Women and men are often afraid of receiving anal or rectal massage because of the stigma of this area, or because of trauma linked to previous sexual experiences. However, it can be a pleasant experience if it is done properly. The general preparation procedure and muscle release is almost the same for men and women, except that men have a prostate.
Let's first distinguish anal and rectal work. The rectum is the end of the digestive tube. It absorbs liquids and nutrients to the bloodstream, but in a special system that circumvents the liver, hence the use of suppositories.
The anus is the group of sphincter muscles at the end of the rectum. They are composed of two major sphincters each composed of 2-3 parts. The internal sphincter is on the inside of the canal, and it is surrounded by the external sphincter, except at the very opening where one part of the external sphincter is outmost. The external sphincter can be massaged from inside the vagina in women, and doing so will ease anal penetration. The role of the anus is to prevent gases and liquids from the digestive tube to come out inadvertently. The anus does not generally block to feces from coming out. These are stopped before by the puborectalis. There is normally very little feces in the rectum close to the anus.
If the client has anal fissures that are bleeding or have bled recently, it is better to avoid anal massage. It the client has external haemorrhoids, simply be more careful as you move your fingers and hand around the opening of the anus. If the client has internal hemorrhoids, be careful to move gently inside the anus and rectum, especially avoiding fast rotations and make sure your fingers are well lubricated. For others, make sure you move your finger in and out when you want to rotate it to avoid pain around the anus. Also, make sure you add lubricant once in a while. Finally, avoid too much rotation of the finger, but do not stay static for too long, as the lubricant moves away from your finger and the glove starts sticking to the anus.
The client should be laying face down, ideally laying with the torso and pelvis on a pillow for comfort of the neck and ease of access to the anus and genitals.
Before doing any anal work, I always give a relaxation massage to the muscles of the buttocks and the groin. You can use a light oil like avocado or almond oil. Then, it is very important, especially for women, to gently drain the lymph nodes and vessels on the skin surrounding the anus. Because women's reproductive organs are internal, they have more lymph nodes and vessels surrounding the anus than men; failing to drain them will make the internal massage uncomfortable for most women. To do so, gently massage the sides of the groin, from the perineum to the sacrum with the chop of the hand stroking the anus every time, essentially crossing the hands. It is like a caress to effectively drain the lymph.
Once the buttocks are prepared, the practitioner is ready to work on the anus. The practitioner should wear a glove, ideally nitrile as they are hypoallergenic and more resistant than others. If you use latex gloves, wash them as they are normally covered with wheat flour. Gloves reduce irritation and are more practical as the practitioner does not need to go wash their hands as often. Invert the glove before use as the outside surface is abrasive for more grip, thus more irritating. Keep a spare glove available on a clean surface in case the first one breaks. Avoid folds in the gloves as they will become irritating to the client.
Use anal water-based lubricant if possible, because its ph is designed to match that of the anus. Coconut oil works but is not as viscous as lubricant. Never use oils with latex gloves as it breaks them down, making them ineffective and leaving chemical residues that can be absorbed by the body.
Personally, I put a layer of coconut oil on the entire gloves, then a layer of lubricant on the thumb and index; this reduces friction on the entire hand as it moves outside, and it creates a double film that reduces it further on the fingers that will penetrate the anus.
I find that it is generally more comfortable for the client to start with the fingers pointing towards the genitals. Use the thumb to start massaging the anus, because it is more fleshy and soft than the other fingers. Massage the outside of the anus, rubbing around until the first part of the sphincters opens up.
Then gradually insert the thumb by rotating it, making sure that you caress all around the anus until the sphincters relax and allow the thumb to go in entirely. Then retract the thumb and insert the index instead. You may choоse to change the glove at this point to avoid contamination, and repeat the lubrication process. However, this is not necessary as there is rarely feces around and in the anus, and you can always wipe it with wet cloth.
Work inside the rectum
Once the index is inside the rectum, explore the area gently. Move the tip of the finger without moving its base too much. Observe that you find a number of structures below the surface of the rectum. On the sides are the pelvic floor muscles, with the pubococcygeus towards the genitals, the iliococcygeus in the middle, and the piriformis towards the back. Massage the pubococcygeus and the iliococcygeus by stroking the muscles along the fibres of the muscles to release them. However, avoid the piriformis unless you have been trained to massage them internally, as they cover two important nerves that could be damaged by the massage. The coccygeus are on either side of the coccyx; massaging it gently is important to maintain proper curvature of the spine and to reduce tension in the pelvis.
The practitioner will find different organs for men and women in the centre towards the genitals and the core of the body. For men, the prostate and the seminal sac are towards the genital. You can massage gently the prostate by stroking it, but avoid the seminal sac if you haven't been trained to do so. Massaging the prostate can be very pleasurable and improves greatly the genital health for men. For women, you will find the G-spot, the A-spot and the cervix as you move towards the back. They will induce as much pleasure as if you massage them from the vagina in most women.
Avoid massaging any bony structures in the rectum. The pelvis and the pubic bones are not fragile, but the attachments of the muscles and the fascia at the surface of the bones is sensitive. The inside of the sacrum and the coccyx are covered with ligaments and nerves that are very fragile and sensitive; you can cause a lot of damage if you press hard on any of them.
To finish the anal and rectal massage, tell the client you will remove slowly your finger(s) and slowly retract. Remove your glove by unrolling it from the cuff, and discard it discretely.