Road Bumps: Navigating Anal Sex With Hemorrhoids

It's not the most glamorous topic, but it is practical.

Hemorrhoids aren’t the prettiest topic, but they’re a practical one, especially if you enjoy butt sex.

According to Mayo Clinic, 75% of people get hemorrhoids “from time to time.” Most of these cases stem from routine habits like straining during bowel movements, sitting too long on the toilet, not eating enough fiber, or engaging in receptive anal sex.

“What most people don’t know is that everyone has hemorrhoids,” Dr. Evan Goldstein, founder and CEO of Bespoke Surgical and co-founder of Future Method, tells Logo. “They’re the body’s natural response to high-pressure activities.”

While hemorrhoids can be a (literal) pain in the ass, they don’t mean any harm. Hemorrhoids actually develop to protect you from the pressures and friction of anal sex, which your hole is not designed to accommodate without training. “Think of them like airbags for your ass,” Goldstein says.

When the pressure or friction of anal sex becomes too great, hemorrhoids can get irritated and become symptomatic, which can lead to swelling, clotting, or bleeding. This causes the area to suddenly become uncomfortable and painful. Should this occur, abstain from anal sex until the swelling and discomfort dissipates. After the hemorrhoids have healed, skin tags, an excess growth of skin around the anus, may develop and should be handled with similar caution.

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Preventing Hemorrhoids

The best way to prevent hemorrhoids from forming is to decrease friction and pressure in the anus. You can proactively begin this process by douching properly, since tap water and the solutions found in store-bought enemas can irritate the area, increasing friction. Of course, water is what’s most available to us, so if that’s what you’re using, make sure the water is tepid and used sparingly, roughly two to three times a week. (If you have the cash, Future Method offers a bum-friendly isotonic solution, which has the same ratio of particles to water as the cells lining the inside of your anus, meaning you can douche as often as you like without irritation.)

Technically, you don’t have to douche at all; most queer folks who enjoy anal sex do it for peace of mind. Pooping and showering roughly 30 minutes to an hour before sex often does the trick.

Since friction and pressure are the primary causes of hemorrhoids, using lube during sex is also imperative. And sorry, babes: Spit won’t cut it. Saliva just doesn’t contain the proper lubricity to ease friction, and we don’t produce enough of it to sufficiently slick up our holes. Not to mention, once it dries, it can actually leave the area drier than it was prior. Silicone-based lubricants are optimal for anal sex, as they tend to be thicker and slicker than other lubricants and don’t have to be re-applied as often. I’ve personally found CBD suppositories to be incredibly helpful. They both lubricate and reduce inflammation in the anus.

Exercising your hole prior to sex is another beneficial preemptive measure. Do you stretch before you hit the gym? Consider doing the same before anal sex since your sphincter is a muscle and responds similarly to a bicep or quad. Regularly dilating your sphincter muscles relaxes the pelvic floor, which significantly relieves pressure and friction, helping you become more receptive to a cock or toy. Anal training also helps toughen the tissue.

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Sex With Hemorrhoids?

If you’re already dealing with hemorrhoids, their current condition should factor into weather you engage in anal sex, since any swelling will increase friction and further irritate your hemorrhoids. Another side effect of receptive anal sex with hemorrhoids is muscle spasms. So it’s critical to listen to your body, and it’s perfectly okay to wait to have sex.

To gauge the state of your hemorrhoids, Goldstein recommends using toys on your own and evaluating the situation. “If there’s pain or irritation, stop and avoid anal sex,” he says. “Try again the following day and see if your symptoms have improved. If after 3-5 days you haven’t noticed an improvement, it’s time to see a doctor for a comprehensive evaluation, both inside and out.”

Before visiting a doctor, you can try self-treating at home with over-the-counter medications like stool softeners, creams, and suppositories, or by increasing your fiber intake. However, it’s important to note that some OTC treatments contain sensitizing agents, and it’s not recommended to numb your anus while having anal sex because you could cause greater damage without knowing.

If things feel sensitive, there are a number of alternative options available, like prostate stimulation. “It involves less thrusting, gives you new or more intense sensations and can help encourage more arousal and blood flow in the area to help you relax,” Luna Matatas, pleasure coach and anal expert, tells Logo. It’s important to note that the prostate can also be stimulated externally (meaning, without penetration), via the perineum.

If your hemorrhoids are active and there’s this really hot dude you want to bone, go at a pace and length of time that feels comfortable for you. “It’s a good idea to learn what our good and bad hemorrhoid days might feel like for your body,” Matatas advises. “Burning sensations, sharp pains, or increasing soreness can be a sign you need to stop, slow down, add more lube, or change things up. Let your partner know your butthole is in charge and leads the way for pace.”

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After intercourse, inspect for blood during your next bowel movement for the next couple days. This can be common for hemorrhoids, but check in with a health care provider if you become concerned. Warm baths, suppositories, CBD oil, and Vitamin E oil are great forms of anal aftercare.

If you think a visit to the doctor is necessary, there are a number of solutions available to you. “Sometimes I will recommend pericoital use of hemorrhoidal treatments which might include cocoa butter or zinc oxide suppositories (over the counter), or sometimes prescription creams or suppositories containing hydrocortisone,” says Jonathan Baker, PA-C, a colorectal surgery PA at Laser Surgery Care in New York City. “If symptoms are consistent, we would consider procedural or surgical interventions.”

Baker says there are less invasive options than getting your hemorrhoids surgically removed, which he describes as “notoriously painful.” As someone who has had hemorrhoids removed, I can concur that the surgery is intensely painful. I’d go as far as to say it’s the most physical pain I’ve ever experienced in my life. After the procedure, I spent weeks in a prescription drug-induced haze, eating ramen and playing Pokemon Shield. Not to mention, I couldn’t have sex for what felt like an eternity. (It was only a few months.)

So, as someone who has been there and done that, I urge you to practice caution when engaging in receptive anal sex with active hemorrhoids. The good news is that your body is a fantastic communicator and will let you know if things aren’t right.

In the end, there’s no shame in having hemorrhoids. They’re incredibly common. Just think of them as wha they are: temporary, albeit literal, bumps in the road toward anal enlightenment.

Bobby Box is a freelance journalist and editor whose work on sex, relationships, culture, and sexuality has been published in the Daily Beast, Playboy, Them., Into, Women’s Health, Complex, PopSugar, among others.
@bobbyboxington