Your 9 Most Intimate Butthole Questions, Answered

Get your ass in gear.
Some things are reeeeally hard to talk about.
Getting to the bottom of anal sex or picking out fun toys for anal sex play are subjects that can get down-and-dirty, but the topics definitely have a playful je ne sais quoi that’s just not found when asking about, say, hemorrhoids, or wondering if you should bleach your butt.
Talking about your vag is way easier (think about how saying that your vagina is depressed just rolls off the tongue at morning coffee or brunch with a BFF) — but not so much with the back end.
Fortunately, Dr. Evan Goldstein, CEO and Founder of New York and Beverly Hills-based Bespoke Surgical, is here to answer your intimate butt questions. For starters, Goldstein recommends some basic heinie hygiene, such as showering at night and making sure to dry your butthole after bathing before you get in bed. Goldstein also suggests using a bidet (“good for your hole and the environment”) and eschewing wet wipes (“They f-cking suck because they get rid of the good bacteria and cause lots of localized irritation,” Goldstein explains candidly). In addition, Goldstein recommends gentle exfoliating soaps for cleaning, and reminds us all to “Wash your hands after you touch your or anyone’s ass!”
And now that we’ve got those booty basics out of the way, let’s get down to the nitty-gritty: a Q&A with Dr. Goldstein.
1. Why does it hurt when I poop?
“Clearly that’s not normal. Going to the bathroom should be as easy as pie. If there is pain involved, there is usually an underlying abnormality. The most common are anal tears (fissures) or dilated veins (hemorrhoids). These pesky f*ckers can for sure be the culprit and should be treated by a medical professional to recalibrate one’s defecation to normalcy. What’s the best way to make sure your poops are soft and easy? Lots of water and increasing one’s fiber intake, either through diet or supplements.”
2. Is bleeding after anal sex normal?
“No. Though clearly with anal engagement, significant pressures are enacted, which may indeed cause local trauma. That trauma can lead to anal tears (fissures) or irritated veins (hemorrhoids) that can easily cause bleeding. Another source can be from the use of enemas to clean before sex. These cause local trauma that can set the stage for significant compounding trauma while receiving the big ‘D’ — continued irritation and then finally bleeding. Improper angulation and aggressive thrusting may aggravate one’s insides, along with the improper use or complete lack of use of lubrication.
“Unlike the vagina, the ass does not naturally self-lubricate. The asshole is sensitive and needs appropriate education — whether that’s proper dilation before the big game, lots and lots of lube, or knowing which positions work best for you. It’s hard work, but the payoff is getting off without injury.”
3. What is an anal fissure?
“An anal fissure is a small tear in the lining of the anal canal. This tear, which may develop from passing hard stools and/or the trauma associated with anal intercourse, may be associated with pain, discharge, bleeding, or the development of a localized skin tag. If treated early most acute fissures can heal without any surgical intervention, but more with an appropriate bowel regimen as well as with the use of topical creams, suppositories, and refraining from intercourse.”
4. How can anal fissures be prevented/treated?
“Many anal fissures can become chronic and non-healing which will require surgical intervention. The constant tearing causes poor scar formation and/or skin tags in the region, which creates this up and down cycle of on and off local anal issues. You feel like it has healed and then either a strained bowel movement or an attempt at anal sex causes re-injury. This is totally a bummer and needs surgical debridement of the fissure with Botox injection into the muscle and skin lines to allow for relaxation. This, in turn, allows for appropriate scar formation, along with the mandatory post-operative local treatments and the use of at home anal dilators. All are key to the success of tough and pliable scar tissue that will not only allow normal defecation, but also accommodate whatever lies ahead. Open for business once again!”
5. What are hemorrhoids?
“Hemorrhoids result from increased pressure in the veins of the anus causing them to bulge and expand, leading to significant pain, swelling, and bleeding. The most common cause is constipation and straining during bowel movements, sitting for prolonged periods of time, and/or anal intercourse. Two different types of hemorrhoids can occur: external or internal.”
6. How can hemorrhoids be prevented/treated?
“More than 90% heal without surgery, and you will be given an appropriate bowel regimen and topical creams to provide relief as they heal. However, hemorrhoids that become chronic may require surgical treatment. There are several surgical approaches (in office and/or in the operating room) to hemorrhoids. Banding, cauterization, radiofrequency ablation or formal hemorrhoidectomy are some of the treatments. The multitude of options are sure to eradicate the different types of hemorrhoids that patients develop. First and foremost are form and function in terms of the goals of any procedure. Second comes the aesthetic piece. Taking all three into consideration is imperative, especially in the anal community. Understanding the principles as it relates to both defecation and anal engagement is paramount to the success of any undertaking. Make sure you are fully educated on your surgeon’s approach, as it will definitely impact any future anal engagement if they have limited experience in the specialty. Demand the sensitivities and the wherewithal of this specialty.”
7. How do I make sure my butt is “ready” for anal sex?
“Being ‘ready’ for anal sex can mean many different things to many different people. Now, pre-sex preparation is a must and it actually should start well in advance to accomplish one’s goals. Everyone thinks they can just shove it in and that’s far from the truth. Anal dilation is key and needs to be done a couple weeks before your anal debut. Anal trainer kits with water-based or toy-safe lubricants can allow for the appropriate relaxation of both the overlying skin and muscles. One needs to gradually work up from small to large toys and this can be done with consistent play two-to-three times a week for just three-to-five minutes in each session.
“Prior to the real deal, many people use enemas or bulb syringes to irrigate the anal canal and flush out any residual stool. Though this is irritating and can cause elevated STD transmission, many people still prepare this way. In reality, increasing one’s fiber intake to help bulk their stool and drinking more water will help facilitate full transit with little to no residual. Regardless of what we teach, most still practice some cleansing and the key is less is more. Less distension and less volume. Gentle irrigation if at all will suffice.
“Lastly, when you’re with your partner, the best way to start is by engaging in foreplay and using anal toys with tons of lube to really prime your orifice. Once one can insert a medium-size plug comfortably and everything is pre-lubricated, then and only then can one finally accept a dick and it should be while one is in complete control. We usually recommend sitting on the dick and maneuvering until comfortable and pleasurable. It takes times and practice. And the best bottoms bottom all the time to perfect the art.”
8. Should I douche my butt? Bleach it?
“See above. As for bleach — it’s totally up to you. I have definitely seen some amazing bleached asses. I do find it looks better in the lighter complexion of surrounding skin, as it blends much nicer. It needs to be subtle, but when done correctly, it can look super attractive. Clean, inviting, and ready for worshipping.”
9. Why do I always seem to be either constipated or running to the bathroom?
“Because we live in a f*cked up and stressful world! Many people are diagnosed with Irritable Bowel Syndrome (IBS), which is really just the constant back and forth of constipation and diarrhea. The best thing to do is to see a gastroenterologist for a full evaluation to make sure there’s nothing more serious going on. It’s super common, butt it’s still fucking annoying. Get evaluated.”
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