Fact check: What are some safer alternatives to anal stretching for sexual pleasure?

1. What advocates and studies claim about pleasure and prevalence — the scale and the sensation story

Multiple studies report that receptive anal intercourse is practiced across demographics and that many people report pleasurable sensations centered on the superficial rectal wall; one 2025 analysis maps the superficial anterior rectum as a commonly reported erogenous zone ^[1]. A 2023 study found that lifetime exposure to receptive anal intercourse correlates with greater reported pleasure and less pain and bowel urgency, implying habituation or adaptation of pelvic sensations over time independent of age ^[2]. These findings frame anal stimulation as a legitimate source of sexual pleasure for many, while also suggesting experience and exposure shape comfort and sensation.

2. Where researchers and clinicians flag the harms — mechanical and biological risks

Longstanding experimental work and clinical commentary raise alarms about physical harm from aggressive or chronic anal stretching. A 1996 animal study documented external anal sphincter muscle damage after severe stretching, and later clinical commentary warns similar mechanisms may underlie human injury, including muscle weakening or necrosis with extreme or prolonged practices ^{[6] [7] [8]}. Separately, a harm note about long-term butt plug wear cites potential habituation of sphincter reflexes and possible contributions to irreversible bowel incontinence, though authors also acknowledge limited human data and variable individual outcomes ^[3].

3. Infection risks and the role of lubricant choice — what the public-health literature emphasizes

Public-health reviews stress that safer-sex education around heterosexual anal intercourse remains limited and that targeted promotion is needed as prevalence rises ^{[4] [9]}. Empirical work connects lubricant selection to rectal STI positivity, specifically linking the use of spit/saliva as a lubricant to higher rectal STI rates, which supports counseling against saliva substitution for medical or harm-reduction reasons ^[5]. Together, these findings position STI screening, lubricant guidance, and provider education as core prevention strategies.

4. Harm-reduction themes that appear across sources — practical safer-alternative principles

Across the literature, the consistent safer-alternative themes are education, avoidance of prolonged prosthetic wear, appropriate lubricant use, and routine STI screening ^{[4] [5] [3]}. The scoping review calls for health-promotion strategies tailored to those engaging in anal practices, implying that behaviorally focused interventions (information on safer technique, equipment safety, and when to seek care) are central to reducing harm ^{[4] [9]}. The literature does not endorse aggressive stretching practices given documented mechanical risks in animal models and clinical caution about prolonged device use ^{[6] [3]}.

5. Conflicts, limitations and where the evidence is thin — why caution persists

Authors repeatedly emphasize limited human research on long-term outcomes of practices like continuous butt plug wear and the translation of animal-stretching models to human behavior, creating uncertainty about prevalence of severe damage in people and thresholds of harm ^{[3] [6]}. The scoping review highlights gaps in provider-facing education and the need for programmatic research into which harm-reduction strategies actually reduce injury and infection rates ^{[4] [9]}. These documented knowledge gaps explain conservative clinical guidance despite widespread practice.

6. How the dates and sources change the picture — more recent behavioral work versus older physiological models

Recent behavioral and epidemiologic work from 2023–2025 foregrounds lived experience, showing associations of exposure with pleasure and lower pain reports, and mapping erogenous rectal zones ^{[1] [2]}. Older physiological studies, including the 1996 experimental work, provide mechanistic evidence of tissue injury from forced stretching ^{[6] [7]}. This juxtaposition highlights a tension: newer studies document normalized pleasurable practices while older and cautionary sources document potential for mechanical harm, underscoring the need for up-to-date clinical studies assessing real-world injury incidence and mechanisms.

7. Clear takeaways for someone seeking safer alternatives — what the literature supports

Based on the compiled evidence, individuals and clinicians should prioritize harm-reduction: avoid prolonged continuous anal device wear, do not use saliva as lubricant, pursue tailored education and STI screening, and be cautious about practices that aim for aggressive stretching ^{[3] [5] [4] [6]}. The literature does not provide a comprehensive inventory of “safe” alternative techniques, but it does support mitigation steps and calls for more research and provider engagement to translate these principles into practical, evidence-based guidance ^[4].

8. Final accounting — where the research should go and what readers should watch for

Consensus across the reviewed documents is that anal practices can be pleasurable but carry measurable risks that warrant prevention efforts and further study, particularly well-designed human research on long-term device wear, thresholds for sphincter injury, and effective education interventions ^{[2] [3] [6] [4]}. Readers should look for newer clinical studies and practice guidelines that translate these harm-reduction principles into concrete behavioral recommendations and safety standards for products and provider counseling.