butt talk
November 19, 2020 7:22 AM   Subscribe

I suspect I have internal hemorrhoids and I would like to see a doctor about it. But the reason why I suspect it is kind of... well... awkward, and I'm feeling anxious about making the appointment as a result. Can you walk me through this?

Ok. The reason why I think I have internal hemorrhoids is partly because as of late I occasionally see blood when I wipe after a bowel movement, and largely because... in the last few months, when I've had anal sex with my boyfriend, we have had to abort because suddenly there will be a LOT of bright red blood. Anal sex isn't uncomfortable for me, I have been partaking in butt play for well over a decade, we use plenty of lube and go slow upon start, and during the act I don't ever feel pain... which is why the blood has been disconcerting, because it always catches us by surprise. As I said, we always stop when the bleeding happens to be safe, but it definitely kills the mood when it happens which is a bummer (so to speak) and I'd prefer to be able to enjoy this fun sex act without having to stop to avoid a literal bloodbath. Casual googling suggests that the bleeding may be because my boyfriend's penis is irritating an internal hemorrhoid. Within 10 minutes of cessation of the act the bleeding stops.

Whatever this is, I want to see a doctor because bleeding from the butt is obviously not normal or okay. The thing is, I would feel super embarrassed to tell a colon/rectal doctor what is causing the bleeding, because anal sex is still sort of a taboo in heterosexual couples (I am a cis female). Am I overthinking it? Would this just go better if I seek a female doctor? Should I be looking for LGBTQ-friendly practices, even though I identify as straight, because they may encounter anal sex-related issues more frequently?

This whole thing is just so awkward. Help me.

posted by anonymous to Health & Fitness (14 answers total)

Medical professionals see A LOT and honestly this is one of the more tame things that could come up.

Would you feel more comfortable bringing it up to a gynecologist? If you have a Planned Parenthood nearby they would help you out without any judgement at all.

It could come up later, but really all you need to say is “I’ve been noticing blood when I wipe after vowel movements and I’m concerned about an internal hemorrhoid.”
posted by raccoon409 at 7:27 AM on November 19 [6 favorites]

You're overthinking it. It doesn't matter whether you see a GP or go right to a proctologist, you're not going to surprise or startle anyone by saying you've experienced bleeding during anal sex and you want it checked out.

I work in a clinic. Even the one doctor I work with who is openly religious and conservative has been frank with me before about how he wishes people could be more open and honest with him. So good on you for asking about this. Be honest about your concerns with your medical practitioners.
posted by late afternoon dreaming hotel at 7:29 AM on November 19 [13 favorites]

Checking for a hemorrhoid isn't difficult or expensive, so you don't need to give them a huge stack of evidence to justify it. Just saying "I'm seeing blood down there and I'm concerned" should be plenty.

You could mention sex, and it wouldn't go badly, because doctors Have Seen It. But if you're more comfortable not mentioning it, it's very unlikely that you'll need to to get the care you need.
posted by nebulawindphone at 7:31 AM on November 19 [5 favorites]

Unless you're in a conservative region, you're probably overthinking it. I chose my GP and urologist mostly based on convenience and availability and have never had a bit of negativity or stigma talking frankly about open relationships or sexual practices with them. One of my NB exes saw the same GP and had similarly good experiences with them,

But if you would feel more comfortable, finding someone that advertises in the local gay paper/web sites/sponsors pride events, etc., that will help decrease the chances of a negative interaction. While my recent experiences have been good, I've had doctors react negatively to me having long hair as a man and an ex had negative experiences with medical staff reacting poorly to the fact she didn't shave her legs. Being able to talk comfortably with your doctor is important, so take whatever steps you feel are necessary to do so.
posted by Candleman at 7:41 AM on November 19 [1 favorite]

Heterosexual anal intercourse (HAI) is not an uncommon behavior with 36% of women and 44% of men 25–44 years old in the United States reporting ever having HAI in their lifetime (1). There is evidence that the prevalence of HAI may be increasing in recent years, which may be due to a true increase in the behavior over time or heterosexuals becoming more comfortable reporting the behavior (2, 3).
Anal sex is common. Go ahead and tell your doctor. Normalize talking about sex and we'll all be better off for it.
posted by aniola at 7:57 AM on November 19 [6 favorites]

PCP checking in, this would not faze me in the least. I routinely ask patients if they have rectal bleeding during their annual. Regarding the receptive anal sex piece, it's something I talk about with my patients often, but if you are feeling especially uncomfortable, I agree with the suggestions that gynecologists or LGBTQ-friendly practices may help you feel more comfortable raising the question.
posted by telegraph at 8:04 AM on November 19 [11 favorites]

Back in the day medical students were often required to watch porn, sometimes many porn films at once, to get them over the idea that sex was embarrassing or weird. I'd be surprised if med schools were still doing this—seems like a minefield—but my point is that doctors' training considers and accounts for the fact that some patients will be doing MUCH weirder stuff in bed than you're doing, and that those people deserve dignity and care. (Though as always it's possible, even easy to run into a shitty doctor—in theory, though, they shouldn't even bat an eye at this.)
posted by babelfish at 8:06 AM on November 19 [1 favorite]

IANAD but my sister is a gastroenterologist in a private clinic "nice" city with a relatively easy patient population, and even for someone with a job setup as cushy as hers, judging from some of the (anonymized privacy-respecting) stories I've heard about her and her colleagues' work your issue could no be more vanilla.

A normal day for her involves dealing with people with serious mental health problems who shoved candles/lightning bulbs/flashlights up there every week, men who make repeated appointments demanding unnecessary procedures to try to involve her in their sexual fetishes and get belligerent when she declines, and so on. You'd fall comfortably within the unremarkable tier of patients I'm sure.
posted by shaademaan at 8:18 AM on November 19 [3 favorites]

You started it very clearly, no euphemisms, good detail, but not excessive detail. Your health care professional should respond in a straightforward manner. If not, the issue is with them not you. This is regular health care, should not get so much as a raised eyebrow.
posted by theora55 at 10:30 AM on November 19

Get it looked at right away. Gastroenterologist or colorectal surgeon, whoever can schedule a colonoscopy - or at least a proctosigmoidoscopy - asap. I will refrain from anecdotes based on years of practice but it is clear colorectal cancer is increasing in a younger demographic. ACS and other groups have noted this and have decreased the recommended ages for beginning screening (belatedly, imo, and not enough).
posted by sudogeek at 10:35 AM on November 19

i bet you a billion dollars a doctor who deals with butt issues also deals with butt sex issues. nbd.
posted by spikeleemajortomdickandharryconnickjrmints at 10:55 AM on November 19 [6 favorites]

You've done nothing wrong or shameful or embarrassing. However, we sometimes find ourselves embarrassed around such things, but that doesn't mean it's wrong. Repeat this to yourself as many times as necessary. Maybe practice saying this with your boyfriend if that makes you more comfortable.

Do you have any gay men friends? You could ask them for advice on doctors who are comfortable with these conversations. But if you have and like your primary care physician, then you can start there. You don't necessarily have to start with a specialist. But please do pursue this soon. You're doing the Dr. Google thing, and you need to see a regular doctor.
posted by bluedaisy at 11:29 AM on November 19 [1 favorite]

Also, if you don’t think you’ll be able to pull off the I’m-cool-with-this straight face, I’ve had success just naming my discomfort (assuming the doctor doesn’t seem like a total jerk). Something like, I feel a little embarrassed to mention this, even though I know there’s nothing actually wrong about it, but... etc. It’s also gives you a slower entry to a difficult subject and cues them in to be extra neutral or reassuring.
posted by sumiami at 12:29 PM on November 19 [4 favorites]

Yes we are supposed to be able to tell doctors these things, they have heard more shocking things from people, yada yada yada...


I've found when I bring up personal things in a matter of fact way, that doctors often have a moment of shock. Perhaps simply at a patient bringing up such things without embarrassment, but as a patient I don't like the air of disapproval it seems to project.

I've found that if I say"This is a little embarrassing to bring up" before launching into the straightforward not mincing any words thing, the medical provider has a moment to get into their "of course I am a professional who would never looked shocked at whatever this is mode" and it avoids this uncomfortable moment.
posted by yohko at 7:55 PM on November 19 [3 favorites]

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