More Sex Talk!

Today, we continue our discussion of real sexual health questions submitted by real Ohio State students.  At first glance, this question seems kind of… obvious.  But that cliché about no such thing as a dumb question is true; there’s more to this “stupid” question than meets the eye.  And if this student was brave enough to ask it, that means that there are a lot more people out there who are wondering the same thing.  Please post a comment and let us know what you think – remember, it’s anonymous.

Q: Is it possible to get pregnant from anal sex?

A: Technically speaking… no.  The anus and the gastrointestinal tract are not connected to the reproductive tract in any way.  There are some rare conditions in which an abnormal connection called a fistula could form between the two tracts, but if you were dealing with something like that, having anal sex would be about the last possible thing on your mind – and even if it wasn’t, the sperm would never survive the trip across the fistula. 

Theoretically speaking… it’s possible, but highly unlikely.  If, during the course of having anal sex, sperm were to somehow land on the vaginal opening and work its way all the way up to the cervix, pregnancy could occur.  But this is very unlikely to happen without vaginal penetration.  The only other conceivable (ha ha) way pregnancy could occur is if you and your partner have a frighteningly bad sense of direction and are NOT where you think you are.

But let’s get to the real issue here.  A lot of people believe that anal sex or oral sex isn’t “real” sex.  Perhaps from a technical – or political – standpoint that may be true, but in reality, that’s a dangerous fiction.  You may not have to worry about getting pregnant, but unprotected anal sex puts you at risk for all of the same sexually transmitted infections that “real” sex does: HIV, HPV, gonorrhea, Chlamydia, herpes, you name it.  In fact, anal sex can put you at an even higher risk for these infections because the anus and rectum aren’t as pliable as the vagina, so there is a greater chance of having a tear and bleeding that increases the likelihood of transmission.

And remember, the “realness” of anal sex (or oral sex or elbow sex or any sex) applies to its emotional and psychological impact as well.  Physical intimacy can have significant and unpredictable consequences that go way beyond infections.  I’ve cared for many patients who came in “just to get tested” but who were really dealing with significant anxiety and other stress-related symptoms. 

So if you don’t feel comfortable doing something, never let anyone talk you into it because it “doesn’t really count.”  And whenever you do decide to have sex with someone, always protect yourself – no matter what you’re doing. 


John A. Vaughn, MD

Adam Brandeberry, Med IV, OSU COM