After anal intercourse in which you were the passive partner, do you feel a sharp pain during and after defecation? Then it could be that you have suffered a so-called anal fissure through penetration. This article explains what to do in this case and why you shouldn’t be too scared.
What is anal fissure
In medicine, an anal fissure is a longitudinal tear that forms at the junction between the very delicate skin of the anal canal (also called the anoderm) and the outer skin. In many cases, an anal fissure is a benign and curable condition. The majority of diagnosed anal fissures are on the midline, and 75-90% are on the side facing the stoma. Despite the midline position, the most severe pain is very often felt on the left side.
One of the most important symptoms of anal fissure is not only the sharp, burning pain during bowel movements, which for many sufferers feels like a shard of glass in the stool. In addition, there may be tiny, bright red traces of blood on the toilet paper or blood splashes in the toilet bowl. Itching, sneezing and secretion of mucus are also possible symptoms of an anal fissure.
A distinction must be made between acute and chronic anal fissure. Acute anal fissures usually heal completely on their own. However, it can develop into a chronic and then more complicated disease if it is not treated or is treated inadequately. A common cause of chronic anal fissure is that those affected delay going to the toilet for a long time out of fear of the pain.
Prolonged stool retention in the intestines leads to harder feces and more painful bowel movements, potentially causing further tears and reduced blood flow that hinder healing. Chronic anal fissures result in itching and discharge, with skin thickening and possible fistula formation requiring advanced treatment.
Possible causes
As already mentioned, anal intercourse (or the use of sex toys such as dildos or anal plugs) with very strong stretching of the anal canal can lead to anal fissures. However, excessive pressing during bowel movements, chronic constipation or diarrhoea or chronic inflammatory bowel diseases as well as pregnancy and childbirth can also lead to this type of injury.
In order to make a clear diagnosis, doctors first talk to the person affected, in which they describe their complaints in detail. During a subsequent physical examination, the outer anal area is carefully palpated. Here, mucosal lesions can be detected relatively easily. If there is any doubt, a so-called proctoscope (endoscopy of the rectum) can be performed. In this way, anal fissures can be distinguished from haemorrhoidal diseases and other diseases in the rectal area.
Treating anal fissure
Which treatment is indicated for an anal fissure is determined primarily by whether it is acute or chronic. This distinction is necessary because the two forms differ not only in terms of the duration of treatment and healing, but also in terms of the extent of the tissue changes that have occurred.
An acute anal fissure usually takes less time to heal than a chronic anal fissure. It usually heals in four to six weeks. This is due to the fact that in an acute anal fissure, the mucous membrane is more superficially injured. Such injuries can usually be treated well with conservative means such as ointments, seatbands or stool regulation. Surgery is not usually necessary. If you do not want any treatment for a diagnosed anal fissure, this is of course possible. In this case, however, you have to expect a longer period of time until healing. Which may restrict your sexual activities longer than is actually necessary.
In the case of a chronic anal fissure, the symptoms often persist for longer than six to eight weeks. Because the acute mucosal injury may develop into a deep ulcer, the wound edges may be scarred and/or the already known outpost fold may have formed. In this case, the treatment of chronic anal fissure also initially includes the classic conservative methods. However, if these prove ineffective, surgery is usually necessary.
Preventing an anal fissure
With regard to your sexual activities and practices, there are two main preventive measures you can take. First, a well-groomed and clean anal area is generally less at risk. With appropriate body care products for the intimate area, this particularly sensitive region can be kept soft and supple.
If you practice anal sex alone or with a partner, it makes sense to rub toys like dildos or plugs with plenty of lubricant before inserting them into the anus. Of course, the same applies to the anus itself. When having anal sex with a partner, make sure that the penis, the condom and the anus of the passive partner are made as slippery as possible with the help of lube. This reduces the frictional resistance.
Specially for sexually active men, good preparation and caution during anal intercourse is an effective way to prevent injuries such as anal fissures. Especially if you are about to have your first ever anal intercourse. It is good not to end it with such an injury. Preparation is half the battle, and being careful in the right place can ensure pain-free and risk-free pleasure.
The size of the penis or the sex toy used also plays a role in preventing anal fissures. One cause of anal fissures is the extreme stretching of the anal area. And the resulting tension on the mucous membrane. Therefore, it is definitely a good idea to train the anus, i.e. to stretch it slowly and get used to accepting larger penises or sex toys.
You can avoid an anal fissure or help it to heal by taking appropriate precautions. For example, eating a healthy diet and getting enough exercise are simple things you can do. There are many preventive measures that are easy to implement.
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