How do you douche before anal sex?

Here’s the thing nobody says out loud: bottoming involves an ass, and asses are where poop lives. Most of the time there’s little to clean, because poop sits higher up until you’re ready to go. A quick rinse just helps you relax and stop thinking about it. Here’s how to do it well.

Step by step

1. Go to the bathroom first. Have a normal bowel movement if you can. That does most of the work.
2. Fill the douche with lukewarm water. Test it on your wrist. Too hot burns, too cold cramps.
3. Lube the nozzle and your hole. A little goes a long way.
4. Squeeze in a small amount. About the volume of a bulb (a cup or so) is plenty. You’re rinsing the last few inches, not your whole colon.
5. Hold it a few seconds, then let it out on the toilet.
6. Repeat until it runs clear. For most guys that’s 2 or 3 rinses. If it’s still not clear after 5 or so, call it, wait a bit and try again later.
7. Give yourself time. Finish 30 to 60 minutes before sex so any leftover water can come out.

What to use

• A bulb douche. Cheap, small and easy to control. The default for most guys.
• A shower douche. Convenient, but turn the pressure way down and check the temperature. A high-pressure blast is the fastest way to irritate yourself.
• What to fill it with: plain lukewarm water is what most guys use. Store-bought saline or “isotonic” douche solutions are gentler still (see the research below).
• What to skip: laxative enemas like Fleet (sodium phosphate), soap, alcohol and anything scented.

What the research says about what goes in

A small study at Johns Hopkins, published in 2013, gave 9 HIV-negative men 3 kinds of enema, then took tiny biopsies of the lining of their rectum. The Fleet-type sodium phosphate enema stripped cells off the lining. A salt-balanced (isotonic) solution and plain distilled water didn’t damage the lining compared with no enema, but plain water let more of a test substance pass through the lining into the blood. The researchers rated the isotonic solution best overall.

The takeaway: water is fine, saline is a little gentler, and laxative enemas are the ones to leave in the cupboard.

Douching and STIs

A 2019 review in the journal Sexually Transmitted Infections pooled 24 studies with more than 20,000 gay, bi and other men who have sex with men from around the world. Men who douched were more likely to have HIV and other STIs:

Don’t read that as “douching gives you STIs.” Guys who douche usually bottom more, and these studies can’t fully separate the two. The authors say longer studies are needed. One plausible piece of it is irritation to the lining, which is another reason to keep it gentle: lukewarm, low pressure, small amounts, not too often.

If you bottom a lot, the bigger wins are the usual playbook: PrEP, a rectal swab when you test, and doxyPEP if it fits.

Tips that make it easier

• Fiber is your friend. A fiber supplement like psyllium makes things firmer and cleaner, so you need less douching. Plenty of bottoms swear by it.
• Don’t overdo it. Douching every day or several times a day is more likely to irritate. Rinse when you need to, not as a ritual.
• Have a towel down anyway. Bodies are bodies. A dark towel and a sense of humor beat an hour in the bathroom.
• Clean your gear. Wash the douche with warm soapy water after, rinse well and let it dry. Don’t share nozzles.

Frequently asked questions

How long before sex should you douche?
About 30 to 60 minutes, so any leftover water has time to come out.

How many times should you rinse?
Until the water runs clear, usually 2 or 3 times. Stop after 5 or so rather than going on and on.

Is it safe to douche with tap water?
Yes, lukewarm tap water is what most guys use. Saline is a little gentler on the lining, and laxative enemas like Fleet are the ones to avoid.

Do you have to douche before anal sex?
No. It’s a personal choice. Plenty of guys skip it, especially with a good fiber routine.

Does douching increase the risk of HIV?
Men who douche have higher rates of HIV and STIs in studies, but that may be because they bottom more. Keep it gentle, and use PrEP and regular testing for the real protection.

Sources: Li et al., Sexually Transmitted Infections (2019), Leyva et al., AIDS Research and Human Retroviruses (2013).