Prevent permanent damage

Prevent permanent damage to your penis and anus

Letting yourself go during sex is hot and exciting. A visit to the emergency room for you or your sexual partner, however, is obviously a huge downer. When using chems during sex, you feel much less pain and are more willing to push sexual boundaries. Sometimes, you only notice later how far it has gone: bruises on your penis, torn nipples or an intensely sore and raw anus. It will heal, but the risk of damage increases the longer your sex session lasts. How do you reduce those risks?

Gently douche your anus.

Take your time, as careless douching can damage the intestinal wall. Use a gentle stream of water. Never douche with laxatives or soap, as they irritate your intestinal mucosa.

Use silicone lubricant,

especially when inserting the douche the first time. Use lube in between as well.

Take breaks between douching,

preferably an hour or longer. This reduces the strain on your intestinal mucosa.

Douche at least an hour before having sex

This gives the mucosa a chance to recover somewhat.

When using vacuum pumps, never pump to the maximum.

Doing so risks bruising on your penis or other mechanical damage of a temporary nature.

Use plenty of lubricant while playing.

Uppers like Tina, MDMA, 3-MMC, coke and speed dry out the mucous membranes. When getting going, spit is often used as a lubricant during sex, but it dries quickly, resulting in excessive friction. This significantly increases the risk of damage. Use lots of lube right from the start.

Avoid sounding when using chems.

Inserting a sound into your urethra requires great focus. Always use sterile equipment during sounding. Sterilise the sounds (boil for 30 minutes), and never touch them with your fingers. Use latex gloves and preferably sterile, water-based lube (KY). Start with a small size. Sounds should never be pushed in; they should be able to slide down on their own.

 Use lube on your penis during prolonged masturbation to prevent damage.

Bowel perforation

Things get really nasty when overly rough anal play causes intestinal perforation. It is rare, fortunately, but everyone has heard the horror stories. An ambulance ride and a hospital visit are a terrible way to end a date.

Fisting and anal play with large dildos are harmless as long as you listen carefully to your body, do not force anything, and communicate well with each other. The time-honoured rule is important here: the bottom is always the boss. If the bottom says “stop”, “hold there”, or “back”, the top must respond immediately.

This communication can be disrupted under the influence of chems. For example, the top may be too pushy, or the bottom may become extremely introspective, making it difficult to read their responses.


Take a break if you cannot communicate properly with your sexual partner due to chems.

Stop immediately if a bottom does not indicate whether something is pleasant. 

Don’t go right for the biggest dildo, but build up with smaller sizes.

Take a break if the lube turns pink; this indicates bleeding. Stop fucking or fisting immediately if more and/or dark red blood is released.

Stop immediately if a top is too pushy or unfocused. Make sure the top does not use more chems when fisting or working with toys. That is a recipe for disaster. The old maxim is that a top should stay as clean as possible, not even  use poppers. This allows him to keep a close eye on the bottom’s reactions.

Never push a dildo entirely past the sphincter; always leave the end sticking out.

Fever or abdominal cramping after fisting or anal play

If you suffer from mild or severe abdominal pain, abdominal cramping or high fever after fisting or playing with toys, 

contact the hospital immediately. You may have peritonitis and need urgent medical attention. An intestinal perforation allows intestinal bacteria to leak into the body, causing acute peritonitis.

Peritonitis from an intestinal perforation can be fatal. When in doubt, always contact the emergency room of the nearest hospital. Talk openly about your chems use and the sex techniques performed.

Other symptoms of peritonitis include decreased consciousness, blood loss and abdominal swelling; these are signs of a medical emergency. Call 112 immediately for an ambulance.


Another risky situation can arise from using the erectile dysfunction medication Androskat and Caverject during chemsex. These drugs are injected directly into the penis. Erections can last too long, potentially resulting in lifelong impotence. Avoid having to call an ambulance or visit the emergency room.

In addition to popular erection drugs such as Viagra, Kamagra and Cialis, drugs such as Androskat (papaverine/phentolamine) or Caverject (alprostadil) are also sometimes used. Urologists and sexologists prescribe these drugs for people with erectile dysfunction with a physical cause (surgery, chemo treatment). Androskat and Caverject are not prescribed if the erection problem is “in your head”. The risk is that these erection drugs will work too well, and the erection will last too long. When an erection lasts too long, it can damage your penile tissue. If no action is taken, it can—in the worst case—lead to lifelong impotence. You will never be able to get an erection again and instead will have to rely on a prosthesis.

How Androskat works

The erectile tissue in the penis fills with blood, and the blood does not flow back. Androskat helps maintain an erection, but it should not last too long. If blood is not refreshed in time, the erectile tissue will suffer an oxygen deficiency, and the blood will clot. This can cause the erectile tissue to break down, rendering it nonfunctional.

The dosage of this type of drug is critical. Half a millilitre more can cause the erection to last too long.

Never inject Androskat or Caverject if you have not been prepared for it by a doctor and given a prescription, as the dosage is critical and should always be built up carefully.

Never let your sex partner inject you with Androskat if you do not have a doctor’s prescription.

Never wear a cock ring, and avoid bondage of the testicles when using Androskat or Caverject.

Never combine Androskat or Caverject with erectile dysfunction medication in pill form (Viagra, Kamagra).

Never use cocaine or Ritalin in combination with injected erectile dysfunction drugs. Cocaine and Ritalin can cause excessively long-lasting erections on their own.

Be alert if an erection lasts longer than three hours. It is important to monitor it from this point on.

The situation becomes critical after five hours. Do not wait any longer. It is critical to receive treatment within six hours, so go to a hospital emergency room immediately. The hospital staff will drain the blood, and you will receive an adrenaline injection. This can often help your penis to become flaccid again, hopefully without permanent damage.