Here’s a question I got on Facebook:
Do you have a grasp of the research on the link between anal sex as a cause for hemorrhoids? Any chance you’ve encountered something like a metastudy?
Some sex educators and columnists claim there’s no link. And I see some medical sites do claim a link, but these same sites also use weirdly moralizing tones about anal sex (i.e. it’s not natural, not designed for sex, etc).
While there’s not much good research on the topic, here’s what I can tell you.
Hemorrhoids are like varicose veins, but instead of happening in the legs, they happen in the blood vessels in the anus. They can occur when the pelvic and anal muscles are too tight, which traps blood in the veins, so they bulge out, sort of like a bicycle innertube pushing out through a weak spot in the tire. There are different reasons people get them such as constipation causing them to squeeze extra hard when they have a bowel movement, the extra pressure on the pelvic floor during pregnancy, or long term stress making the pelvic muscles tighten for extended periods without relaxing (especially during prolonged sitting or driving). Unfortunately, a minor case of hemorrhoids can be uncomfortable, causing an itching or burning sensation. That feeling can, in turn, make the anus tighten further and create an ongoing cycle of discomfort and muscle tension.
Some folks wonder whether anal sex can cause hemorrhoids, but when it’s done correctly, anal sex can actually help you avoid them by helping the pelvic floor to relax. The trick is to never go further than your body is capable of enjoying because if you do, it’ll make the muscles tighten up. In fact, mild cases of hemorrhoids can be helped by gentle anal massage, in much the same way that any tight muscles can be encouraged to relax through massage. I’m talking about a finger, a slim buttplug, or perhaps one of the Aneros products. The goal is to be very slow, and very mild. It’s not about sexual stimulation as much as soft touch. Given the discomfort, you probably don’t want to have much anal play when you have a case of hemorrhoids, anyway. If you’re experiencing hemorrhoids, it can also help to slip on a glove and lubricate the anus a before bowel movement in order to reduce how much you need to squeeze. That’s especially beneficial if you’re having constipation or for pregnant women.
It is possible for anal sex to lead to hemorrhoids when it’s not done right. If, for example, you don’t use enough lubricant or if you go faster than your body prefers, you can end up irritating the sensitive anal tissues. That can cause the muscles to tighten up in response to the discomfort, which can lead to hemorrhoids. Anecdotally, I’ve heard of this happening when folks are drunk or stoned past the point of being able to pay attention to the signals during sex that would be telling them to add lube or slow down. The same thing can happen when the receiver doesn’t feel comfortable telling their partner what they need during anal sex. And if you have a minor case of hemorrhoids, anal play can irritate them and make them worse.
So the answer to your question is: sort of. Anal sex really does require a fair bit of know-how to do safely and pleasurably, just as lifting weights needs to be done correctly to avoid injury. That’s why we have a whole chapter devoted just to that in our book.
And yes, a lot of people do have some unfortunate anal-phobic attitudes. That doesn’t mean that they know what they’re talking about. After all, lifting weights isn’t all that “natural” either, but I’ve never heard anyone say that people shouldn’t do it on that account. So don’t let those attitudes get in your way. Listen to your body, follow the pleasure, and have fun!
If you have questions about any kind of sex or sexual health issue, drop me a note through our contact form, through my website, or through Facebook. I’m always happy to track down info and help you have the best sex you can!