Haemorrhoids are a topic that is often not discussed, especially among men who have sex with men. It makes sense to know the most important facts about haemorrhoids and to protect yourself from discomfort through appropriate behaviour.
What are haemorrhoids ?
First, it is important to know that the blood-filled cavernous bodies are naturally present in every person. They have the task of sealing the rectum and, together with the sphincter muscle, ensure that it is properly closed. Contrary to popular belief, there is nothing pathological about haemorrhoids. This only changes when they become larger due to blood congestion and cause discomfort.
Anal sex does not cause haemorrhoids
There is a widespread opinion that the pathologically enlarged swellings are caused by anal sex, but this view is incorrect. Everyone has haemorrhoids. For this reason, men do not have to refrain from practising anal sex with a partner. In fact, massaging the anus during penetration can even prevent pathological changes in the haemorrhoids. However, anal sex must be performed in the correct way, i.e. using lubricant. Avoiding lubricant during anal sex, on the other hand, can favour the enlargement of haemorrhoids.
The assumption that haemorrhoids change pathologically due to a one-off irritation is also incorrect. The cause of haemorrhoidal complaints in the form of increased blood vessels can be, for example, a lack of exercise, chronic constipation or constant pressure on the pelvic floor.
Why haemorrhoids can become a problem during anal sex
During anal sex between men, the penis of the active partner penetrates the rectum of the passive sexual partner. As long as the haemorrhoids are only slightly enlarged and not palpable or visible (in the early stages), pain during anal sex is rare. Only severely enlarged haemorrhoids, some of which can also protrude outwards, make penetration difficult. If, at a more advanced stage, they can only be pushed back into the anus with a finger or not at all, anal sex is usually only possible with pain for the affected partner.
Since anal sex involves strong frictional forces, inflammation and even bleeding can occur. The mechanical pressure can cause the urethra to tear, which can lead to heavy bleeding. Where blood is involved, the risk of becoming infected with pathogens during anal sex also increases. That’s why you should always ensure you have as much protection as possible, for example by using condoms.
If you discover that you have haemorrhoids, you should have them treated or be careful when having anal sex. The more inflamed the haemorrhoids become, the more they can push outwards. Rubbing the skin in the buttock crease together can damage it and cause so-called anal eczema to form.
Avoid anal sex after treatment for haemorrhoids
Haemorrhoids complaints can be divided into four stages. From stage II, they are usually removed by means of a so-called rubber band ligation. This involves the treating doctor tying them off so that the tissue dies off. The remains are excreted with the stool. After such treatment, you should refrain from anal sex for at least three weeks, as there is an increased risk of arterial bleeding after the rubber band ligation. In the worst case scenario, this can end fatally, as only a doctor can stop such bleeding. You should also refrain from using anal sex toys for the first three weeks after rubber band ligation.
In addition to rubber band ligation, the Longo or Stapler method and the HAL procedure are also used. With the first method, the excess haemorrhoidal tissue is removed by incision. In the HAL procedure, the doctor stitches around the haemorrhoids and thus restricts the blood supply. This leads to a woundless reduction of the haemorrhoids.
If you can no longer push the haemorrhoids back into the anus, they must be surgically removed. The Milligan-Morgan or Parks procedure causes tissue wounds that take several weeks to heal, which is why you have to stay in hospital longer. Anal sex is prohibited until the wounds have healed, which can take four to six weeks depending on the surgical method. Sometimes the anal canal can narrow as a result of haemorrhoid surgery, which must be repaired before anal sex can be resumed. As a rule, anal intercourse should be possible again without pain after six weeks.
What you can do yourself if you have haemorrhoids
Depending on the type and severity of the haemorrhoidal symptoms, you can also do something yourself to alleviate the symptoms. Various ointments usually help to protect your anus or anal region. They not only have an anti-inflammatory effect, but are also able to promote wound healing.
Experts recommend ointments containing witch hazel, jojoba oil or beeswax, for example. You can use greasy ointments to protect the anal area from irritation and make it easier to go to the toilet. If acute discomfort/pain occurs, you should use pain-relieving preparations containing lidocaine, which are also available to buy over the counter in low doses.
If you need a stronger ointment due to severe pain, your doctor can also prescribe a haemorrhoid ointment with cortisone. This is only available on prescription. However, you should only use cortisone-containing ointment for a short time because it not only makes the skin thinner, but also weakens the defence against fungal infections and bacterial diseases in the area of application.
Proper nutrition can prevent haemorrhoids
In addition to too little exercise, constipation and connective tissue weaknesses, a low-fibre diet can also contribute to the development of haemorrhoids. Therefore, by eating a diet rich in fibre and drinking plenty of fluids, you can do something to prevent your haemorrhoids from becoming pathological and then literally getting in the way of your lovemaking. It is also a good idea to follow the advice of many doctors and not push too hard in the quiet place in order to achieve success. As the saying goes, good things take time, and this also applies to emptying your bowels when going to the toilet.
How to use ointment correctly
The use of haemorrhoid ointments is relatively simple. It is best to use it two or three times a day. It is applied to the anus and around the anal opening. To do this, put on a finger stick, apply a little ointment. Insert the finger into your anus and twist it a little. This allows the ointment to get to where it needs to go. To be effective, the ointment does not need to be used in large quantities. Even a small amount is enough for it to take effect.
Communicating with your partner
If you suffer from haemorrhoids, you should not take them lightly and communicate the problem to your partner. The pathological change can certainly be concealed for a certain period of time. But at the latest, when anal sex becomes a painful affair, you should be open with your partner and discuss with them how you can continue sexually until treatment is successful. Ultimately, it’s about your health, and you will find ways to compensate for the time without anal sex in other, exciting ways. As soon as the haemorrhoids are a thing of the past and your body has fully recovered from the treatment, the path to new adventures is literally clear again.
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