Maybe you’re new to butt play and excited to see if it helps you have really great sex. Or perhaps anal activities are a consistent part of your sexual repertoire, and you don’t plan on changing that anytime soon. Either way, it’s worth discussing whether anal sex can cause hemorrhoids. It’s not that we want to be complete anal buzzkills. We just want you to know the potential pros and cons of anal penetration so you can prepare as much as possible to have an excellent time.
When it comes to the anal sex and hemorrhoid question, however, the answer is a little complicated.
What even are hemorrhoids?
They’re basically piles of veins inside your rectum (internal hemorrhoids) and around your anus (external hemorrhoids), according to the Cleveland Clinic.
You may have only heard of hemorrhoids as some annoying health condition, but as the Cleveland Clinic explains, they happen to be a completely normal physical feature. The internal ones actually serve a purpose. They essentially act as cushions to help “prevent stool or anal leakage when [you] cough, sneeze, or increase abdominal pressure,” Alexis Grucela, M.D., an assistant professor of the department of surgery, and director of the colon and rectal surgery fellowship program at NYU Langone Medical Center, tells SELF.
External hemorrhoids don’t really have a job like that—they’re just hanging out underneath the skin surrounding your anus.
You and your hemorrhoids can coexist peacefully without you even being aware of them. The only time you should really notice either internal or external hemorrhoids is when they cause symptoms, according to the Cleveland Clinic.
Let’s talk about those hemorrhoid symptoms.
You might never experience a sign of hemorrhoids in your life. In a 2012 International Journal of Colorectal Disease study, 55 percent of the 380 participants with hemorrhoids had never experienced symptoms.
These piles of veins tend to only make themselves known when they’re irritated or swollen, says Dr. Grucela. This often happens if there’s too much pressure on the area, like if you regularly strain a lot when you poop. Another example is if you’re pregnant, because the added weight puts more pressure on your lower body. (And pregnancy hormones can often make you constipated, too, so that’s a nice double whammy.) Symptoms can also happen due to a thrombosed hemorrhoid, which is basically when a blood clot forms in one of these external piles of veins.
Per the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), common hemorrhoid symptoms include:
- Bright red bleeding when you poop
- Anal itching
- Anal tenderness
- An actual lump around your anus, which may hurt
- A lump protruding from your anus
If you have these symptoms, Dr. Grucela recommends you consult someone like your primary care doctor, gastroenterologist, or gynecologist. These issues don’t always happen due to hemorrhoids; conditions like anal fissures (small tears in the anal tissue) and genital warts (caused by the sexually transmitted infection HPV) are other possible culprits. It’s smart to get a formal diagnosis so you can best treat whatever’s making your butt misbehave.
For what it’s worth, treating symptomatic hemorrhoids usually comes down to at-home remedies, such as sitz baths, pain relievers, and over-the-counter hemorrhoid medications, according to the NIDDK. Additionally, if your hemorrhoids are due to constipation, your doctor may recommend lifestyle changes like eating more fiber (it makes your poop softer and easier to pass) and drinking more water (so the fiber can more easily do its job). Only rarely and in severe cases is something intensive like surgery necessary for hemorrhoids, Alex Ky-Miyasaka, M.D., a colon and rectal surgeon and associate professor of surgery at the Icahn School of Medicine at Mount Sinai Medical Center in New York City, tells SELF.
So, can anal sex cause hemorrhoids?
Since hemorrhoids are natural parts of your anatomy, the short answer is no, anal sex should not cause new hemorrhoids to pop up, says Dr. Ky-Miyasaka. However, the penetration could theoretically irritate hemorrhoids you already have, leading to symptoms like bleeding and tenderness, Suneeta Krishnareddy, M.D., a gastroenterologist and assistant professor of medicine at Columbia University Irving Medical Center in Manhattan, tells SELF.
Anal sex can also irritate or tear the lining of your anus, causing anal fissures, according to the Mayo Clinic. It’s important to do what you can to prevent this type of outcome, says Dr. Ky-Miyasaka.
That brings us to the key topic of how to have the best and safest anal sex possible. If you’re experiencing hemorrhoid symptoms, you may want to hold off on anal sex to avoid increasing discomfort, says Dr. Krishnareddy. Otherwise, you can follow these tips from Jennifer Gunsaullus, Ph.D., a sociologist and sexologist in San Diego and author of the forthcoming book From Madness to Mindfulness: Reinventing Sex for Women.
- Research any health conditions you have that could impact anal sex. Whether it’s occasionally symptomatic hemorrhoids or a GI issue, familiarize yourself with important information that may make you feel more at ease.
- Explore on your own first. Using your pinky finger and a lot of lubricant (particularly one that’s thick and silicone-based for staying power), slowly and gently explore what kind of anal stimulation feels good to you. Becoming familiar with what you like may help you feel more relaxed if you decide to try anal play with a partner.
- Establish boundaries. Before you even begin to explore with your partner, state upfront what’s OK and what isn’t. Also mention at what point you may want to stop (like if you begin to feel pain or start to bleed) or that you may need to pause to give your body time to adjust to sensations.
- Engage in a lot of foreplay. If you’re just starting out and super nervous, it’s really important that you’re already aroused before you dive in. This way, your body is more likely to respond positively when you start any anal play, rather than being like: um excuse me what is that doing there?
- Use a ton of lube and go slowly. When you try anal with a partner, you can essentially do exactly what you did when trying it with yourself. Basically, douse your anus and whatever will be penetrating it with a ton of lube, start small, and go as slowly as necessary.
- Wear a condom to reduce the risk of contracting STIs. Unless you’ve both been tested and are sexually monogamous, safe sex is a must during anal penetration. That might mean putting a condom on a penis or on a sex toy that your partner is also going to take for a whirl (or that’s going to touch any part of you besides your anus). This is another reason why silicone-based lube is excellent for anal play; the oil-based stuff can degrade the latex in condoms.
Most of all, when dealing with anal play, try not to be embarrassed about anything that feels like it might be “weird,” such as the fact that, hey, hemorrhoids are just part of being human. Sex is weird and great and messy. That’s how it’s supposed to be. Trying to remember that will make it a lot easier to focus on the important stuff, like having a really, really great time in bed.