Bottoming - Getting Started with Dilation

Some men take to bottoming naturally, while others require a bit more “training.” Wherever you fall along the spectrum, we believe that anal dilation is an important, albeit overlooked, first step in the process of learning or re-learning to bottom. Ideally, any man anticipating being a bottom should do anal dilation in advance to make their first experience comfortable, pleasurable, non-traumatic, and safe.

The act of dilation not only allows you to familiarize yourself with your body and the sensations you may experience during penetrative sex, but also prepares the muscles and lining of your anorectal canal for bottoming.

The sensations felt during bottoming can feel unfamiliar and sometimes uncomfortable at first, so the goal of anal dilation is to help you become more comfortable and confident with your ability to bottom. It is important to remember that sex should be enjoyable for all parties involved. By following the steps outlined below, you can find personal pleasure in the act of bottoming.

understanding the terminology

Anal Sex: Anal sex is a form of penetrative sex where one partner uses a penis or strap-on to penetrate the anorectal canal of the other partner. Though bottoming can occur between two partners of any gender, for simplicity, in terms of pronouns and descriptions, we will be discussing anal sex as between two cisgendered men. Therefore we will refer to the penetrating object as the “penis,” and describe biologically male anatomy when discussing the anus that is penetrated.

It is important to note that being a “top” or “bottom” is not an identity, but rather a temporary position that one partner takes within an individual sexual encounter. You can be the top one minute and the bottom the next. Or a top one week and a bottom the next. For some men, the title of being the top or bottom is more fixed, while for others, it’s more fluid. Either way, being a top or bottom doesn’t define your role or your importance in the relationship. 

A “top”: In anal sex, the “top” partner is the penetrating partner, i.e., the partner that uses his penis to penetrate the anorectal canal of a second partner. (Some people consider the penetrating “top” partner to be the “active” partner, but we believe that both partners can equally participate in anal sex. This active/passive distinction is neither accurate nor useful.) These distinctions are not permanent labels, but rather depictions of the role of the person in that moment. Should the partners switch roles, the “bottom” then becomes the “top,” and vice versa.
A “bottom”: In anal sex, the “bottom” partner is the receptive partner, i.e., the partner whose anorectal canal is being penetrated by a penis.

Diagram

Prostate: The prostate is a small gland located in front of the rectum, between the bladder and penis. The prostate’s primary functions are to make a fluid that supports and nourishes sperm, and to push this fluid into the urethra to mix with sperm during ejaculation. However, given the prostate’s location relative to the rectum, and the fact that it’s covered with nerve endings, the prostate can also be stimulated for pleasure. The prostate can be stimulated externally by pressing the back of the perineum (the skin between the scrotum and anus), or internally by pressing against the gland through the front of the rectal wall. In this guide, we will focus more on internal stimulation through anal penetration.


Dilation: Generally speaking, dilation is the act or condition of widening, opening up, or being made larger. In the body, dilation often refers to non-conscious relaxation of muscles around a tube, which allows the tube to widen. One example is the dilation of blood vessels during arousal, which allows blood to flow into the penis and results in an erection. Another example is anal dilation during anal intercourse.

Anal Dilation: In the context of anal sex, anal dilation refers to the stretching or widening of the anorectal canal in preparation for penetrative sex. Anal dilation is a bodily function that can be done voluntarily, but this process requires a combination of muscle relaxation and site preparation (as detailed below).

Pelvic Floor: The pelvis is the lower half of the torso, and refers to the area between the abdomen and thighs. The pelvic floor is a collection of muscles in the bottom of the pelvic region that support a variety of functions, including holding or releasing the contents of your bladder and bowels, and erectile function and ejaculation. For anal penetration to comfortably occur, the muscles in the pelvic floor need to be relaxed. 

How to Dilate Your Anal Canal

To ensure that your anal canal can be comfortably and pleasurably penetrated, you’ll need to slowly dilate your anal canal, so that you can accommodate a partner’s penis.

Learning to bottom is a “slow and steady” process. The key to success is consistently and persistently achieving incremental milestones. The pace and progress you make depends on what works for you. With relaxation and consistency, the progress will come.

What You'll Need

To dilate your anal canal, you will need:

  • A comfortable, private, and safe space to practice
  • Lubricant (“lube”): Typically, you will want to avoid using any silicone-based lubes on silicone toys, as the lube can bond and cause swelling to the toy. Instead, use oil and water-based lubes for silicone toys or anal diltors. For example, unrefined, virgin coconut oil is an easy and convenient option.
  • While not to be used for silicone toys, silicone-based lubes tend not to dry out as easily, making them an excellent option for finger-dilation.
  • At Maze, we use Sliquid Silk, which is a mixed water-silicone based lube. Although it does contain silicone, it has been curated to work well with medical-grade silicone toys. We have found that this lubricant doesn’t dry out or require reapplication as often as a water-based lube, and also does not stain fabric when it dries.
  • In the case of penetrative intercourse with a partner, it is important to note that only silicone and water-based lubricants are safe to use with latex condoms. Any oil-based lubricants will cause the latex to erode.
  • Don’t worry about applying “too much” lube. It is better to use a generous amount of lube rather than use it sparingly and risk injury. You may even find that you need to apply more lubricant as you continue dilation/penetration.
  • Possibly a set of dilators (see our recommendations below) if you are using the dilator method.
  • Relax. Breathe.

Anal dilation is first and foremost a matter of relaxing the pelvic muscles. The first step to letting that tension go is finding a safe space, breathing, and relaxing.

It’s important when you first start to dilate that you find a space to practice where you feel comfortable, safe, and free from distractions. Once you’re settled, take big, deep, full-bellied breaths. Relax your abdominal and pelvic floor muscles. Think calming thoughts. Enter a relaxed state.

Note: You may also want to practice finding a state of mindful relaxation at other times, not just when practicing dilation. Techniques like progressive muscle relaxation can help increase your awareness of muscle tension throughout your body and its relationship to your mood and stress level in a given moment.

Once your breathing is steady and your pelvic floor is relaxed, you can proceed to the next step: physically dilating your anal canal.

Dilation Methods:

Two Methods

Two effective methods of anal dilation are: The Dilator Method and the Self Massage Method.

We typically recommend dilators to patients, but each method has its pros and cons. The dilator method uses a foreign object for penetration and builds up in gradual steps, but the finger method does not require an additional purchase or hiding dilators if you live in a space without privacy.

Method 1: The Dilator Method

The dilator method uses a graded set of dilators to stretch and adjust your anal canal over time. For this method, you will need: a comfortable space to practice, lubricant, and a set of anal dilators. The goal of the dilator method is to prepare you for penetrative intercourse.

Finding the right dilator set:

When deciding which anal dilation set to use, we recommend purchasing dilators that have long tapered heads, teardrop shapes, and flared bottoms. The long, tapered heads will allow for a gradual entry upon insertion, the teardrop shape minimizes the pressure put on the anal sphincter, and the flared bottoms ensure that the inserted item won’t get sucked up into the rectum and can be easily removed. At Maze, we use Paloqueth dilators, which are teardrop-shaped and easier than a dildo or other dilators. (Put in a link for purchase.) You can shop around and see which dilators work best for you. Whichever dilators you ultimately choose, be sure that the set is made of a medical-grade silicone that is free from phthalates and BPA, and that the bottoms are flared.

Use a dilation set, not a dildo: 

While a dilator and a dildo can perform similar functions, they are two distinct objects. A dilator is an instrument used to stretch your anorectal canal. A dildo is an object that resembles a penis and is used for sexual stimulation. We recommend against using a penis-shaped instrument/dildo to dilate for 4 reasons:

  1. The average dildo is much wider than the smaller dilators, so it is not a good starting point in dilation.
  2. The girth and cylindrical shape of the dildo can stretch your anorectal canal too rapidly and cause discomfort.
  3. The wider base may put too much pressure on your anal sphincter.
  4. Dildos that are too long can be inserted too deeply and potentially cause damage to the lower intestine.

Because the ultimate goal of dilation is preparing for the insertion of a penis, and dildos are more anatomically similar to penises, dildos can be used down the line as an optional transition between dilators and the penis of a partner. We recommend not using a dildo as a starting point for dilation, but only after you have achieved a similar diameter with a dilator, and prior to being penetrated by a penis.

How to perform the dilator method:

The dilator method works by using a set of dilators that progressively increase in diameter. It is important not to rush through the “course,” as the muscles of your anorectal canal will need time to adjust to being stretched, and the lining of your canal will need time to thicken and strengthen in response to friction. You should move through the dilator set one dilator at a time, being sure not to skip any dilator sizes. We recommend spending at least one week on each dilator size. If your anus is very tight, leave every other day to be a “rest day” without dilation as you move through the course. The purpose of this “rest day” is to allow the cells of your anal lining to physiologically respond to the friction and movements involved in anorectal penetration. You can move on to the next dilator size if you can dilate and play with the current sized dilator with very little effort.

 To use the dilators:

  1. Take deep breaths to relax your body. Take special care to unclench and relax the muscles of your pelvic floor.
  2. When you are ready to begin dilation, apply a generous amount of lube to the dilator
  3. Push out your pelvic floor (as if gently pushing out stool) to make sure you don’t clench, and slowly insert the lubricated dilator into your anus. Do NOT push the dilator straight into your anus. Instead, you will be gently “twisting” the dilator in by applying a gentle forward pressure as you turn the dilator in 90º turns.
  4. As you proceed with gentle twists, you should feel your anal canal accommodate the dilator. If you begin to feel resistance, give your muscles time to relax around the dilator. Then, when you feel ready, gently withdraw the dilator a small amount, and twist forward into the next point of muscle resistance.
  5. Do NOT push any further if you experience any pain. Some mild discomfort is to be expected, but if you find yourself wincing or struggling do not keep going.
  6. The dilator is considered fully inserted up until the flared base. It is important to note that the widened base of the dilator is not meant to be inserted into the anorectal canal. The first time you are inserting a dilator, it may take up to 5 minutes to slowly and comfortably insert the dilator following the above steps. Over time, as your body adapts to the physical changes of dilation, you may notice that you can insert the dilators fully with less time.

Ultimately, the dilator method will help you prepare for penetration in terms of relaxing the muscles, toughening up the mucosa (the lining of the rectum), and getting used to the sensation of having something in your rectum.  In addition, the dilator method will also teach you about your own body. Some anorectal canals are equally as tight all the way through, while others are tighter at the sphincter/entrance or deeper into the canal. Knowing your anatomy and staying cognizant of your body’s responses will help you move through the course without injury. As a reminder, the goal of the dilator method is to help you enjoy bottoming, and to avoid pain and injury. There is no need to force or rush dilation progress. The key to successful and efficient dilation, as well as long-term enjoyment, is consistency and patience.

Method 2: The Self-Massage Method

The self-massage method uses your index finger to stretch and adjust your anal sphincter over time. The limitations of the self-massage method are that it does not provide the same dilation to the rectal canal that an anal dilator can, and that it does not increase dilation capacity in measured gradations like the dilators do. Instead, the self massage method uses the sides of your index finger to “massage” the walls of your anorectal canal and help them relax and stretch in response to stimulation. Though to a lesser degree, the self-massage method works similarly to the dilator method in that your sphincter muscles adjust to being stretched, the lining of your anorectal canal toughens up in response to friction, and you can prepare for physical penetration both physically and emotionally. The self-massage method is useful for men that can’t keep dilators at home, that are struggling with the insertion of the first dilator, or that only need help relaxing the entryway to their anorectal canals.

For this method, you will need: a comfortable space to practice, lubricant, and to make sure that the nail on your index finger is not sharp. The goal of the self-massage method is to prepare your anus (the muscles and the lining) for penetrative intercourse.

How to perform the self-massage method:

The self-massage method requires two 10-minute sessions a day: once in the morning, and once in the evening.

The goal of the self-massage method is to familiarize yourself with your body, to dilate your anorectal canal, and to normalize the sensation of anorectal penetration. The instructions below outline this method as happening over the course of 7 days, but it is important to note that this outline is meant as a loose guideline for progressing through the course. Typically, one would not expect to dilate their canal to fit a penis by the end of the 7 days. It will likely take closer to 2-4 weeks. If you do not feel that significant dilation progress has been made by the end of the 7 days, or if you cannot continue with the dilator method, you can extend the duration of course by repeating steps 6-10 until you have achieved your desired diameter. Remember not to force or rush dilation progress. The key to successful and efficient dilation is consistency and patience.

The typical 7-day structure is as follows: 

Day 1-2:

  1. Breathe deeply. Relax your body, taking special care to relax your anus.
  2. Apply a generous amount of lube to the entirety of your index finger as well as the anal sphincter and gently insert your finger into your anus. The ultimate goal is to have the tip of your finger pass through the high pressure area of your anal sphincter and into the more spacious and relaxed area of your rectum.
  3. Continue breathing deeply. Keep your anus relaxed. Leave your finger inserted into the rectum for about 5 minutes.
  4. Repeat steps 1-4 once in the morning, and once in the evening for about 5 minutes each session.

Day 3-7:

  1. As always, begin each session with slow, deep breaths and relax your anus.
  2. Lubricate your index finger and insert it as far into your anus as you comfortably can.
  3. When you’re ready, slowly move your entire finger in a small, gentle, circular motion. You will not be twisting your wrist or “screwing in” your finger, but instead moving just your finger in a circle as though you’re tracing the sides of the rectal wall.
  4. As your anus relaxes, you should be able to increase the diameter of the circular motion of your finger. Continue to “massage” the anorectal walls as your finger moves in a circular motion. Ultimately, you will want to achieve a diameter that is slightly larger than an average penis, or at least as large as your partner’s penis, if he is particularly large.
  5. Only push out as far as is comfortable. There is no diameter or deadline that needs to be met in “x” number of days. You will know when your body is done dilating for that session. If you proceed slowly and listen to your body, you should not feel any pain.
  6. Repeat steps 6-11 for 10 minutes in the morning and 10 minutes in the evening.
  7. As you continue the process, you can try to insert an additional finger.

Ultimately, the self-massage method will help you prepare for penetration in terms of relaxing the muscles, toughening up the lining of the rectum, and getting used to the sensation of anorectal penetration by a foreign object. As a reminder, the goal of the self-massage method is to help you enjoy bottoming, and to avoid pain and injury. There is no need to force or rush dilation progress. The key to successful and efficient dilation, as well as long-term enjoyment, is consistency and patience


Dilation Maintenance

It's important to maintain the dilation progress you've made after completing one of the method sequences above.

If you are not regularly participating as the bottom in anal sex but want to remain prepared for spontaneous sex, you should continue to dilate at least 2-3 times per week.  Again, the act of dilation is to stretch the muscles of the anal sphincters. Like any muscle, without continued training (dilation, in this case) the muscles will return to their original state and you may lose the progress made from dilation over time.

If utilizing the anal dilator method, continue practicing with the largest sized dilator you are able to tolerate. Keep the dilator inserted for about 10 minutes per session, and always remember to apply a generous amount of lubricant with each insertion!  

If you are utilizing the finger technique, follow the same regimen of inserting your finger(s) and tracing the walls of the anorectal canal in a circular motion. We recommend continuing this for at least 10 minutes twice a day every 2-3 days in the beginning.

The more that you practice anal dilation, the more you will find a schedule that works for you. Over time, you may discover that you can relax your dilation schedule to once a week, or you may find that more frequent dilations help you maintain the progress you have made. 

Learning How To Bottom With A Partner

Some men prefer complete privacy when learning to bottom, while others have a trusted partner who would like to join them for the journey. Learning how to bottom can be a partnered activity, but there are certain requirements that must be met: the bottom needs to feel totally safe and in control; communication and trust are a MUST; the top needs to learn how to touch the bottom gently. The most important thing to remember is that the bottom is in charge of this process in terms of choosing whether or not to learn, learning alone or together, and the pace of progress.

It is essential that the bottom learns how to bottom using the dilator or finger methods as described above. There should be no thought of anal penile penetration during these sessions, until the bottom can comfortably accommodate a dilator or finger dilation larger than the top’s penis.

For some men, learning how to bottom with a partner is anxiety provoking. If that’s the case, do not feel pressured to have a partner present as you progress through a dilation method. The choice to learn to bottom is yours alone. That being said, if you’re open to partnering up, learning how to bottom with a partner can be quite an erotic activity. There is nothing wrong with finishing off the daily session with sex – as long as the future top keeps his penis out of the future bottom’s anus!

If you feel more comfortable learning how to bottom with a trusted partner, here are some tips on how to incorporate your partner:

  1. Communication! The first step is to talk with your partner about your interests and boundaries – if possible before you enter the bedroom – in a safe and neutral space. Make sure you are both comfortable and listened to. And don’t forget to breathe.
  2. If this is the bottom’s first time exploring anal stimulation, the top can begin normalizing touch to the area by applying a broad pressure around the anus with a flat hand or a light, feathery touch/pressure around the anus with fingers. The purpose of this is to help the bottom relax and enjoy any sort of stimulation near the anus.
  3. Once the receptive partner is ready for insertion, make sure to start slowly and small. Lube up a dilator, manicured finger, or small toy, and work through one of the dilation methods as described above. Practice inserting the finger or toy while the receptive partner contracts their anal muscles, holds the position for at least 3-5 seconds, then relaxes their muscles. Feel free to re-apply lube as needed. There’s no such thing as too much lube

Orgasms in the Bottoming Partner: What to Expect

The vast majority of men cannot achieve orgasm through prostate stimulation alone. This is especially true for bottoming beginners. Though you may have heard of “milking the prostate,” “P-orgasms,” or “super-O’s,” all of which denote an orgasm derived from the prostate, there is very little research on how to achieve these orgasms. 

This is not to say that the bottoming partner will not enjoy anal sex or achieve orgasm. The bottom may orgasm because he enjoys the physical sensation, pleasing his partner, or the erotic pleasure in a shared sexual activity. Many men that bottom find pleasure in the physical connection with their partner during the act.

Ultimately, bottoming beginners should not expect to orgasm from penetration alone. Some bottoms will require manual stimulation during penetration. Others may prefer to “take turns” being the bottom. Speak with your partner about expectations and desires. It is crucial that both you and your partner are excited for and enjoy sex.

Tips on Prostate Orgasms.     

How Do I Clean My Anus & Rectum in Anticipation of Sexual Activity?

Using a One-way Road as a Two-way Street

The anorectal canal’s primary functions are fecal continence, or controlling the movements of your bowels, and defecation, or expelling/releasing feces from your body. This is not to say that your body can’t be enjoyed in other ways, but it’s important to remember that the tubing, muscles, and nerves of the anorectal are primarily trained for defecation. This has a few implications for people interested in anal sex:

  1. Some people prefer that the bottom’s canal is as devoid of feces as possible.
  2. During intercouse, the bottom may experience a sensation similar to that of needing to defecate, and may not be sure if they are in fact defecating or not.
  3. Sometimes, people will actually defecate during anal sex.

We don’t feel that these points should prevent you from engaging in anal sex, but want to prepare you to face these issues to the extent that you are interested/concered. Therefore, in this section, we will talk you through changing your habits, “cleaning” your anorectal canal before sex, and how to talk through any accidents before and during sex.

Regulating Your Bowel Movements and Improving Your Diet

After we eat, food moves through the gastrointestinal (GI) tract so that our bodies can digest all of the nutrients and materials we need, and separate out the “waste” that we don’t want or can’t use. The GI tract is a long and winding tubing system, and ends in the rectum and anus, where stool (poop) leaves our bodies.

It typically takes between two and five days for food to pass through the GI tract, but there are many factors that contribute to the frequency and consistency of a person’s bowel movements. To be able to best predict your bowel habits, you have to learn what is normal for you. You can think of your own bowel habits in terms of the frequency of bowel movements—which should range from three times a day to three times a week—and consistency—or how firm/soft and fully formed your stool is.

To help regulate your schedule and fully empty your rectum, practice the following steps:

  1. Make sure you get enough fiber.
    If your movements are not regular, and/or if the consistency of your stool is not formed, you can increase your fiber intake through dietary modification or fiber pills. Fiber will help regulate and solidify your stool, decrease gassiness, and even reduce your cholesterol and blood sugar levels (which aren’t related to bottoming but are always important!).Fiber is found in plant-based foods, with different plant foods having a different amount of fiber per serving. Alternatively, you can supplement with daily fiber pills. We usually recommend Pure for Men, which blends all-natural ingredients and contains both soluble and insoluble fiber, though there are plenty of other good fiber supplements available online. Make sure that any fiber product you use is FDA-regulated. If you elect to take fiber pills, we recommend taking 2-3 capsules twice per day, and always taking the pills with 16 oz of water. PLEASE NOTE that the purpose of fiber pills is to slow down digestion, so fiber supplements should not be taken 2-3 hours before or after any other medications or supplements.
  2. Completely empty your bowels with each bowel movement.
    Fiber should make it easier for you to empty your bowels, but you can also sit with your knees higher than your hips, keep your back straight and lean forward, and rest your forearms on your thighs while you defecate.

Washing Up Just Before Sexual Activity

Typically, if washing the area before anal sex, people will use a douche, which washes the exterior and immediate inside of the anus, or an enema, which penetrates further into the anorectal canal and flushes out the entire inside of the rectum. Washing up is completely optional, and is based exclusively upon your and your partner’s preference.

WARNING: While use before occasional sexual activity shouldn’t cause any issues, regular washing and emptying with an enema (and sometimes with a douche) can lead to serious health issues, including a dependence on enema use to be able to defecate, chronic constipation and altered nerve control, dried out bowel lining, and stretched out bowels.

The purpose of douching is to relieve any anxiety surrounding fecal matter in the rectum prior to penetration. The reality is, however, that there is unlikely to be any fecal matter present during the act. Stool is stored in what is called the sigmoid region of the colon, above the rectum. During penetration, fingers, toys, and/or a penis is unlikely to reach into the area of the sigmoid colon. An important note is that the purpose of douching (for anal sex) is not to fully cleanse the colon of any stool. A full-colon cleanse can take hours to complete, and should only be performed in specific medical situations if indicated by your doctor. Repeated full-colon cleanses can cause harm to your intestines over time.

That said, if you restrict douche and especially enema use to the times you need extra assurance of cleanliness before bottoming, you can follow these steps:

Washing Up Just Before Sexual Activity:

Typically, if washing the area before anal sex, people will use a douche, which washes the exterior and immediate inside of the anus, or an enema, which penetrates further into the anorectal canal and flushes out the entire inside of the rectum. Washing up is completely optional, and is based exclusively upon your and your partner’s preference.

WARNING: While use before occasional sexual activity shouldn’t cause any issues, regular washing and emptying with an enema (and sometimes with a douche) can lead to serious health issues, including a dependence on enema use to be able to defecate, chronic constipation and altered nerve control, dried out bowel lining, and stretched out bowels.

The purpose of douching is to relieve any anxiety surrounding fecal matter in the rectum prior to penetration. The reality is, however, that there is unlikely to be any fecal matter present during the act. Stool is stored in what is called the sigmoid region of the colon, above the rectum. During penetration, fingers, toys, and/or a penis is unlikely to reach into the area of the sigmoid colon. An important note is that the purpose of douching (for anal sex) is not to fully cleanse the colon of any stool. A full-colon cleanse can take hours to complete, and should only be performed in specific medical situations if indicated by your doctor. Repeated full-colon cleanses can cause harm to your intestines over time.

That said, if you restrict douche and especially enema use to the times you need extra assurance of cleanliness before bottoming, you can follow these steps:

How to Douche the Rectal Canal:

If you plan on bottoming and are worried about the presence of stool, it’s a good rule of thumb to lubricate a finger and do a “self-test.” If you feel some stool present, try to go to the bathroom or consider douching the rectal canal. We encourage you not to get into the mindset of needing to douche before every bottoming encounter. This would not only increase your anxiety, but can take away from the fun and pleasures of bottoming!

If you decide to douche, having the right materials on hand is key. We recommend a bulb douche, which has a squeezable bulb that stores the water and a plastic rigid spout that you use to insert the water into your rectum. While there may be some variations in the appearance of bulbs, most products designed for anal douching  hold the same amount of water. Local pharmacies usually carry enemas, such as a Fleet enema. Although the bottle itself can be used as a douche, it is important that you empty any contents inside these enemas prior to use, rinse it out, and fill them with plain, lukewarm tap water instead. Fleet enemas usually contain a laxative that will result in a prolonged full-colon cleanse.

With the douche available, filling the bulb with lukewarm water is essential. The plastic spout can usually be removed to get water into the bulb. The temperature receptors present in the lining of your anal canal are more sensitive than the temperature receptors found on your skin, so warmer water can harm the lining, and colder water can cause cramping and potentially prevent you from being able to comfortably bottom.

Once the bulb is filled and the spout is placed back on, place a generous amount of lubricant around the spout. Stand with your dominant leg on the toilet bowl, and insert the spout just enough into the anorectal canal to be able to squirt water inside. For the first time, it is better to start with small amounts of water as you get more comfortable with the process. Fill the bulb halfway and gently squeeze 2-3 times, releasing a low-pressure wash of water. Inserting too much water can cause water to go past the sigmoid bend, which would overstimulate the colon and result in needing a full colon cleanse.

Once the water is inserted, hold it in for about 30 seconds, and then release into the toilet. You can repeat this process of inserting the water and expelling until the water runs clear. Most of the time, the water will be clear after inserting/expelling the water 3-5 times.

You may notice some light-green/yellow type mucus expelled in the water. This is normal mucus from the lining of your rectum. You should not douche with the intention of completely removing all of the mucus, as this can result in over-douching and cause harm to the lining of your rectal canal.

Talking With Your Partner Before and During Sex

In the case that some fecal matter/poop is visible at any time during sex, don’t stress about it. Anal sex can sometimes be messy, and that’s okay! There is no shame in an accidental bowel movement or in some fecal residue. Remember, we are trying to turn a “one-way street” into a “two-way road.” Getting comfortable with the idea that defecation can happen and can easily be cleaned off will help you relax and enjoy the pleasures you’re experiencing! If there is surprise stool, you and your partner can laugh it off, clean up, and carry on or take a break. That’s up to whatever you both are feeling.

If you are truly concerned that you will defecate during sex, bring up your worries with your partner before entering the bedroom. The right partner will understand that these things happen, and that your body isn’t gross. If your partner does try to shame or mock you over an accidental bowel movement or some fecal residue, maybe the sex should wait.

The Feeling – May Be An Acquired Taste:

If you have prepared and trained for anal sex, and still feel unsure about whether or not your body is ready for the act, you can try stimulating your anorectal canal with a finger or dildo. If you have sufficiently prepped, your body will realize that the need to defecate is just a reflex, and that your rectum is in fact empty. If the sensation doesn’t pass and you still feel the need to defecate, perhaps you do have stool stored, in which case you should review the preparation steps you completed and double check that nothing was missed.

The physical similarity between defecation and the in-and-out thrusting involved in anal penetration will be most pronounced in the beginning of your bottoming journey. Until a person begins to experiment with anal penetration, the physical sensation of a full rectum is associated exclusively with the need to defecate. As such, the removal of the penis may initially feel like you are defecating. It may take some time to get comfortable with anal penetration, let alone anal sex. Don’t be surprised or disappointed if you don’t take to it like a duck to water. Given time, it can be a very pleasurable and satisfying experience. Or, if after you’ve adjusted you find that bottoming is still not for you, there are other ways to engage with a partner sexually.


Meet our Gay Men’s Health Providers

Matthew Phillips, LCSW, MED

As a licensed clinical social worker, sex therapist, and gay man myself, I am well-positioned to support the mental health needs of my community. I have over fifteen years of clinical experience, which enables me to provide assessments and therapy that emphasize sexual identity and functioning as critical components of a balanced life. I practice from a social justice perspective and actively work to affirm people of diverse experiences and relationship models.

Anthony Angeloni, PA-C

Throughout my clinical training in both primary care and specialized settings, I noticed a distinct separation between the patients’ physical complaints, mental well-being, and their own personal lives. As a provider at Maze Health, I assess all of these factors to ensure each patient receives a plan-of-care most appropriate to their needs. With an emphasis on care regarding sexual identity, I address the concerns and distinct needs of gay and bisexual men that are often overlooked in medicine. 

I am currently an NCCPA board-certified physician assistant at Maze Men’s Health. I  graduated from DeSales University as part of an accelerated program where I received both a Bachelor of Science in Medical Studies and Master of Science in Physician Assistant Studies over the course of five years

Michael A. Werner, MD, FACS, Medical Director/Founder

I am the proud member of an astoundingly queer family. Our son, Adam Eli, is a gay activist, writer and community organizer. My wife and I (though mostly my wife) cofounded Mosaic of Westchester, which has focused on integrating Westchester’s Lesbian, Gay, Bisexual, Transgender and Questioning Jews into the fabric of Jewish life, thus enriching the entire Westchester Jewish community.

Since the founding of Maze in 1994, I have been committed  to being inclusive and welcoming to the LGBTQ community. With this gay/bisexual unit, I am hoping to offer even more services that are specifically needed by our patients, utilizing primarily LGBTQ providers.

Learn More About The Team

Additional Resources

HPV Screening: What You Should Know

The Study of Prevention of Anal Cancer (SPANC)

The Anal Cancer HSIL Outcomes Research (ANCHOR) Study

How to Bottom Safely and Enjoyably

Bottoming: Getting To Know Your Bodily Functions

Bottoming: Positioned for Success

from the maze men's health blog

Pelvic Floor Dysfunction: What Is It?

Pelvic Floor Dysfunction: Who Gets It?

Pelvic Floor Dysfunction in Men Defined

Male Pelvic Floor Dysfunction: Signs and Symptoms

Last updated: September 2022