Are there potential health risks associated with hemorrhoids during anal sex?

Dear KraZy,   

Hemorrhoids can certainly get in the way of many aspects of life and end up leaving you butthurt. However, excessive contact with hemorrhoids can irritate them and lead to more pain in the long run. If you’re hoping to reduce pain, it might be best to hold off on having receptive anal sex. If your hemorrhoids or their symptoms aren’t going away on their own, consider meeting with a health care provider to discuss how best to treat them. Keep reading to get to the bottom of your pain! 

What’s a hemorrhoid? 

Technically, almost everybody has hemorrhoids—they’re small blood vessels between the rectum and the anus that help you control when you go to the bathroom (and when you don’t!). However, the term hemorrhoid has come to describe the condition where these blood vessels are swollen or irritated, sometimes even popping out of the anus. Most hemorrhoids are caused by straining or pushing too hard while going to the bathroom, which people often do when they’re experiencing constipation. 

What happens if a hemorrhoid pops? 

Some people approach their hemorrhoids like they’re pimples and think “popping” them will help relieve painful symptoms. However, this is not recommended as a hemorrhoid treatment. That said, contact with the anus or rectum can also unintentionally cause hemorrhoids to rupture. Either way, bursting or irritating hemorrhoids may make your pain more severe and last longer. The area around the anus is also sensitive and surrounded by bacteria. This means that trying to pop a hemorrhoid can create wounds that are prone to infections, including sexually transmitted infections (STIs). 

How can hemorrhoids be treated? 

Luckily, many hemorrhoids go away without any help. For those that don’t, different treatments are available, spanning from ointments to surgeries. Depending on the severity of the hemorrhoids, the following might help treat them or prevent them from reoccurring: 

• At-home treatments: There are several over-the-counter creams that you can apply to the area around a hemorrhoid to soothe pain and reduce swelling. For people with hemorrhoids, it’s also recommended to sit in a bath of warm water (such as a sitz bath) for 20 minutes after each bowel movement, as well as two to three other times per day. These baths can help relieve pain and relax the muscles in and around the anus. 
• Lifestyle changes: Taking steps to reduce straining while going to the bathroom can help decrease your risk of getting hemorrhoids again. Eating more fiber (found in whole grains, fruits and vegetables, and fiber supplements) and drinking more fluids helps poop form in softer and larger pieces, making it easier to pass. Additionally, going to the bathroom when you feel the urge to, rather than waiting, can prevent poop from backing up and becoming more difficult to pass. It may also be helpful to incorporate more movement into your life since it can stimulate bowel movements.  
• Medical and surgical procedures: Health care providers can also treat more complicated cases. The most common (and effective) method is called rubber band ligation, where a small elastic band is placed around the hemorrhoid, stopping blood from flowing to it and allowing it to heal. For more severe cases, surgeries to remove the hemorrhoid or staple it in place may be effective options.  

List adapted from Harvard Medical School 

Should you have anal sex while you have hemorrhoids? 

Ultimately, it’s safer to not have receptive anal sex while you have hemorrhoids. The contact and friction from sex could irritate or rupture the hemorrhoids, which can worsen and prolong your pain and lead to complications like infections. Small hemorrhoids often go away in less than a week, even without treatment—so instead of trying to reduce the pain from having sex with hemorrhoids, consider waiting for them to heal. In the meantime, if you’re hoping to remain sexually active, you might try switching things up by not being the receptive partner or by having oral sex or non-penetrative sex (sometimes called outercourse). 

If you do decide to have anal sex while you have hemorrhoids, consider:   

• Extra lube to decrease friction and reduce irritation of the hemorrhoids. 
• Using condoms as a barrier in case of a hemorrhoid bursting and to decrease the risk of STI transmission. 
• Taking it slow and communicating with your partner(s) about any pain or discomfort.  

If you’d like to find a treatment option that works for you, it may be useful to meet with a health care provider. It’s also recommended to visit a provider if you think a hemorrhoid has ruptured since this can lead to more severe complications. 

Hope this advice sits well with you!