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Dear Dr. Joe: Can I Use the Backdoor with Hemorrhoids?

Thu, Feb 2, 2012

Advice, What's Up Doc?

photo via flickr

Every few weeks, Dr. Joe DeOrio, a urologist in Chicago, tackles questions about male sexuality here on EMandLO.com. To ask Dr. Joe your own question, click here.

Dear Dr. Joe,

Is it safe for me to enjoy receiving anal play if I have hemorrhoids?

– Backdoor Bob

Dear B.B.,

I guess the pertinent words here are “safe” and “enjoy.” If your definition of a safe and enjoyable sexual experience involves potential pain and bleeding, then we might be in business.

Okay, okay…maybe I’m exaggerating a bit, so let’s get into it. Surrounding the anal canal are plexuses of veins. In addition to performing the normal function of veins (returning blood to the heart), these plexuses may also contribute to fecal continence. A hemorrhoid is simply an abnormal dilation, or varicosity, of one of these veins. Since there are veins located both within the anal canal and at the level of the anus itself, one can develop both internal and external hemorrhoids.

Internal hemorrhoids are usually painless, and you might not even know that they are there. With irritation, however, they may bleed. Occasionally, they can prolapse, or stick out from the anus. Besides being a little unsightly, prolapsed hemorrhoids may become strangulated and lose their blood supply, which can be painful. External hemorrhoids, on the other hand, are often visible, appearing like a bulge at the anal verge. They are sometimes painful, they frequently itch or cause irritation, and they often bleed.

So what causes these little bundles of joy? Truth is, we don’t really know for sure. Hemorrhoids are associated with chronic constipation, occupations that involve prolonged sitting or standing, pregnancy, obesity, chronic diarrhea, and the abuse of laxatives — in essence, conditions that produce straining or increased intra-abdominal pressure or conditions that cause chronic irritation to the anal canal.

Does anal sex cause hemorrhoids? The jury is still out on that one. Undoubtedly, anal sex can increase anal pressure and cause some spasm. And it can also cause irritation, especially if you don’t use enough lubrication. Despite these facts, however, I suspect that anal sex, properly performed, will not result in hemorrhoids. In the presence of pre-existing hemorrhoids, however, anal sex can certainly irritate, inflame, or disrupt them, which can lead to pain, bleeding, and prolapse.

My recommendation? If you know you have hemorrhoids, treat them properly before attempting anal sex. Oftentimes, hemorrhoids will spontaneously resolve by increasing dietary fiber, maintaining good hydration, and moving about a bit during the workday. If that doesn’t do the trick, see a surgeon. There are a multitude of treatments that he or she can offer.

If you don’t know that you have hemorrhoids, if you are ignoring my advice and attempting anal sex anyway, or if you are just looking to prevent hemorrhoids, follow the common recommendations for healthy anal play: use plenty of lubrication, go slowly, and do not do anything painful. And don’t forget that the risk for acquiring STDs is higher with anal sex, so be safe.

– Dr. Joe

Dr. Joe earned his undergraduate degree in Molecular Biology from Princeton University. After attending the Loyola University Stritch School of Medicine, he completed his residency training in urological surgery at the Los Angeles County Medical Center. He lives and works in Chicago, IL. Keep an eye out for his upcoming blog at docjoe.net.

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6 Responses to “Dear Dr. Joe: Can I Use the Backdoor with Hemorrhoids?”

  1. Johnny Says:

    Ah jeez. I’ve never experienced a hemorrhoid, but my father described it as like squeezing a hot coal between your butt cheeks.

    I commend your dedication to butt play, Backdoor Bob. You’re a tougher man than me.

  2. Jose Antunes Says:

    Great article.
    There is a blog with good content about hemorrhoids. It is the address for those who want to know:


  3. anonymous Says:

    I have hemorrhoids after my second kid. Admittedly, anal play was never something I was very interested in myself, but if it had been important to a partner, I would have given it a try. But now? The idea of anyone coming anywhere near that area makes me want to run screaming from the room. And I even like a certain amount of pain. Just … not that … anything but that. Best of luck to the letter writer.

  4. Ihsomiet Says:

    I have often imagined that pegging would take the itch away.

  5. advisor Says:

    I have hemorrhoids and have had them for 6 years. I had anal sex for the first time a few weeks ago and it hurt like he’ll. We didn’t use lube or anything it was Kkind of like a oops wrong hole situation. My hemorrhoids took forever to heal. But we tried again this weekend with lube and it didn’t hurt nearly as bad.my hemorrhoids flared up for about 2 days but I’m fine now. So I guess it’s just a process and a matter of getting use to it. The more lube and the Hornier you are the better. Hope all ended well for you

  6. jemmy Says:

    i have hemorrhoids and i had anal sex yesterday. They are inflamed today but im hopeful that will not last. At 1st it was painful, but with plenty of lube, it was feeling really good and my partner was so happy, he has been begging me for weeks.

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