
In most cases, yes. Haemorrhoids are swollen cushions of tissue in and around the anus, and having them does not mean you must avoid intimacy. Vaginal and other sex that does not involve the anus does not make piles worse, and the condition is not contagious or passed on to a partner. What matters is comfort: if sex hurts, bleeds or leaves you worried about symptoms flaring, it is reasonable to adjust what you do, or to wait until the area has settled. This guide covers what to expect, how to look after yourself, and which symptoms are worth having examined.
External haemorrhoids sit under the sensitive skin around the anus, so pressure, friction or a tight position can feel sore, especially if they are swollen, itchy or recently inflamed. Internal haemorrhoids are usually painless, but a prolapsed haemorrhoid that has come down can feel like a lump and be tender when touched. Some people also feel self-conscious about itching, mucus or bleeding, and that worry alone can make intimacy harder. None of this is unusual, and it is worth talking to your partner openly about what feels comfortable.
Anal sex or anal play is the activity most likely to irritate haemorrhoids. Friction and pressure can cause pain, a small amount of bleeding, or a flare-up of swelling, and the lining of the anal canal is delicate. If you have active symptoms, it is sensible to avoid it until they have settled. If you do choose to have anal sex, go slowly, use plenty of water-based or silicone-based lubricant, and stop if there is pain or bleeding. Condoms also reduce the risk of infections that can cause similar symptoms. Pain that is sharp or tearing may be an anal fissure rather than piles; our guide to haemorrhoids or anal fissure explains how to tell them apart.
A little bright red blood on toilet paper or in the bowl after sex can come from irritated haemorrhoids, particularly after anal sex or straining afterwards. But blood can also come from a small tear, an infection, or from the vagina, so it is not always possible to know the source without an examination. Bleeding that is heavy, keeps happening, comes with pain or a change in bowel habit, or is the first time you have noticed it should be checked rather than assumed to be piles. Our articles on bleeding haemorrhoids and on when to see a doctor about haemorrhoids set out the warning signs.
A few simple steps can make intimacy easier. Choose positions that put less pressure on the area, and avoid anything that causes pain. Use a good lubricant if there is any friction. Empty your bowels beforehand if you can, without straining, and wash gently afterwards with warm water rather than rubbing; our hygiene article explains how to clean gently. A warm bath can ease soreness, and an ice pack wrapped in a cloth can help with swelling for short periods. Keep stools soft with fibre and fluid, as straining is one of the main triggers for flare-ups; see our guides on constipation and haemorrhoids and straining on the toilet.
Haemorrhoids are common in pregnancy because of hormonal changes, constipation and pressure from the growing baby, and they often appear or worsen after delivery. Sex is generally safe in a healthy pregnancy, but if piles are painful you may want to choose gentler positions and avoid anal contact. Many people find symptoms ease in the weeks after birth. Our guides to piles during pregnancy and haemorrhoids after childbirth cover this in more detail, and you should ask your midwife or GP if bleeding is heavy or pain is severe.
Sex itself is not a recognised cause of haemorrhoids. They develop mainly because of raised pressure in the veins of the lower rectum, often linked with straining, constipation, long periods sitting on the toilet, pregnancy, being overweight and age. Anal sex can irritate existing piles, and vigorous activity can cause a flare in someone who already has them, but it is not the underlying cause. If your piles keep coming back, our article on why haemorrhoids keep coming back looks at the common triggers.
Many people with piles feel embarrassed and avoid intimacy without explaining why, which can leave partners confused. A short, honest conversation helps: haemorrhoids are common, they are not caused by poor hygiene, and they are treatable. Agree on what feels comfortable, and pause anything that hurts. Treating the piles, rather than putting up with them, often makes the biggest difference to confidence and comfort.
See a GP or specialist if you have bleeding that is heavy, repeated or unexplained, pain that does not settle within a week or two, a lump you cannot explain, or any change in your usual bowel habit lasting more than a few weeks. Seek urgent help for heavy bleeding, fainting, severe worsening pain or fever with anal swelling. If you notice discharge, sores, warts or itching that do not fit with piles, it is also worth being examined, as some infections can cause similar symptoms. A proper examination, sometimes with a short proctoscopy, is the quickest way to know what is going on.
Mild haemorrhoids often respond to softer stools, more fibre and fluid, avoiding straining, and short-term use of creams recommended by a pharmacist. When symptoms keep returning, or are affecting intimacy and day-to-day life, there are in-clinic treatments for internal haemorrhoids that do not need a general anaesthetic. Our overview of non-surgical haemorrhoid treatments compares the main options, and our guide to haemorrhoid treatment costs in the UK sets out typical prices.
At our clinics in Glasgow and London we examine patients and treat internal haemorrhoids with eXroid electrotherapy, which applies a low-dose direct current to the base of the haemorrhoid so that it shrinks over the following weeks, without cutting or a general anaesthetic. Of 116 patients treated at our clinics since January 2025, 84% needed only one session, although individual results vary and some people need a follow-up. A consultation with examination is £365, consultation and treatment on the same visit is £1,095, and a follow-up treatment, if needed, is £795. If what we find is not something we treat, or needs a referral for further tests, we will say so and tell you who to see.
If piles are affecting your comfort or your relationship, you do not have to put up with it. Our severity test takes a couple of minutes and can help you think through your symptoms, although it is not a diagnosis. You can read about our procedure or book an appointment at our Glasgow or London clinic.
Haemorrhoid centre London
93 Wardour Street
London, W1F 0UD
Haemorrhoid centre Glasgow
1 Blythswood Square
Glasgow, G2 4AD
Haemorrhoid centre Edinburgh
53 Dundas Street
Edinburgh, EH3 6RS
Tel: 020 3910 1601
Email: info@haemorrhoidcentre.com