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PSA: Bleeding After Anal Sex Is Not Normal

February 15, 2023 by Dr. Evan Goldstein

Whether it’s your first time trying it or you enjoy it regularly, anal sex can be a fun source of pleasure for you and your partner. You can spice it up with toys, stick to fingers, or enjoy penetration but if you don’t prepare right, you could bleed in places you don’t want to be bleeding in.

Anal bleeding after anal play isn’t necessarily uncommon, but we’d like to highlight that it is not normal to constantly bleed after anal sex. There’s a lot of delicate tissue in and around the anus, but your activities shouldn’t be causing bleeding every time. We dive into what is and isn’t normal about rectal bleeding post-anal play below!

Is Bleeding after Anal Sex Normal?

Bleeding after anal sex is a common occurrence. The walls of the anus can tear during anal intercourse, resulting in anal fissures that bleed and feel uncomfortable. However, we’d like to underline that while it may be common, it is not normal. You should not be bleeding after every anal engagement!

Most people will notice spots of blood every now and then, if they regularly have anal sex. However, it should only be a couple drops of light pink blood, or discomfort that lasts no longer than two days. Anything more severe should be discussed with a doctor.

Why Do I Bleed After Anal Sex? What Causes Bleeding?

Bleeding from anal sex is caused by tears in the walls of the anus. Tears could be caused by too much friction, the anal play could have been too rough, or fingernails could cause small cuts to the delicate skin if fingers were used. Hemorrhoids or anal fissures could also increase the likelihood of bleeding.

Some other causes of anal bleeding include:

  • Constipation
  • Enemas or improper douching
  • STIs, like herpes, gonorrhea, or chlamydia

Changing the Perception

I’m Dr. Evan Goldstein, proctologist and owner of Bespoke Surgical. In 2018, I stopped by the podcast GayTalk 2.0 for my regular appearance, during which we spoke about a double penetration blog post and the repercussions to boot. Nick Bussett, one of the hosts, confessed to 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.

What to Do if You’re Bleeding After Anal Sex

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. Don’t continue having anal sex until your body heals. Having anal intercourse while you have an anal fissure can increase your risk of infection or could lead to further damage.

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.

How Do You Prevent Anal Bleeding?

  • Increase your fiber intake to reduce constipation.
  • Don’t overdouche, or douche with tap water or enemas. Instead, opt for an isotonic and iso-osmolar solution, like Future Method.
  • Drink lots of water to stay hydrated.
  • Lube up! Always over-lubricate if you’re worried.
  • Avoid being rough during anal intercourse, unless you know your body’s limitations and consent to this type of play.
  • Trim fingernails to lessen chances of nail scratches.
  • Use smaller toys, or softer sex toys to help reduce pressure.
  • Take your time! Warm up your body and don’t rush anal intercourse.

When to See a Doctor for Rectal Bleeding

When should you see a doctor? We recommend going to see a doctor if you have the following symptoms:

  • Severe, prolonged pain from the anus
  • Severe abdominal cramping or pain
  • If the bleeding does not stop

If you match the symptoms above, 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!

How We Can Help

We’re an elite NYC anal surgery practice with a focus on encouraging sexual wellness. We believe that encouraging accurate information and conversation about intimate topics is vital to promoting overall health. If you’re concerned about bleeding after anal sex, get in touch with us today to make an appointment.

Follow us on Instagram for more information: Dr. Goldstein and Bespoke Surgical.

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About the Author

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.

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