Modiel's sparked a huge debate about the health risks of anal sex. Picture: Wikimedia Commons

Boitumelo “Boity” Thulo's mother Modiehi Thulo set Twitter tongues wagging when she commented on anal sex.  

Tweeting to her more than 48 000 Twitter followers Modeil said: “I’ve seen many, many people dying from constant anal sex. 

The muscles on the anus don’t contract back after sex, once the sphincter muscle laxity is reached, nothing can be retained. Hence people start wearing adult napkins.”

Modiel sparked a huge debate about the health risks of anal sex. 

In response Joburg-based family doctor Lerato Masemola shared her insights on this subject during a lengthy Twitter thread.

"Anal sex is any type of sexual activity that involves the anal area. Many people engage & enjoy anal sex, regardless of sexual orientation. In 2016, the Journal of Sexual Medicine reported that 36 percent of women age 18-44 yrs have had heterosexual anal sex."

Here's some of the tips Dr Masemola shared:


It’s advisable to use a condom due to presence of many bacteria in the anus. 

If having vaginal sex straight after anal sex, change the condom to avoid contaminating/ infecting the vulva and vagina with anal bacteria.


Unlike the vagina, the anus is not self-lubricating. Use a water-based lube, safe for condoms. 

Don’t use:

  • Spit (dries quick)
  • Cooking oil/coconut oil/baby oil/ or any oil actually, it breaks condoms
  • Pre-ejaculate and/or semen (risk of STIs)

Dr Masemola also warned of the risks associated with anal sex:

  • Piles
  • Bowel injury is uncommon but the risk greatly increases if sharp objects are used 
  • Anal tears during penetration/thrusting
  • Anal fissure ie, a deeper tear which is painful and makes it difficult to pass stool due to pain.
  • Tears bleed and increase chances of STIs by allowing bacteria and viruses to enter the body easily
  • Faecal incontinence
If you are experiencing any of the above symptoms, experts advise that you see a doctor.