Is anal sex okay if I'm in remission from Crohn’s?

Dear to anal or not to anal,  

Crohn’s Disease, also referred to as Crohn’s, can be irritating, but anal sex doesn’t have to be! Most experts agree that anal sex is fine as long as you aren’t experiencing an active flare-up of Crohn’s Disease. However, there isn’t a lot of research on whether anal sex can cause a flare-up. Some people in remission from Crohn’s might also have fistulas, scarring, or rectal thickening that could make anal penetration more painful. Using enough lubricant and starting penetration with fingers or a small sex toy can help you keep the pain to a minimum. It also allows you to explore whether deeper penetration feels comfortable. Read on to get to the bottom of anal sex with Crohn’s Disease.  

Can anal sex cause a Crohn’s Disease flare-up?  

There isn’t enough research on whether anal sex can cause a flare-up of Crohn’s Disease. It’s generally recommended to avoid anal sex if you’re actively experiencing a flare-up. During flare-ups, people with Crohn’s Disease might experience anal bleeding, diarrhea, and stomach pain or cramping. This isn’t a recipe for comfortable, fun sex. All this to say, if you’re in remission, you’re likely in the clear for anal sex. 

How could Crohn’s Disease impact anal sex?  

Although people with Crohn’s Disease can have anal sex, there are some things you might want to keep in mind before diving into the deep end.  

People with Crohn’s can experience anal discomfort after eating certain foods, even when they’re in remission, which can worsen with irritation from douching or sex. Consider tracking what foods tend to cause you the most problems so you can avoid them in the days leading up to sex. If you’re planning to douche before sex, you might opt for a product that has the same pH as the anal canal, which can help prevent damage to the rectal skin.   

Additionally, people with Crohn’s are often prescribed medications that weaken the immune system, making it more difficult for the body to fight off infections. This can put you at greater risk for sexually transmitted infections (STIs), so you might consider using a condom even if you’re having sex with a committed partner.  

Some people in remission from Crohn’s might still have anal fistulas, which are small tunnels between the anal canal and the skin. Fistulas can make anal sex painful, since they impact the anal muscle’s ability to stretch. If you’ve had fistulas in the past, they might have caused scarring that can make the area feel dry or tight during sex. Using lube may help to reduce friction by minimizing this dryness. 

Speaking with a health care provider can help you better assess whether anal sex is possible, especially if you’ve ever had anal fistulas. Even though it may feel awkward to talk about your sexual practices, anal sex is common, and many health care providers—especially those who work on gastrointestinal disorders like Crohn’s—are experienced in treating patients who engage in it. 

How can you make anal sex more comfortable?  

Having anal sex for the first time can be uncomfortable for anyone, but you might face some extra challenges if Crohn’s Disease is joining you in the bedroom. Using enough lubricant and starting penetration with fingers or sex toys can help keep pain to a minimum. If you notice yourself worrying about your Crohn’s, discussing these anxieties with your partner might make it easier to relax during sex. Your anus muscles can tighten up from anxiety, which makes penetration more painful. If you find that penetration with a penis or larger sex toy is too painful, small anal beads or your partner’s tongue could provide gentler penetration to get things started.  

To anal or not to anal, that is the question! While Crohn’s flare ups may appear from time to time, it doesn’t mean your condition should hold you back from having anal sex. Having honest conversations with your partner and being in tune with what’s going on with your body may help you on your journey. Mild discomfort during anal sex with Crohn’s may occur. However, pain could be a sign of something more concerning so speak with a health care provider right away if this occurs.  

Bottoms up!