Anal Pain After Intercourse: Causes and Remedies

After anal intercourse, how many days later might one experience anal pain?

Hello Doctor: I am a male.
Recently, I had anal intercourse for the first time without any issues.
However, during the second time a week later, my partner was a bit rough while penetrating, and I felt pain, so I asked him to stop.
Afterward, he used some saliva to make it wetter, and we were able to continue with anal intercourse.
After that, I experienced slight pain in my anus.
Now, two weeks later, I have developed sharp pain in my anus, especially when my sphincter contracts.
I also noticed some white discharge when I have a bowel movement.
I checked with a mirror and did not see any wounds or redness, but I feel some swelling at the end of the anus, and that is where the pain is concentrated.
Recently, I bought some ointment for anal fissures, but it doesn't seem to help much.
Now, I have to be careful with any sudden movements because if I exert myself suddenly, it causes sharp pain.
I would like to ask the doctor if internal ejaculation in the anus has any relation to my symptoms.
Thank you!

Y, 20~29 year old female. Ask Date: 2016/09/21

Dr. Ke Fangxu reply Surgery

Based on your description, it seems to be a typical symptom of anal fissure, which includes pain during bowel movements accompanied by slight bleeding.
If there is concurrent bleeding from hemorrhoids, the amount of blood may be greater.
It is recommended to take warm sitz baths to alleviate the symptoms, and topical ointments and suppositories can also be used for treatment.
If conservative treatment does not yield satisfactory results, surgical intervention may be considered.
This should not be related to internal ejaculation, but adequate lubrication is still essential.

Reply Date: 2016/09/21

More Info

Anal pain after intercourse, particularly following anal sex, can be a concerning and uncomfortable experience. It’s important to understand the potential causes of this pain and the appropriate remedies to alleviate it.

Causes of Anal Pain After Intercourse
1. Trauma or Injury: The most common cause of anal pain after anal intercourse is trauma to the anal region. This can occur if there is insufficient lubrication, excessive force, or if the anal sphincter is not relaxed. The rectum and anus are sensitive areas, and any rough handling can lead to micro-tears or bruising.

2. Anal Fissures: These are small tears in the lining of the anus, often caused by trauma during anal intercourse or passing hard stools. Symptoms include sharp pain during bowel movements and sometimes bleeding. The presence of white discharge, as you mentioned, could indicate irritation or inflammation in the area.

3. Hemorrhoids: Swollen veins in the rectal area can cause pain, especially after anal intercourse. They can be internal or external and may lead to discomfort, itching, and bleeding.

4. Infections: Bacterial or sexually transmitted infections (STIs) can also cause pain and discomfort in the anal area. Symptoms may include unusual discharge, itching, or swelling.

5. Proctitis: This is inflammation of the lining of the rectum, which can be caused by infections, inflammatory bowel disease, or sexually transmitted infections. Symptoms include pain, discharge, and sometimes bleeding.

6. Muscle Spasms: The anal sphincter can go into spasms, causing pain when it contracts. This can be triggered by anxiety, tension, or pain from previous trauma.

Remedies and Management
1. Rest and Avoidance: It’s crucial to give your body time to heal. Avoid any activities that may exacerbate the pain, including further anal intercourse until the pain subsides.

2. Warm Baths: Soaking in a warm bath can help relax the anal muscles and alleviate pain. This can also promote blood flow to the area, aiding in healing.

3. Over-the-Counter Pain Relief: Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation.

4. Topical Treatments: While you mentioned using a cream for anal fissures, ensure that it is appropriate for your symptoms. Some creams contain hydrocortisone to reduce inflammation, while others may contain lidocaine for pain relief.

5. Increase Lubrication: If you engage in anal intercourse again, ensure that adequate lubrication is used. Water-based or silicone-based lubricants can help reduce friction and prevent trauma.

6. Consult a Healthcare Provider: Given that you are experiencing persistent pain and discomfort, it is advisable to consult a healthcare professional. They can perform a thorough examination to rule out any serious conditions, such as fissures, hemorrhoids, or infections, and provide appropriate treatment.

7. Dietary Adjustments: To prevent constipation and hard stools, which can exacerbate anal pain, ensure you are consuming a high-fiber diet and staying hydrated.

Conclusion
Anal pain after intercourse can stem from various causes, including trauma, fissures, or infections. It is essential to listen to your body and seek medical advice if the pain persists or worsens. A healthcare provider can offer a proper diagnosis and treatment plan tailored to your specific situation. Remember, taking care of your anal health is crucial, especially after engaging in activities that can cause trauma to the area.

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