Is Bleeding Normal After Anal Sex?
Being a proud member of the anal sex fan club is fun for so many reasons. One is that I get to do things like investigate anal-sex-induced bleeding for you, dear reader. Trust me when I say I understand how alarming it can be.
As a queer woman who dates people of all gender identities, I love that anal pleasure is something most interested people can enjoy regardless of orientation, gender, or genitals. Anal also just feels really excellent for me. But nothing jolts me out of post-anal bliss like a little bit of butt bleeding.
For my own peace of mind and that of anyone else who’s experienced this (or is considering trying anal), I talked to experts to find out if bleeding after anal sex is ever okay. Overall, the answer is pretty reassuring.
Bleeding after anal sex can be normal.
“Blood from the anus after anal sex may occur,” Thomas P. Sokol, M.D., a colorectal surgeon at Cedars-Sinai in Los Angeles, tells SELF. This is due to the basic anatomy of the anus and rectum. (Once you insert something past your anus, it makes itself at home in your rectum, the final portion of your large intestine.)
The lining of the anus and rectum are very thin, according to the CDC. This lining can tear easily under pressure, like the kind that happens during anal penetration or when you strain to poop. These tears, known as anal fissures, can cause bright red blood, pain, and even visible cracks in the skin around your anus, according to the Mayo Clinic.
Beyond that, it’s important to remember that unlike the vagina, the anus isn’t self-lubricating. Without sufficient lubrication—which might be a lot more than you’d imagine—those fragile tissues are even more prone to tearing and bleeding.
Anal penetration can also irritate hemorrhoids you may not even realize you have, Dr. Sokol says. Hemorrhoids are essentially cushions of blood vessels inside and outside of your anus, according to the Mayo Clinic. They typically arise due to increased pressure on the lower rectum, which can happen for a variety of reasons. Take pregnancy, for example. The weight gain can add stress to that portion of your body. Hormone fluctuations in pregnancy can also make it feel nearly impossible to poop, which can lead to bearing down, which can then lead to hemorrhoids. Interestingly, the Mayo Clinic points out that anal sex can create enough pressure to cause hemorrhoids, too.
You might think you’d definitely know if you had a hemorrhoid, but sometimes they don’t cause symptoms until something irritates them...like a dildo/finger/penis/whatever (safe) object you put into your butt. Since hemorrhoids are piles of blood vessels, bright red blood is a common sign of this issue. You might also experience pain, itching and irritation, and anal swelling, according to the Mayo Clinic.
Just because bleeding can happen during anal doesn’t mean you can’t try to prevent it.
One way to do this is by trying some anal play on your own time, without a partner. “It’s really important to know your body,” Kelly Wise, Ph.D., an LGBTQ-friendly sex therapist based in New York City, tells SELF. To put it simply, understanding what your anus can handle may prevent you from going too big too soon with a partner or not using enough lube. Both of these are common reasons for anal tears and discomfort.
If you have no idea where to begin, here are a few suggestions. Overall, the goal is to do what feels good, comfortable, and exciting for you. This is a general guide for experimenting with anal, not a hard-and-fast sequence of steps to which you must adhere. The only exception is the hygiene-related advice, which you should definitely follow to stay as safe and sanitary as possible.
First, wash your hands thoroughly before playing around with your butt. Let’s avoid any jalapeño/genital interactions or similar mishaps, people. Be sure to wash your hands before switching from anal play to touching your vulva or vagina, too. That will help you avoid the transfer of bacteria that can cause an infection like a UTI or bacterial vaginosis.
Since we’re on the subject of your hands, make sure your nails aren’t dangerously sharp or jagged, either of which could land you in anal-fissure territory. Take a quick second to file ‘em down if necessary.
After washing your hands, Wise recommends starting by gently touching your anus and the surrounding area to get used to the sensation. Once that feels good and comfortable and you’re ready for more, try inserting an extremely lubed up pinky finger into your anus, bit by bit.
There’s basically no such thing as too much lube when it comes to anal play, especially when you’re first giving it a go. Silicone lubes are often great for anal penetration as they tend to last a long time. However, if you’re using a silicone toy, opt for a water-based lube, as silicone can degrade silicone. (We’ll discuss the right type of lube to use during anal play with a partner in a bit.)
If you like the sensation of a pinky finger and are curious about exploring further, you can try inserting another (similarly lubed up) finger, then another if that’s something you want to try. But remember that this progression doesn’t all need to happen on the same day—or ever, even. You don’t need to force yourself past your limits for any reason. Your anus has a ton of nerve endings, so if you feel pain, that’s your body sending you a message that you either might want to prepare more before pushing forward, or you might want to stop altogether.
If you’ve experimented with a few fingers and would like to try something bigger, butt plugs are a great next step. Always make sure any plug you use has a flared base to keep it from slipping inside your body. If you’re looking for a beginner butt plug, here’s a handy list.
To avoid bleeding during partnered anal, go slowly, gently, and with a ton of lube.
If you’re comfortable with your fingers and butt plugs, you might be ready to move onto penetration with a partner. This should be someone you trust enough to listen to every single direction you give them when it comes to making anal a pleasant and safe experience for you. It’s perfectly OK to request that they go half-centimeter by half-centimeter, pause after each movement so you have a chance to breathe, or just stay still so you can get used to the sensation. Whatever you need is fine.
Just like when you play around with anal on your own, you need to prepare your butt when you’re with a partner. Your anus simply cannot go from zero to 60 without time to warm up. That progression might look different with a partner than it does on your own. But whatever you landed on by yourself can give you a good working knowledge of what your body needs to feel ready.
Of course, we also need to talk about safety with a partner. Since the anus and rectum can be prone to tearing, unprotected receptive anal sex makes it easier to contract sexually transmitted infections such as HIV, the CDC explains. Unless you are in a fluid-bonded relationship (meaning you are choosing to forego protection because you’ve both been tested recently and know one another’s STI status), you should practice safe sex. If your partner has a penis, that means using an external condom when they penetrate you anally (or vaginally, for that matter).
You should also use a condom on a sex toy going inside your anus if your partner intends to use it as well or if there’s a chance it might touch your vulva or vagina. Be sure to change the condom before sharing it or putting it anywhere besides your anus.
Finally, when it comes to matters of slickness, never use an oil-based lube with latex condoms (or dental dams). The oil can break down the latex and render your safe-sex method less effective.
When should you see a doctor if you're bleeding after anal sex?
Sometimes even the best preparation in the world won’t stop a little anal bleeding. I know this firsthand. It’s just how my body reacts to anal sex sometimes, regardless of how much groundwork I lay in advance.
If you only see a few small splotches of bright red blood and you aren’t in a ton of pain or discomfort, you may be dealing with something like a small tear or hemorrhoid, Dr. Sokol says. These can both heal on their own, and you can try at-home methods to reduce discomfort, like soaking in warm baths, applying cold compresses to the area, and taking measures to prevent constipation that can exacerbate hemorrhoids and fissures. But if the bleeding and pain persist for even a couple of days, you should definitely see a doctor for evaluation. That could indicate a more severe issue.
It’s possible to get a serious anal tear due to anal sex, Dr. Sokol says, though it’s much less likely if you follow all the steps above. “This is easily diagnosed by a colorectal surgeon or a gastroenterologist,” Dr. Sokol says.
Treatment for severe anal fissures typically involves topical anesthetics to dull the pain, medications to increase blood flow to the area for speedier healing, and more, according to the Mayo Clinic. “If conservative measures do not heal a fissure, then surgery may need to be performed,” Dr. Sokol says. Again, this is incredibly rare, especially if you walk through anal preparation steps like taking it really slowly and using so much lube you’re practically swimming in it. This is one of those times when an ounce of (lubed up) prevention is absolutely worth a pound of cure.
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