Sexual Wellness Resource Center
For Adults over 50.

The perineum, the anus, and the prostate gland as erogenous zones

By Michael Bates, M.D.

After the penis and the scrotum, the perineum, the skin between the scrotum and the anus, is very highly sensitized with pleasure nerve endings. Many men enjoy this area being gently stroked and/or having firm pressure applied during foreplay and intercourse.

The anus is also saturated with a high concentration of pleasure nerve endings. Light anal touch, gentle massage and pressure, and gentle introduction of a lubricated finger can increase the intensity of orgasm.

Others, and their partners, are concerned about cleanliness. This can be solved with:

  • Emptying of the rectum ahead of time
  • Washing the exterior before and after contact
  • The giver can use a rubber glove or condom over the finger, or wash the finger thoroughly after massage

The prostate gland has two functions:

  • Production of the transport media, semen, for sperm
  • Prevention of the mixture of semen and urine

Most men don’t think about their prostate gland unless it is giving them a problem. One such problem is prostatitis, an infection of the gland that causes an achy-like pain between the scrotum and the anus. This can become chronic.

Another problem is benign prostatic hypertrophy. This is a gradual enlargement of the gland, which can cause a decrease in stream size and force, incomplete emptying and frequency.

Cancer of the prostate is the most feared problem. Those 50 and older are advised to have an annual rectal exam to check the size and consistency of the prostate and a periodic PSA test. PSA is the eponym for prostate specific antigen and a persistently elevated result can indicate prostatic cancer. 

The positive side of this story is that the prostate can also be a source of great sexual pleasure. Some men fear that the pleasure of prostatic stimulation is an indication of being gay, but that is not true. The nerves that allow for an erection pass along each side of the prostate gland. When the prostate is stimulated, even by a doctor’s exam, it may lead to an erection simply because the nerves are stimulated.

Prostatic massage therapy was first recorded as a medical treatment in 1893, by German Dr. Posner. It was used for treatment of chronic cystitis (bladder infection).

Today the medical indications for prostatic massage are:

  • Diagnosis of prostatitis
  • Treatment of chronic prostatitis
  • Treatment of benign prostatic hypertrophy, to delay or avoid prostatic surgery

Erotic prostatic massage evidence exists in pottery from the diverse and ancient cultures of India, China, Japan, Greece, and Peru. Erotic massage enhances and intensifies male orgasm. The prostate can be massaged with firm pressure on the perineum or by direct massage through the anus. The gland is about the size of a walnut and is located two to three inches inside the rectum on the belly side of the body. It can be stroked with gentle pressure.

Besides the finger, massagers or adult toys can be used. These should have a flange or wide base to prevent accidental slippage of the entire device into the rectum. Massagers can be washed with soap and water. Aneros models such as Helix (link), Progasm (link), and Eupho (link) are best selling products. They can be used for solo or partnered sex

Anal eroticism has historically been a powerful taboo. Just how common is it? No one knows. The Center of Disease Control and Prevention reports an increase in anal sexual activity, for both men and women. A University of Chicago “Sex in America,” 1994, reported anal sexual play in 10% of men and 9% of women.   A 2000 study of 1,267 HIV negative women reported a 32% incidence of anal sexual play. The most common technique is anal touching, whether during masturbation, intercourse, or oral sex. Anal Pleasure and Health, a Guide for Men, Women, and Couples, Morin, 2010, is a useful resource for those interested in exploring the pleasures of stimulation of the anus and the prostate.

What are the risks? HIV and an increase in ano-rectal cancer. Both are prevented by condom use.

The take home message? Heterosexual-anal play has been a part of human sexuality for centuries. Never succumb to pressure from your partner if you are not ready or interested in trying anal sexual play. Men’s enjoyment of anal sexual play is not a sign of homosexuality. Cleanliness is important, never touch the vagina after anal touch. Gentleness, slowness, and lubrication are fundamental. Anal sexual play is safe if practiced correctly.

About the Author

Michael Bates, M.D.

Dr Bates practiced obstetrics and gynecology for 34 years in Wichita, Kansas, until his retirement in 2011.

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