What the studies say overall
The evidence is scarcer than for vaginal use and comes mainly from studies of men who have sex with men, carried out in the context of infection prevention.
A systematic review carried out for the WHO concludes that, although the evidence is limited, lubricants appear to be an acceptable option for improving sexual health and wellbeing (Kennedy et al., 2021).
In a diary study of adult women, water-based lubricant was associated with more pleasure and satisfaction in anal sex than using none (Herbenick et al., 2011).
In a survey of men who have sex with men in Tanzania, two thirds said they always used lubricant for anal sex, and many used it to make penetration easier (Romijnders et al., 2016).
As for condoms, one study of male couples linked breakage to not using additional lubricant or to using an unsuitable one (Golombok et al., 2001).
Other studies add nuances: a small trial saw changes in the rectal microbiome after applying a hyperosmolar lubricant for seven days; in Nigerian men, using petroleum jelly was associated with lower microbiome diversity; a carrageenan gel showed no protective effect against anal HPV and had more adverse effects than placebo; and in a case-control study, sharing lubricant during fisting was associated with recent hepatitis C (Haaland et al., 2018; Laurie et al., 2022; Schmidt et al., 2024).
Saliva appears in several studies as a common lubricant: in a cohort of men in San Francisco, almost nine in ten had used it at some point in anal practices (Butler et al., 2009).
In another cohort, of Black men who have sex with men in six US cities, using saliva as a lubricant was associated with more new rectal infections, and a narrative review notes that anorectal gonorrhoea can be acquired this way (Allan-Blitz et al., 2021; Chow et al., 2019).
In a large online survey of people who practised anal sex, more than half used lubricant consistently (Javanbakht et al., 2010).
A representative US survey helps explain why this matters: about seven in ten women and one in seven men reported pain during anal intercourse, and many did not tell their partner (Herbenick et al., 2015).
Where they disagree
There is no single message because the studies measure different things: pleasure, pain, condom breakage, the microbiome or infections. A lubricant may be associated with greater comfort and, at the same time, with changes that we do not yet know how to interpret.
Saliva is similar: it is very common, but in studies of men who have sex with men it is linked to rectal infections (Butler et al., 2009; Allan-Blitz et al., 2021; Chow et al., 2019).
The studies, one by one
We have gathered 13 verified studies. Each summary is our own; the quotation in inverted commas is taken word for word from the original abstract, in English.
Type of study: Systematic review2021
What they found: A systematic review carried out for the WHO concludes that, although the evidence is limited, lubricants appear to be an acceptable option for improving sexual health and wellbeing. (Kennedy et al., 2021)
Population Review of effectiveness and preference studies in diverse populations Journal Sex Reprod Health Matters
Verbatim quotation from the original abstract (in English)
“Although evidence is limited, lubricants appear to offer an acceptable approach to improving sexual health and well-being.” Kennedy et al., 2021
See the original: DOI · PubMed
Type of study: StudySample n = 2,4532011
What they found: In a diary study of 2,453 women, water-based lubricant was associated with greater pleasure and sexual satisfaction in anal sex with a penis compared with not using lubricant. (Herbenick et al., 2011)
Population 2,453 adult women who used one of six water- or silicone-based lubricants for 5 weeks Journal J Sex Med
Verbatim quotation from the original abstract (in English)
“Water-based lubricant use was associated with higher ratings of sexual pleasure and satisfaction for penile-anal sex as compared with no lubricant use.” Herbenick et al., 2011
See the original: DOI · PubMed
Type of study: Survey (cross-sectional study)2016
What they found: In a survey of men who have sex with men in Tanzania, two thirds said they always used lubricant for anal sex, and many used it to make penetration easier. (Romijnders et al., 2016)
Population Men who have sex with men in Dar es Salaam and Tanga (Tanzania) Journal Int J STD AIDS
Verbatim quotation from the original abstract (in English)
“Two-thirds of the men reported always using a lubricant for anal sex.” Romijnders et al., 2016
See the original: DOI · PubMed
Type of study: StudySample n = 2832001
What they found: In a trial with 283 male couples, condom breakage was associated, among other factors, with not using additional lubricant and with using an unsuitable lubricant. (Golombok et al., 2001)
Population 283 male same-sex couples Journal AIDS
Verbatim quotation from the original abstract (in English)
“Behaviours associated with breakage were unrolling the condom before fitting to the penis, longer penis length, absence of additional lubricant, the use of inappropriate lubricant, and longer duration of intercourse” Golombok et al., 2001
See the original: DOI · PubMed
Type of study: Randomised controlled trialSample n = 602018
What they found: In a trial with 60 men who have sex with men, applying a hyperosmolar lubricant in the rectum for seven days was associated with changes in the rectal microbiome, without affecting the concentrations of HIV prophylaxis drugs. (Haaland et al., 2018)
Population 60 HIV-negative men who have sex with men Journal J Int AIDS Soc
Verbatim quotation from the original abstract (in English)
“Repeated rectal application of a hyperosmolar lubricant does not affect mucosal PrEP drug concentrations but is associated with changes in the rectal microbiome.” Haaland et al., 2018
See the original: DOI · PubMed
Type of study: Randomised controlled trial2022
What they found: In a placebo-controlled trial in men who have sex with men, a carrageenan gel used in anal sex showed no protective effect against new detections of anal HPV and had more adverse effects (59.8% versus 39.8% with placebo). (Laurie et al., 2022)
Population Gay, bisexual and other men who have sex with men in Montreal (Canada) Journal Sex Transm Infect
Verbatim quotation from the original abstract (in English)
“The interim analysis did not demonstrate a protective effect of carrageenan on the risk of new detections of anal HPV infection among gbMSM.” Laurie et al., 2022
See the original: DOI · PubMed
Type of study: Observational study2026
What they found: In Nigerian men who have sex with men, using petroleum jelly as a lubricant in anal sex was associated with lower diversity of the rectal microbiome (observational study). (Nowak et al., 2026)
Population Nigerian men who have sex with men Journal Sci Rep
Verbatim quotation from the original abstract (in English)
“Lower α-diversity (Shannon) was associated with use of petroleum jelly lubricant for anal sex.” Nowak et al., 2026
See the original: DOI · PubMed
Type of study: Case-control study2024
What they found: In a case-control study of men who have sex with men in Germany, sharing the lubricant used in fisting was associated with recent hepatitis C infection, along with other practices involving exposure to blood. (Schmidt et al., 2024)
Population 197 cases of recent hepatitis C and 314 controls, men who have sex with men, in Germany Journal HIV Med
Verbatim quotation from the original abstract (in English)
“Factors independently associated with case status included sex-associated rectal bleeding, shared fisting lubricant, anal douching” Schmidt et al., 2024
See the original: DOI · PubMed
Type of study: Observational studySample n = 2832009
What they found: A cohort study of 283 men who have sex with men in San Francisco found that 87% had used saliva as a lubricant in some anal practice during their lifetime. (Butler et al., 2009)
Population Men who have sex with men in San Francisco Journal J Acquir Immune Defic Syndr
Verbatim quotation from the original abstract (in English)
“Among 283 MSM, 87% used saliva as a lubricant in insertive or receptive penile-anal intercourse or fingering/fisting at some point during their lifetime” Butler et al., 2009
See the original: DOI · PubMed
Type of study: Observational studySample n = 1,5222021
What they found: A cohort study of 1522 Black men who have sex with men in six US cities found that using saliva as a lubricant was associated with incident rectal infection (aHR 1.7). (Allan-Blitz et al., 2021)
Population Black men who have sex with men in the US Journal Sex Transm Dis
Verbatim quotation from the original abstract (in English)
“use of saliva as lubricant (aHR, 1.7; 95% CI, 1.1-2.8) were associated with incident rectal STI” Allan-Blitz et al., 2021
See the original: DOI · PubMed
Type of study: Survey (cross-sectional study)Sample n = 6,1242010
What they found: An online survey of 6124 people who practised anal sex, mostly men aged 25 or older from North America, found that more than half used lubricant consistently and that barriers varied by age and region. (Javanbakht et al., 2010)
Population People who practise anal sex, mostly men from North America Journal Sex Health
Verbatim quotation from the original abstract (in English)
“Rectal lubricants are widely used, but barriers to use vary by age and region for dry sex.” Javanbakht et al., 2010
See the original: DOI · PubMed
Type of study: Narrative review2019
What they found: A narrative review on gonorrhoea and chlamydia in men who have sex with men concluded that anorectal gonorrhoea can be acquired when saliva is used as a lubricant in anal sex. (Chow et al., 2019)
Population Men who have sex with men Journal J Int AIDS Soc
Verbatim quotation from the original abstract (in English)
“anorectal gonorrhoea can be acquired when saliva is used as a lubricant for anal sex and rimming” Chow et al., 2019
See the original: DOI · PubMed
Type of study: Survey (cross-sectional study)Sample n = 1,7382015
What they found: A nationally representative survey in the US of 1738 women and men found that about 72% of women and 15% of men reported pain during anal intercourse, and that many do not tell their partner. (Herbenick et al., 2015)
Population Adult women and men in the US Journal J Sex Med
Verbatim quotation from the original abstract (in English)
“About 72% of women and 15% of men reported pain during anal intercourse events, with more of these events including moderate or severe pain (for the women) and of mixed duration.” Herbenick et al., 2015
See the original: DOI · PubMed
If you have pain or discomfort, speak to a healthcare professional.