What Men Should Know

Anal Health

Many men are reluctant to discuss or even consider their anal health.

Your anus is the one part of your own body that you are least likely to have seen. It is also an embarrassing part of your body to discuss with a healthcare provider. Anal sex is seldom mentioned in mainstream HIV prevention messaging.

Anal health is generally neglected in spite of some anal conditions being completely curable while others, if left untreated, increase the risk of getting and spreading HIV through condomless anal sex.

Anal STIs
  • Many germs causing sexually transmitted infections (STIs) in your penis and throat can also affect your anus. Common symptoms of anal STIs are itching, irritation, pain which may occur only during sex or while using the toilet, a feeling that the rectum is still full even after using the toilet, a discharge of pus or blood, or finding a sore or lump either outside or inside your anus.
  • Bacterial STIs that affect the anus include gonorrhoea, chlamydia and syphilis, which are curable with antibiotics. These germs can be present in the anus without causing any symptoms, making it important that you get screened for STIs if you have anal sex.
  • Viral infections of the anus are human papilloma virus (HPV), causing warts (hard bumps) around and inside the anus, and herpes simplex virus (HSV) which causes painful blisters and sores which heal but often come back. These STIs are not curable but the symptoms and associated risks can be managed with correct medication or small surgical procedures.
  • Anal STIs can be avoided by always using condoms for receptive anal sex.
Other Anal Problems
  • Haemorrhoids (piles) are dilated (stretched) blood vessels around or in the anus. They are usually related to diet and ongoing constipation and are not caused by anal sex. They feel like soft smooth bumps and may bleed when you use the toilet or during sex. They can be cured with special creams or a small surgical operation.
  • Anal fissures are small but very painful tears in the anal muscle ring that occur when the muscle is stretched too quickly. They usually heal with medication but sometimes need a small operation.
  • Abscesses and fistulae are painful collections of pus that occur if one of the anal glands becomes infected with bacteria. They cause a lump which may burst and release pus, and are treated with antibiotics and surgical drainage.
  • Anal cancer is more common among gay men than in heterosexual men, especially if they have a history of anal warts. Anal cancer starts off as a sore which won’t heal or as a lump in the anal area. Cancer is confirmed through a biopsy (taking a sample) of the sore or lump so it is very important to consult your healthcare provider if you develop these symptoms.