Tales from the Tail — Can Anal Sex Help Relieve Hemorrhoids?

Dr. Evan Goldstein
5 min readApr 13, 2021


Client’s Tale.

I have a fucking grape on my asshole. Not literally, of course. But I do have a big piece of who-the-fuck-knows that recently appeared after some amazing bottoming (if I don’t say so myself). But before I go any deeper, let me frame the situation: my precious hole needs to be working 100% this weekend. My primary relationship (a long distance one with the man who provides for me), is flying in for some one-on-one time and good old-fashioned love making. I sure do miss our physical and mental connection.

Since we’re long distance, our open relationship allows us both to fuck other people and that’s how I got this pain in the ass of a hemorrhoid. What caused it? Well, the other day, I took a huge cock. We’re talking enormous. It was one of those cocks that was so wide and so long, with veins popping all over it. I wanted it inside me from the second I saw the pic on Scruff. Well, I got what I wanted. The sex was so hot. There was plenty of foreplay and I was so wet I would have made Cardi B proud, even before his throbbing cock was inside me. Believe it or not, I took my time. Why? Because even though I’m a seasoned bottom, I know that I can’t let my appetite get ahead of my body’s natural limitations. It was the ride of my life, until we both finished. While I was in the shower cleaning up — both inside and out — I noticed a swelling on the left side of my hole (on the outside). There was some noticeable tenderness, but shit — it looked awful.

I shot off a quick photo to my asshole surgeon, Dr. Evan Goldstein at Bespoke Surgical, and he set a plan of action in motion right away. At the time, he thought it could be one of two things: a clotted hemorrhoid, which was more likely, or the beginnings of an anal abscess. We started with steroid creams and local treatments to help aid the healing. But don’t forget — timing was of the essence since I only had one week until my regular, monthly visit. So, of course, my natural reaction and question was: when is it safe to bottom again after the development of an external hemorrhoid?

I’ll let Dr. Goldstein take care of the details, but I did manage to take my partner — multiple times — without any issues. It was an explosive weekend, that’s for sure. I still had a mild, pea-sized remnant of a hemorrhoid at the time, but sometimes you need to take one for the team, right?

My Discussion.

External thrombosed hemorrhoids are nasty fuckers, ranging from the size of a pea to larger than a grape. They are a result of elevated pressures that stem from things like shitting, anal play, and even exercising. These hemorrhoids or dilated veins engorge themselves with blood to help protect your sensitive ass when we exert such forces. Butt sometimes it goes a little too far, with large amounts of blood clotting that stretches the overlying skin. On the outside, it looks like a nodule and feels super round and hard, and comes with significant pain. Functionally, it can limit even basic activities, like going to the bathroom and working out, and of course bedroom activities like bottoming.

The good news is that most go away with conservative treatments like Epsom salt baths, stool softeners, nsaids, steroid creams, and time (sometimes 6–8 weeks). As mentioned above, this particular client, who I love dearly, didn’t have that kind of time. His hole had to be ready for a big undertaking and, unfortunately, it wasn’t fully healed by the time it needed to be used. However, as with any situation I’m faced with at my practice, we work with what we got (and never with any judgement or stigma).

As soon as I saw the pic of his ass (you won’t believe how often this happens), I initiated his treatment. We followed up with an in-office evaluation to make sure I wasn’t missing anything the picture didn’t reveal. I checked inside and out and I also did swabs to make sure there were no STDs present. The diagnosis was correct: a simple, clotted hemorrhoid. The only downside is that they do indeed take time to completely resorb or go away, time that this client didn’t have.

We discussed all options, knowing that taking a break from bottoming simply wasn’t going to work. A lot of people do ask me when they can start to engage sexually again after issues like these. Hence the reason for this particular blog post. Honestly, it has more to do with your symptoms. The key initially is to abstain from anything that can elevate pressures in the anal region — constipation or straining bathroom breaks, squats and/or deep leg and gluteal workouts, and, of course, bottoming. But once you’ve made it through that initial week or so and you feel up to the task, try going for a spin on your own with small toys to see if it aggregates the area or causes more symptoms. Be sure to go slow, use lots of lube, and continue the aforementioned management. If you are able to take the small stuff, gradually increase the size and girth. Sometimes bottoming for the real thing can actually break up the clot, which decreases pressures of the anal muscle and eventually improves the issue. Who knew?

And that’s exactly what we did here. I used my scope in the office to make sure there were no persisting symptoms and then this client used his anal dilating kit with my protocol. It all went off without a hitch, not only providing he and his partner the sexual satisfaction they both wanted, but also without aggravating the hemorrhoid even further. I’d like to point out that his rapid success story is more the exception than the norm. He was very lucky since I do see some clients persistently having the same fucking hemorrhoid flare up over and over again. If that happens, we just cut the fucker out.

Hemorrhoids are the veins of our existence and they will occur in all people at some point in their lives. With that said, understanding their functions, mechanisms of action, and treatment strategies are paramount. Check out our website for more information on hemorrhoids, including some preventative techniques that you can applied. And as we learned today, believe it or not, fucking can actually help make them go away. When you open your hole, you stretch the muscle in a controlled manner. This can decrease the pressures in your anus and minimize the activation and formation of hemorrhoids. Isn’t science fucking grand?

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