PSA: Bleeding After Anal Sex Is Not Normal

Is Bleeding after Anal Sex Normal?

There is nothing normal about bleeding with anal intercourse. While it may be common, it is not normal.

Last night, I stopped by the podcast GayTalk 2.0 for my regular appearance, during which we spoke of last week’s double penetration blog post and the repercussions to boot. Nick Bussett, one of the hosts, confessed of regular bleeding during anal play and it made me realize that many of us are either in denial of a potential problem or has simply accepted this as normal. So, I will say again, no, anal intercourse should not involve any sort of rectal bleeding — whether pink or bright red.

That said, yes, there can be the one-off spot of blood from the trauma of douching or anal penetration since rectal tissue is more sensitive, but it should not be something that happens frequently. Hemorrhoids or anal fissures could also increase the likelihood of bleeding.  If bleeding does ensue, the first and most important thing is to not freak out — it can totally happen as it is a common occurrence in our anal community. Start with some over the counter remedies — stool softeners and a suppository (Calmol-4), take Epsom salt baths and, obviously, abstain from anal intercourse. Things should improve over the next couple of days. If so, then ease back into bottoming again by starting with an anal dilator or butt plug as a test, making sure your ass is ready for full engagement.

When to See a Doctor for Rectal Bleeding

The other scenario is if the bleeding hasn’t stopped from the initial injury, then please go see a doctor. And by “doctor”, I don’t mean just any doctor, but rather, one who has the wherewithal to understand our community and the needs that surround it. Early intervention can set the stage for complete eradication. The longer one waits, the higher the probability that the acute issue enters the chronic phase, with its chronicity requiring a more detailed surgical intervention. Some of the issues surrounding bleeding can be from dilated veins (hemorrhoids), anal tears (fissures), anal warts (condylomata), or from the over use of douching for sex preparation. I see it over and over again that when we correct the issue at hand, the client usually states, “I should have done this weeks or months or years ago!”

Prevention is key, along with understanding the art of bottoming — all paramount to its success. Complete annual evaluations are warranted and if issues arise, immediate consultation improves the outcomes. No shame, just solutions. Bottom on!

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About Dr. Evan Goldstein

Dr. Evan Goldstein is the Founder and CEO of Bespoke Surgical. Dr. Goldstein has extensive experience educating and shedding light on health care issues relating to the gay community, and has been published in several national publications including The Advocate, OUT Magazine, Vice, Refinery 29, NY Mag and more.