Hemorrhoids With Anal Sex

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Welcome back to Burning Questions, the column where we ask the health questions that you wish an expert would answer but you can’t quite bring yourself to ask. Today’s topic is a very personal and intimate butt question.

Hello! This will be anonymous… right?!
I’m a middle-aged female who’s had hemorrhoids since I was 19. I was horrified when I first realized something was wrong “down there.” I screwed up the courage to ask my mom what was going on, and she calmly replied, “Yeah, those are hemorrhoids. You’ll have them forever. Get used to them.” Specifically I have both internal and external hemorrhoids that are Stage 3 (closer to Stage 2 than Stage 4). I have no skin tags and almost no bleeding, but a constant dull ache for many, many hours after a bowel movement.
I’ve tried everything to deal with them: Metamucil, Miralax, scandalous amounts of fiber through beans, exercise, sleep… I’m scrupulously clean and use a bidet to completely clean with water after every bowel movement. They’re a pretty permanent part of my body at this point. I’ve had a couple rubber band ligations, but those just made me sore and didn’t improve the overall situation. My colorectal surgeon also said that I was just shy of the miserable limit that would show I could benefit from the newest surgeries.
I have had anal sex twice and loved it. I want to have anal sex again, but both times I was terribly self-conscious. I’d prepared quite a bit beforehand, mostly mentally. (I don’t believe in doing enemas or anything crazy in order to have sex.) I chose the exact times based on when I’d last gone to the bathroom. It’s been four years since all the stars have aligned (meaning I’m ready, my husband is ready, my mind is ready, and I haven’t had a difficult bowel movement in the last 18 hours) and I am desperate to do it again. I can occasionally handle being touched on the outside of my anus and I love that, too, but again, I’m often symptomatic and so self-conscious that I rarely allow it.
I really enjoy anal stimulation and anal sex, but it’s not going to happen until I can make my anus look better and feel better. I simply cannot handle anyone seeing ugly bulges the size of small grapes during intimacy, whether it’s PIV sex or anal sex, because of the pain and the embarrassment. Is there ANY process/procedure I can go through that will help me out? I’ve heard of doctors in LA or NYC who work with gay men to create a better back door landscape, but are they my only option?”
“A little sad to hear the story of someone who wishes for safe and comfortable anal stimulation but can’t, when there are so many people ‘better equipped’ who won’t,” says Stuart Spitalnic, a clinical professor at Brown. The bad news for our letter writer is that there’s no surefire way of eliminating all hemorrhoids forever painlessly. But there are some things that can help make the situation a little better.
First of all, let’s tackle the embarrassment issue. Just because somebody is having sex with your butt does not mean they have to look at your butt. Dr. Spitalnic quotes Benjamin Franklin as saying “In the dark, all cats are gray.” Ever the responsible journalist, I looked up the source of that quote, expecting it to be some misquoted old saw, but in fact Franklin used the phrase in a letter on why old women make the best mistresses. So that’s a thing we know now.
Besides doing it in the dark, Michael Reitano, physician in residence at men’s health service Roman, also points out that there’s no rule saying you have to spread your cheeks and stick your butt in the air. “Rear entry can be performed while lying flat, eliminating any visualization of the hemorrhoids,” he says.
Dr. Reitano also hopes that you’re approaching anal play in a safe and smart way. It sounds like you probably know what you’re doing, but for the readers who are just catching up: you want to start small, like with your own finger at first, and lubricate lubricate lubricate. You can also work on anal sphincter exercises in your spare time, which are like the butt version of kegels. They help you get more control over the muscles involved.
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And finally, let’s talk about your options for cleaning up the landscape, as you put it. This is tricky, because figuring out whether a surgery or procedure works will depend on how you define “works.” For example, the banding procedures you mentioned probably made the individual hemorrhoids go away, but you say they didn’t make you feel better overall.
“There are ultrasound guided artery ligations and devices specifically designed for hemorrhoid removal,” Dr. Spitalnic says. But they’re not magic bullets. The hemorrhoids may come back, or you may have pain even after the surgery, including pain with defecation. There’s also a risk of incontinence. And those are just the outcomes that have been studied! He points out: “unfortunately ‘return to pleasurable anal sex’ is not an oft reported research measure.”
What this all means is really that if you don’t want your partner to see your hemorrhoids, you’re going to have to spend a lot of time talking to doctors about your hemorrhoids. Dr. Spitalnic doesn’t trust websites advertising rejuvenation; it’s too hard to tell which ones are scammy. Instead, he suggests asking a surgeon you trust whether they can recommend someone who is experienced in the more advanced techniques. And be honest with that person about why you’re asking and what you hope to achieve.
In the meantime, enjoy your anal as best you can, and consider all your options there, too. Dr. Reitano points out that people who have a lot of anal can end up with fecal incontinence, and hemorrhoids might make that more of an issue. Instead, he says, why not try toys? “Anal stimulation with a vibrator or manually, without penetration, may be an interim way to derive pleasure while pursuing a permanent resolution to the hemorrhoids.”
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That’s it for this installment of Burning Questions. Join us next week, when I promise we will not be talking about sex at all. It’s about toes. Really! Just toes. If you have burning questions of your own, email them to me at elizabeth.skwarecki@lifehacker.com (please put BURNING QUESTION in the subject line), or drop them into the anonymous form at bethskw.sarahah.com.

Beth, Lifehacker's senior health editor, has over 10 years' experience as a science journalist and is the author of two books. She competes in strength sports and deadlifts over 315 lbs.
I’ve been a longtime follower of lifehacker, and this is enough for me. I absolutely do not wish to see such degenerate “advice” in my news feed. Good luck and good riddance, I’m out.


Posted on 10 January 2019 by Maryanne Johnson
Sure, you’ve taken a sexual education course here and there, but how much do you know about hemorrhoids and sex? First—how much do you know about hemorrhoids?
You probably don’t know a whole lot and might even think that hemorrhoids are something that your older parents or even grandparents complain about. While it’s true that hemorrhoids become more common for people hovering around the age of 50, it doesn’t mean that you can’t get them!
There are some things you should know about hemorrhoids and sex, like when to have sex if you’ve got a hemorrhoid flare-up and how sex can affect your hemorrhoids. 
Everyone is different, and when it comes to hemorrhoids and sex, this is no exception. The most important thing to keep in mind is that you need to take it easy on yourself if you’ve got any type of hemorrhoid and allow your body time to heal.
Find out what works best for you and stick with it, but in the meantime, reading up on the relationship between hemorrhoids and sex will help bridge the gap of understanding how the two affect one another.
You’ll be glad to know that there’s one less thing to worry about as far as sexually transmitted diseases are concerned—that’s right, hemorrhoids are not sexually transmitted nor are they contagious.
Essentially, hemorrhoids are your body’s response to a factor that’s constricting the blood flow to your lower rectal veins.
A few of these factors can include:
As you can imagine, all of these actions or states can place an enormous amount of stress and pressure on your lower rectal veins. Your rectal veins will respond by becoming inflamed, and when this happens, you develop hemorrhoids.
Hemorrhoids will come and go. For some people, flare-ups are a frequently experienced thing, and for others, a hemorrhoid flare-up only happens once in a blue moon.
For many people, the symptoms are all the same:
Many of these symptoms occur with external hemorrhoids. With internal hemorrhoids, sufferers tend only to see rectal bleeding.
As you’ve just read, hemorrhoids aren’t sexually transmitted, but they certainly don’t seem like a whole lot of fun.  The symptoms of pain, discomfort, anal itch, burning, throbbing, and rectal bleeding are enough to affect anyone’s sex life.
That’s why it’s important to know how to address hemorrhoid flare-ups when they occur—and even prevent them in the first place—so you can enjoy your sex life without hemorrhoids getting in the way.
Sure, some people are more prone to developing hemorrhoids because it runs in their family history, but by a dietary and lifestyle adjustment, even they can keep flare-ups at a minimum.
Here’s how to stop hemorrhoid flare-ups from affecting your sex life:
Most importantly, if hemorrhoids have become a persisting problem that frequently gets in the way of your sex life, you should make an appointment with your doctor to see what else you can do to prevent them.
Hemorrhoids produce painful symptoms like itching, burning, and discomfort. They can make your anorectal area extra sensitive and even swollen. Symptoms can be managed with over the counter hemorrhoid medications like creams, ointments, medicated wipes, suppositories, and other hemorrhoid solutions.
In some cases, anal or vaginal intercourse can cause hemorrhoids. 
During intercourse, the genitals and rectal area are engulfed with blood needed for stimulation, and this can increase pressure to the affected area, resulting in the development of a hemorrhoidal flare-up.
If you experience rectal pain or discomfort after intercourse, it could be a hemorrhoid flare-up. Look out for the common hemorrhoid symptoms over the next day or so to determine if this is the case.
If you have existing hemorrhoids, try to not engage in sex, especially anal sex, as you could aggravate them and worsen your symptoms. Allow your body a few days to heal from the flare-up before having sex.
And if hemorrhoids are a reoccurring problem for you and interfere with your sex life, then you should talk to your doctor about a prevention plan for your hemorrhoids.
Try getting more exercise, like a brisk 20-minute walk, staying hydrated throughout the day, and eating whole foods with plenty of fiber. If conservative approaches have failed, then there are other options like non-operative procedures like sclerotherapy and rubber band ligation.
You can have sex with hemorrhoids, yes, but keep in mind that by doing so, you could be aggravating them. You won’t pass your hemorrhoids onto your partner—they aren’t contagious or sexually transmitted. 
There is a possibility that your hemorrhoid symptoms could worsen with sexual intercourse during a flare-up. You could encourage the hemorrhoids to hang around longer if you choose to have sex while you have them.
However, everyone is different. Vaginal intercourse may be just fine for you and your partner, although anal sex is not advisable, as it will undoubtedly make your hemorrhoids worse.
Use over the counter treatments to your advantage if you plan on having sexual intercourse while you are experiencing a hemorrhoid flare-up. Things like topical ointments and hemorrhoid supplements can manage your symptoms, preventing them from worsening from sex.
But if you find that having sex leads to flare-ups, you'll want to make an appointment with your doctor to see what you can do to treat better and prevent your hemorrhoids. You don't have to let your hemorrhoids affect your sex life, and there are plenty of treatment options available to you.
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