Insertions for Sexual Pleasure: Safety and Other Concerns

By Mitchell Tepper, Ph.D., M.P.H.

Sexuality and Disability, Sexual Pleasure, Orgasm HSAB Affiliation: Managing Director

Ed. Note: This article was commissioned from a knowledgeable and well respected MD by Dr. Mitchell Tepper, Managing Director of the Health and Science Advisory Board.

Penetration, with both body parts and objects, has long been a source of sexual pleasure. Despite major religious and cultural taboos, humans have always enjoyed inserting objects into various genital orifices as part of their sexual activities. Some people are turned on by the shape, texture, size, or hardness of their object-of-choice. For others it is the thrill of the unknown. For some people it's the challenge to see if they can insert the biggest, longest, widest, or most unusual object. Most people, though, have no idea why they do it -- they just do.

In case there were any doubts, very little time in medical school is spent on sex and even less on what some would consider "unusual" sex. Large scientific studies on the safety of inserting various objects into bodily orifices just do not exist. This article will provide some simple suggestions concerning safer techniques for inserting objects. My purpose is not to prohibit anything, but rather to understand how it can be done more safely. Please note that I did not say safe, but more safely.

Some general comments: One of the biggest risks of inserting objects into your genital orifices (vagina, urethra, and anus) is that of infection. Your body naturally prevents infection from taking hold by closing off orifices to the outside via sphincter muscles and covering body cavities with a protective layer of skin. If you damage the muscles or the surrounding skin, infection can occur. Particularly with the sphincter muscles that clamp the ends of the orifices, damage can occur over time without you ever noticing. All you might realize is that you're getting more infections than usual. These infections can then further damage the muscles, creating a vicious cycle. Breaking the skin surrounding the orifices not only can cause infection, but localized bleeding, pain and damage to internal organs.

Before you get started with any insertion, make sure the object you're inserting, as well as the particular orifice, is clean and well-lubricated. First choice for lubricants is water-based without additives (e.g., fragrances). Lubricants with Nonoxynol-9 should be avoided. Food like whipped cream, carrots and bananas can be inserted, but organic objects are more difficult to clean and are a great breeding ground for bacteria and fungi. If you're using fruits or vegetables, wash the insecticides and other chemicals off with water and a gentle soap before insertion. If reasonable, cover the object with a condom. To get an idea of what people have tried inserting, use a search engine to look up variety of "street" terms like pee hole sex or "vegetables and sex."

Particular Orifices:

Vagina – The vagina is made to have things inserted into it. Penises, tampons, fingers, etc. are all relatively common and do not usually cause problems. In general, the vagina is relatively durable. Remember it can be stretched to allow a baby to pass through. Of course, stretching, especially frequently or over time, can cause it to become stretched out. If you are going to insert large objects, you should do Kegel exercises (named after the doctor who prescribed them for urinary incontinence) to keep your muscles toned. To find the muscles involved, sit on the toilet with your legs spread and urinate. The muscles that stop the urine stream are the muscles you will want to strengthen. Any basic sex education or childbirth education book will have detailed directions for doing Kegels.

You also want to avoid damaging the vaginal lining. You want to stay away from objects that have splinters, sharp edges, are breakable, or have rough surfaces. Many objects can be covered with a condom or similar covering that will protect the vaginal lining. As a physician, occasionally I have had to retrieve small round objects that got caught behind the cervix. Just as a note, there is an opening in the cervix to the uterus, known as the cervical os. It is usually a bad idea to insert anything into the cervical os. It is also dangerous for pregnant women to insert anything other than a penis or fingers into their vaginas as it can force air into the uterus, through the placenta, into the mother's blood, and onward to her lungs, where it can cause death. Intercourse is generally safe for most women throughout pregnancy, unless there is a medical indication not to.

Urethra – The urethra is the tube that carries urine from the bladder to its elimination outside the body. The size and shape of the urethra leads people to insert long and slender objects into it. Unfortunately, things long and slender are prone to break, and cuts in the urethra are not fun. Although it is hard to imagine, individuals have put objects as unusual as toothbrushes into the urethra, bristle side first. Some women have dilated their urethra so it can accommodate a penis. In any case, the real dangers of urethral insertion include infection and damage to the sphincters. Incontinence, or loss of urinary control, can result from the damage. The urethra could also scar, becoming narrower and making it harder to urinate. If you choose to insert something into your urethra, always make sure you hold the end of whatever you're inserting. If you let go, it can get lost in the bladder, which is quite problematic.

Rectum – Your colon makes an S-shaped curve (called the sigmoid colon) and then ends in the rectum. The anus is the opening between the rectum and the outside world. Any object which becomes lost in the rectum usually winds up in the sigmoid colon and is very difficult to retrieve. To prevent this from happening, anything placed in the anus should have a flange (a lip that prevents it from sliding easily into the rectum) and a string attached so it can be retrieved if the flange fails. Despite these safeguards, we still have had to take patients to surgery to remove objects from their rectums. Insertion of liquids (enemas) is also common and potentially less damaging. Some people have used coffee or alcohol in enemas; however, these are rapidly absorbed by rectal tissue. Thus, the effects of the coffee or alcohol will be felt much more quickly than if the same amounts had been ingested by drinking.

All in all, if you're going to insert something, make sure it's clean, well-lubricated and easy to get out so you can have the pleasure while reducing the risks