Why Does My Ass Hurt After Sex?

The skin and tissue of the anus is thin, delicate, and prone to tears. These tears, known as anal fissures, can bleed—a lot.

If the pain is constant and throbbing, this may indicate an abscess in your anal canal or an untreated STI. Talk to your doctor right away.

Anal soreness can also be caused by irritation, sensitivity, or allergies to ingredients in lube and condoms. Try using different brands and adding a little extra lube.

1. Dry Penetration

Whether it’s the anus, rectum, or penis, penetration can hurt if you don’t have enough lube. If you’re allergic or sensitive to ingredients in lube, condoms, or toys, it can cause pain during and after sex as well as during anal penetration (Nguyen, 2021).

You may also feel an uncomfortable sensation when your partner has too-long of a penis during anal sex, causing friction that can create micro-tears on your anal wall (Little, 2021). This can lead to painful anal sex and lingering discomfort afterwards.

In addition to having more lube and changing positions, you can use butt plugs or sex toys to warm up the area before penetration (Little, 2021). It’s also important to communicate with your partner about what feels good and what doesn’t, so he or she knows to move slowly. This can help reduce pain from deep penetration. In some cases, sex therapy or pelvic floor exercises can also help.

2. Unrelaxed Muscles

When you need to move a part of your body, your brain sends a signal that causes those muscles to contract. After you’re done moving that part of your body, those muscles relax until the next time you need them to work. If your rectal muscles or pelvic floor muscles don’t relax properly, you can get pain in the anal canal that can last from a few minutes to 30 or more minutes. This is called muscle tension or rigor. It’s usually caused by a lack of fiber in your diet, constipation, hard stools or medications that tighten muscles, such as birth control pills.

3. Hemorrhoids

Hemorrhoids (also known as piles) are swollen blood vessels in the area around your anus and lower rectum. They often cause pain and itching, but they are not dangerous. About half of men and women will have hemorrhoids by the time they are 50.

Hemorrhoid symptoms are usually mild and go away on their own, but you may want to visit a doctor if they persist. This will help make sure your pain isn’t due to something more serious, such as a digestive tract problem like Crohn’s disease or ulcerative colitis.

A doctor can do several tests to check for hemorrhoids, including a digital rectal exam. During this, the doctor will put on gloves and inserts a lubricated finger inside your back passage to feel for any swollen blood vessels.

If you have hemorrhoids, you can try over-the-counter creams and ointments to ease the pain and itching. Witch hazel wipes (Tucks) also soothe pain and reduce swelling. You can also sit on a soft surface to decrease pressure on your anal area and prevent new hemorrhoids from forming.

4. Fissures

Fissures (splits) in the skin lining your back passage (your anal canal) are painful and sometimes cause bleeding. They usually develop towards the back of your anus, but can occur elsewhere.

Anal fissures may get better on their own, especially if you have a lot of fiber in your diet and don’t strain during bowel movements. However, they can also be treated with medicines. A calcium-channel blocker (for example, diltiazem cream) relaxes the muscles and improves blood flow to your bottom. You can get this from your GP or specialist colorectal surgeon.

Another option is surgery to release the pressure in your anal sphincter muscles. This is called a sphincterotomy and can be done as a day surgery. A doctor cuts a small cut into the sphincter muscle in your bottom, and this releases tension and helps your anal fissure heal. This is usually done after other treatments haven’t worked.

5. Infections

During anal sex, you put your pelvic organs in close quarters—the uterus, bladder, and prostate are all neighbors, like townhouses that sit on top of each other. If one of them gets infected it can hurt when sex is performed (especially if you use a dilator) or afterward. If you have a throbbing pain in your anal canal that lingers after penetration, it could be a sign of an abscess and needs to be checked out by a doctor right away.

A bacterial infection—yeast, a UTI or chlamydia—can also make penetrative sex painful and itchy. Treatment with oral meds usually fixes this issue, but a doc may also want to do some lab tests to check for infections in your penis and vagina.

Other things that might cause pain during and after sex include anal herpes, endometriosis (when tissue from the uterus moves outside the uterus), and cervical dyspareunia—pain when you go for a tit. A doc will diagnose these issues by asking you personal questions and examining you. STIs/STDs are diagnosed with urine and vaginal fluid samples and can be treated with antibiotic creams and pills.