature down just a bit more. That’s what can go up your butt.
Get the right equipment.
OK, you got the right water and the right temperature. Now how are you getting it up your butt?
You’ve got a few different options if you’re looking for the right douching equipment. Here are the options I know about—and my recommendations for each.
Fleet enemas: These are your best bets for safe douching. Fleet enemas come in multiple versions so be sure to get the one that just has normal saline in it. They also have pre-lubricated nozzle tips which is less likely to cause tearing or other damage. The volume is also smaller so you are less likely to overdo it.
Shower shot: Nothing says that you are prepared to bottom more than installing a hose on your shower to rinse out your butt. These require you to be extra careful with your douching. It is very easy to have the water pressure on too high or have the water too hot. If you choose this option, be very careful. It is also very easy to have the water too hot, which can burn your insides. The nozzle doesn’t even need to go in your butt. You’ll find that just having it at the opening that you’ll get an effective rinse.
Anal douche bulb: If you walk into your favorite porn store, you’ll see a box with some muscled porn star holding a big douche bulb. These have a reusable rubber bulb that you can fill up with your home made normal saline. They are convenient but many of them have a hard plastic nozzle. Use lubricant on the nozzle for safer insertion.
Baby mucous sucker: This may sound strange but some guys use a baby mucous sucker to douche. You can find them in your pharmacy’s baby section. They are similar to the anal douche bulb but they actually are a bit better because the tip of the nozzle is softer and more flexible than that of an anal douche bulb. You’ll use it the same way you do the anal douche bulb.
Get your butt ready.
Don’t be a rude top and just shove the nozzle of an enema bulb or nozzle of a shower shot up your butt without getting your butt ready first. It’s kind of like bottoming during anal sex—it might hurt if you’re not properly loosened up.
There are two rings of muscles in your butt. The external muscles you can control and relax on your own, but the internal sphincter only loosens up if it senses pressure. So take a finger, lube it up, and loosen up your butt before you try to push anything up there.
Lube it before you stick it.
While you have that lube out for your finger, be sure to lube up the nozzle of whatever you are putting up your butt. The anal douche and shower shot are generally hard nozzles that can easily cause tearing if you are not careful. Take a moment to put plenty of lube on the nozzle and insert it slowly so you don’t tear. And remember that unlike your ex, the shower shot can do a good job without going in.
Pushing a stiff nozzle into your rectum without lube can cause ripping and tearing. Not only will that be painful, it can increase your risk for HIV and other sexually transmitted infections. If you irritate the lining of your mucosal membranes in your colon, white blood cells (the kind of immune cells that HIV preferentially infects) congregate in the area to help repair your body. So if you are exposed to HIV there (i.e., your partner is living with HIV and cums in your ass) you’ll be more likely to be infected with HIV.
You are not that kind of catcher. Don’t spray too much in.
You don’t need the water to go very far up inside your intestines. The amount of water than an enema bulb can hold is sufficient.
If you’re using a shower shot, go easy. Start with the lowest water setting at first until you can judge the right level that doesn’t resemble you sitting on an active fire hose.
Stick it in and do it.
You’ll want to be close to your toilet or in your shower when you do this. Putting yourself in the right position can make it easier to insert the nozzle. Stand in front of the toilet and put your dominate leg up on the toilet. After loosening up your butt with a lube finger like a good top, slowly insert the lubed douche nozzle. Squeeze the bulb to slowly squirt in the liquid. Pull out the nozzle. If you can’t hold the liquid, sit down on the toilet immediately but if you can hold it, jump up and down a few times before sitting on the toilet. If you are in the shower, do the same thing by holding onto something sturdy and put your leg up on the edge of the tub but don’t do the jumping around part as you’ll probably fall.
Don’t douche too much.
You don’t want to overdo it. Even if you douche with the right water, the right temperature, and the right equipment, you can damage the lining in your butt that can put you at higher risk for getting an infection from your partner. There is no magic number of times that makes douching unsafe. But if you can, limit yourself to once a day and only 2-3 days per week.
Give yourself time before sex.
Most of the water will come out of your butt right way but don’t expect that you’ll be able to have sex right after douching. Allow some time for all the water you squirted inside yourself to come back out (and stay close to a toilet while you wait). You might need an hour or so to make sure it’s all come out before you’re ready for sex. Use this time to clean up your place, take your PrEP or your HIV meds, or get your lube and condoms if they are part of your sexual health plan.
Don’t use laxatives. Other bulking agents are OK.
Unless you need laxatives to treat constipation, don’t use laxatives as a way to prepare for anal sex. Laxatives irritate the lining of your intestines, and they’ll give you abdominal cramping which can end up ruining sex. Also, they might just end up forcing more poop out that wouldn’t have come out otherwise.
Other bulking agents like fiber supplements are OK to take. They might help you normalize your stool if you’re constipated or help you get all of your poop out at once. If you have loose stools or diarrhea, fiber supplements can help.
Be reasonable – remember, poop happens!
I think it’s time that we all realize and acknowledge that if you’re having anal sex, poop is going to make an appearance sometimes. You don’t go to the chocolate factory without getting sample. I’ve heard countless stories of people who bottom, and have a little bit of poop show up—only to have the top basically say, “sex is over, get out.” The bottoms are made to feel dirty or are shamed. And this just isn’t right. It’s like farting during sex. It happens!
My advice is “Don’t keep it in your pants boys” and douche in moderation if it helps you feel more prepared for anal sex.
Pierre-Cédric Crouch, PhD, ANP-BC is a PrEP provider and nursing director at Magnet for San Francisco AIDS Foundation.