Ask Kait: Why Can I Only Have Anal Sex in One Position?

Jaye asks:

“I can only have anal sex in one position: cowgirl. Why is that?”


Given—or perhaps because—anal sex remains taboo, it’s the topic I get the most questions about at my sex classes and workshops. This question was a first for me, though, so I turned to my friend and colleague Dr. Marqui Rennalls, a pelvic floor physical therapist and owner of It’s Private Practice Physical Therapy, PLLC in Harlem, NYC for answers.

The following has been edited for clarity and length.

First of all, why do people enjoy anal sex?

Anal sex is pleasurable for people of all genders. For people a clitoris, there’s a strong possibility that the “legs” of the clitoris are in such close proximity there is a carryover of stimulation. For people with prostates, anal sex allows the prostate to be stimulated. Often, prostate stimulation is reported to cause stronger orgasms. 

What is the most important thing to know about having anal?

You must train for it! 

Jumping right into anal penetration without preparation can cause you to jump right out of the thought of ever trying it again. Most can identify the need to prepare with hygiene and/or lubrication but preparing the musculature should be the first step! 

The pelvic floor muscles are the gatekeepers of the anus (amongst others). They contract, they keep it closed, and they relax to open the pathway. Teaching these muscles when and how to relax is make or break for anal penetration. The “anal wink test” is a test used to test the reflex of the muscle around the anus. Poking the anus naturally and reflexively causes a squeeze. Unprepared anal sex could cause you to elicit the same response. Desensitize the area first by starting slow with soft touches. Gradually move on to penetration with fingers and work your way up to plugs, props, and peni

Is it common for someone to only be able to enjoy anal penetration in certain positions? Why is that?

Positions that give the penetrated partner control will always be more enjoyable for the partner being penetrated. Getting comfortable in a certain position takes time and patience from both parties. Switching up what works takes a little more effort which may lead some to stick to what they know.

Is there something about cowgirl that makes anal intercourse easier?

It is common for anal to be more enjoyable when approached from above or in cowgirl. It allows the person being penetrated to take control of the situation and move at their own pace. The exit strategy is easily mapped out and that puts you at ease. Gravity helps your natural decent in the position that mimics a wide sumo squat. This position helps stretch the pelvic floor muscles and the prolonged stretch allows for more flexibility. Overall it’s the ultimate position to feel relaxed, mentally, and for your pelvic floor.

How can pelvic floor physical therapy help someone enjoy anal?

Pelvic floor physical therapy helps you enjoy anal by helping you understand your body. It’s uncommon to think of your genital areas as muscles, but they are. Pelvic floor physical therapists are muscle specialists. We teach you how to relax and stretch the pelvic floor muscles which is necessary to enjoy anal. I typically bring dilators—devices similar in shape to a penis—to the table when working with patients exploring anal. They are graduated and created especially for the pelvic floor muscles to stretch them safely, provide elasticity to the tissues, and overall to allow for comfortable and functional sexual activities. Ranging in size from a finger to the size of your partner, dilators allow my patients to do the homework.

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