I recently received a couple of questions about anal sex, specifically concerning the impact of hemorrhoid treatment on anal play and how long a butt plug can be safely left in. I'll answer one question this week and one next week. Here is this week’s question:

I had some hemorrhoids rubber-banded about a week ago. How long should I wait to have anal sex?

Hemorrhoids are swollen, inflamed blood vessels at the end of the rectal canal. They are very common; almost half of all adults will experience hemorrhoids by age 50. The swollen blood vessels can be found externally (at the opening of the anus) or internally (inside the rectum) and can cause itching, bleeding, discomfort and pain.

Does this mean that people with hemorrhoids can't have anal sex? Not necessarily. In the case of the writer of this question, I would recommend consulting with your doctor, since you are receiving treatment for hemorrhoids, and the best person to advise you on when that treatment will be complete and when it's safe to resume normal activities would be the clinical care provider who is administering that treatment. Don't be shy about bringing up this topic with your doc; it's important that she or he know the full range of your sexual activities in order to be able to provide the best possible care for you. If your health care provider is judgmental or unwilling to discuss anal sex, it's probably time to look for a new one.

For folks who have mild or occasional hemorrhoids that do not necessarily require medical treatment, the regular rules of anal sex apply: Use lube, go slowly and listen to your body. Stop any activity that causes pain, discomfort or irritation. Using a position where you are lying on your stomach and have your butt slightly elevated may decrease swelling in the area during anal play. Lots of friction can be irritating, so you might want to use plugs or other forms of play that don't involve a lot of in-and-out or thrusting action. Go for smooth toys and condoms rather than ones that have ribs, bumps or other kinds of texture. Try a lube that contains aloe vera or other soothing ingredients (we like Aloe Cadabra, which is 95% organic aloe and has a thick, cushiony consistency).

On a side note, having anal sex does not cause hemorrhoids. Many people worry that anal play will cause some kind of permanent damage to the body, but this is not the case, as long as you use lube and common sense. Hemorrhoids are caused by increased pressure on the veins in the rectal area, such as bearing down for a bowel movement, lifting something heavy, pregnancy, or even standing for long periods of time.

Want Laura to answer your questions in SEXpress? Send them to laura@shepex.com. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.

Laura Anne Stuart has a master’s degree in public health and has worked as a sexuality educator for more than a decade. She owns the Tool Shed, an erotic boutique on Milwaukee’s East Side.