Moment: Can Fiber Improve Your Sex Life? The Science, Explained!

Summary

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Podcast Summary: "Can Fiber Improve Your Sex Life? The Science, Explained!"

Rena Malik, MD Podcast (November 12, 2025)
Host: Dr. Rena Malik | Guest: Dr. Will Bulshowitz (Gastroenterologist)

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Episode Overview

In this science-driven conversation, Dr. Rena Malik, a urologist and sexual health expert, sits down with gastroenterologist Dr. Will Bulshowitz to unpack the surprising links between gut health—especially fiber intake—and sexual function. The duo addresses questions many are too embarrassed to ask, using the latest evidence to explore gut health’s relationship to sexual vitality, hormonal balance, pelvic and anal health, and more. The episode is packed with practical tips, memorable analogies, and actionable advice for optimizing sexual health through better gut care.

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Key Discussion Points

1. How Gut Health Impacts Sexual Function

[01:04 - 03:05]

• Connections to Erectile Dysfunction:
  Dr. Bulshowitz highlights major risk factors for erectile dysfunction: hypertension, hyperlipidemia, and diabetes—all tied to poor metabolic health, which in turn is shaped by gut health.
  • "There's clear cut evidence that gut health plays a role… fiber has been shown to address in randomized controlled trials blood pressure and lipids and blood sugar control." ([01:13], Dr. Bulshowitz)
• Inflammation:
  Chronic inflammation affects blood flow and is a key player in erectile dysfunction. The gut regulates bodily inflammation as 70% of the immune system resides there, influencing the release of inflammatory cytokines.
• COVID-19 Changes:
  Dr. Malik observes more erectile dysfunction since the pandemic, linked to sedentary lifestyles and inflammation after infection.
  • "People are sitting more, they're getting high toned pelvic floor which is then affecting blood flow to the penis..." ([02:29], Dr. Malik)
  • "It's one of the manifestations that can occur, and they, too, typically will also manifest gut symptoms at the same time." ([02:58], Dr. Bulshowitz)

2. Psychological & Neural Pathways

[03:05 - 03:59]

• Stress, anxiety, and the balance between the sympathetic and parasympathetic nervous systems influence sexual function. Good gut health may support a healthier mental state and, by extension, sexual performance.
  • "Through the brain-gut connection, there are ways in which the gut does play a role in affecting our mood." ([03:43], Dr. Bulshowitz)
  • "In order to activate blood flow to the genitals, we need to activate the parasympathetic nervous system." ([03:29], Dr. Bulshowitz)

3. Gut Microbes, Hormones & Sexual Health

[04:06 - 05:38]

• Microbiome and Hormones:
  Certain gut microbes are linked to sex hormone production (e.g., “estrobolome” in women, Clostridium sindens in men and testosterone).
  • "There are microbes that have been found to be associated with the production and activation of testosterone." ([04:35], Dr. Bulshowitz)
• Diversity and Erectile Dysfunction:
  Men with erectile dysfunction tend to have lower gut microbiome diversity.
• Rising Tide Analogy:
  "When we elevate our health, we're rising the tide on many different aspects. And that can include sexual health." ([05:20], Dr. Bulshowitz)

4. Supplements, Minerals & Realistic Expectations

[05:39 - 07:28]

• Recommendations for boosting testosterone (e.g., zinc, magnesium, boron) are popular but lack robust scientific backing unless a deficiency is demonstrated.
  • "If you have a deficiency in zinc, magnesium, or boron? Yes...If you don't, then probably not." ([07:17], Dr. Malik)
• Testing levels and tracking how you feel is key.

5. The Impact of Alcohol and Marijuana on Gut & Sexual Health

[07:40 - 11:36]

• Alcohol:
  Can damage the gut barrier; even small amounts may hurt the microbiome and disrupt REM sleep.
  • "If you drink to the point of having a hangover, you have caused harm and damage to your gut microbiome." ([07:56], Dr. Bulshowitz)
  • "REM sleep is clearly disturbed by even one drink." ([10:04], Dr. Bulshowitz)
• Marijuana:
  Chronic use may shrink brain size and, in GI medicine, is linked to cannabinoid hyperemesis syndrome (severe nausea/vomiting relieved by hot showers).
  • "The chronic use of marijuana can ultimately lead to the development of chronic nausea and vomiting, sometimes called cyclic vomiting syndrome." ([11:03], Dr. Bulshowitz)

6. Toilet Habits, Pelvic Floor & Hemorrhoids

[11:38 - 13:19]

• Risks of Sitting Too Long:
  Prolonged toilet time can cause the venous beds (hemorrhoids) to swell, increasing disorder risk.
  • "By the age of 50, about 50% of people have these issues." ([12:22], Dr. Bulshowitz)
• Five minutes is the advised maximum—phone use in the bathroom is discouraged.
  • "Don't force it...don't sit with your phone...ideally five minutes, certainly less than 10 minutes." ([12:28], Dr. Bulshowitz)

7. Hygiene: Bidet, Toilet Paper, and Overwashing

[13:19 - 14:44]

• Bidet vs. Wipes:
  Bidets are superior; wipes can dry and irritate delicate tissues, leading to itching (pruritus ani).
  • "I'm 100% team bidet... it's also... a great way to clean the bottom." ([13:23, 13:35], Dr. Bulshowitz)
  • "That's actually the number one cause of pruritus ani, which is anal itching." ([13:40], Dr. Bulshowitz)
• Parallels drawn between over-washing in the rectal and vulvar areas leading to irritation.

8. Anal Sex: Safety, Preparation, and Recovery

[14:44 - 17:54]

• Preparation and Caution:
  Open communication, gradual progression, and proper lubrication are crucial.
  • "It's really important to...ease into it...work through what could be a period of time where it's foreplay...using toys and starting small." ([15:18], Dr. Bulshowitz)
  • "Like in the same way that we develop a callus on our feet...it sort of helps that skin to get a little bit tougher prior to moving forward with anything." ([15:55], Dr. Bulshowitz)
• Use of fiber and stool softeners for recovery from minor injuries or bleeding (Colace, magnesium citrate/sulfate/oxide recommended).
• Avoid wipes post-anal sex; use water, rest, and dietary fiber to promote healing.

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Notable Quotes & Memorable Moments

• On fiber’s role:

  • "When we heal our gut, one of the benefits that we receive is improved metabolic health." ([01:37], Dr. Bulshowitz)

• On pandemic effects:

  • "People are sitting more...getting high toned pelvic floor which is then affecting blood flow to the penis." ([02:29], Dr. Malik)

• On microbiome diversity:

  • "We would discover that on average, those men [with ED] have less gut diversity compared to healthy men." ([04:43], Dr. Bulshowitz)

• On bidet advocacy:

  • "I'm 100% team bidet...I think it's one of the best things you can spend your money on, honestly." ([13:23], Dr. Bulshowitz)

• Fun Med School Mnemonic:

  • "So remember point and shoot in med school? Parasympathetic to get the erection. Sympathetic to have the ejaculation." ([03:33], Dr. Malik)

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Timestamps for Key Segments

• Gut health, metabolism, and sexual function: [01:04 - 03:05]
• Inflammation and erectile dysfunction: [01:37 - 03:05]
• COVID-19 and lifestyle change impacts: [02:29 - 02:58]
• Psychological & neural pathways: [03:05 - 03:59]
• Gut microbes, hormones, and diversity: [04:06 - 05:38]
• Supplements & individualized advice: [05:39 - 07:28]
• Alcohol & marijuana effects: [07:40 - 11:36]
• Toilet habits & hemorrhoids: [11:38 - 13:19]
• Bidet vs. wipes for anal health: [13:19 - 14:44]
• Anal sex tips & tissue care: [14:44 - 17:54]

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Key Takeaways

• Your gut is deeply linked to metabolic and sexual health: A healthy, diverse microbiome not only supports digestive health but helps regulate hormones and inflammation affecting sexual function.
• Pandemic-induced sedentary habits can worsen sexual function: Movement matters!
• Fiber, sleep, and minimal alcohol are foundational for gut and sexual health.
• Good hygiene means gentle washing and bidets—not wipes.
• Anal sex is safest with communication, slow progression, lubricant, and aftercare (fiber, stool softeners).

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This episode is a must-listen for anyone curious about the practical interplay between diet, gut care, and sexual wellness. Dr. Malik and Dr. Bulshowitz’s science-backed tips and open, humorous dialogue make complex health topics accessible and actionable.

Transcript

[Podcast Host]

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[Reena (Sexual Health Expert)]

Style, every home how does Gut health Impact Sexual Function?

[Dr. Will Bulshowitz (Gastroenterologist)]

All right, let's do this.

[Reena (Sexual Health Expert)]

Do it.

[Dr. Will Bulshowitz (Gastroenterologist)]

So I might need your help on some things here, Reena, because you're the expert on sexual function. And let's start with this. There are risk factors for erectile dysfunction, hypertension, hyperlipidemia, diabetes, every single one of those things. There's clear cut evidence that gut health plays a role. Clear cut evidence. And by the way, fiber has been shown to address in randomized controlled trials, blood pressure and lipids and blood sugar control. So that is one of the opportunities that we have, is that the gut is connected to our metabolism. Hypertension, hyperlipidemia and diabetes or lack of blood sugar control are all indicative of a metabolism that's out of balance and needs to be healed. When we heal our gut, one of the benefits that we receive is improved metabolic health. Number two, one of the things that's quite strongly connected to erectile dysfunction is inflammation. And inflammation can affect blood flow. That's interesting because the gut is clearly connected to inflammation. 70% of the immune system is actually resident in the gut. And when that immune system that's resident in the gut gets activated, it releases cytokines. Those cytokines activate inflammation throughout the entire body. And there's pretty clear evidence that inflammation is connected to erectile dysfunction. Out of curiosity, since the pandemic started, have you noticed an increase in erectile dysfunction?

[Reena (Sexual Health Expert)]

I have, yes. But the reason being is people are sitting more, they're getting high toned pelvic floor which is then affecting blood flow to the penis so that's one of the big reasons I've been seeing after Covid. Because now people are working from home. Before, they were at least walking to the car and walking around their office, and now they're just sitting at home.

[Dr. Will Bulshowitz (Gastroenterologist)]

Gotta get up, move around.

[Reena (Sexual Health Expert)]

Yeah, so that was one. But yes. I mean, certainly people who had Covid, who got inflammation, also had, like, long Covid. Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

Had.

[Reena (Sexual Health Expert)]

Had erectile dysfunction afterwards.

[Dr. Will Bulshowitz (Gastroenterologist)]

Exactly. It's one of the manifestations that can occur, and they, too, typically will also manifest gut symptoms at the same time.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

So showing the connections in real time that exist between these things, there are some people where anxiety and stress play a role in erectile function. And it goes back to what you and I were discussing earlier with the autonomic nervous, this balance that exists between sympathetic and parasympathetic. And in order to activate blood flow to the genitals, we need to activate the parasympathetic nervous system.

[Reena (Sexual Health Expert)]

So remember point and shoot in med school? Exactly. Parasympathetic to get the erection.

[Dr. Will Bulshowitz (Gastroenterologist)]

Oh, man, you're kicking me back to 2003 right now.

[Reena (Sexual Health Expert)]

Sympathetic to have the ejaculation. Yeah, yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

Sympathetic for the ejaculation and anxiety in general. Right. Where, as we discussed earlier through the brain gut connection, there are ways in which the gut does play a role in affecting our mood. I am not, by the way, claiming that this is the only thing. Right. There's other aspects.

[Reena (Sexual Health Expert)]

Sure.

[Dr. Will Bulshowitz (Gastroenterologist)]

But I do believe that this is part of the story of how we can actually improve our health and address those issues.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

Right. So we've talked about metabolism and metabolic risk factors. We've talked about inflammation, and we've talked about. From a psychological perspective. Now let's focus on the gut microbes themselves. Of course, testosterone plays a role in the ability to get a vigorous erection in women. There's specific microbes associated with female sex hormones. And we actually have a word for it, which is the estrobolome. I'm not aware that there's been a word for men's microbiome. Whatever. We could come up with something for that.

[Reena (Sexual Health Expert)]

Sure.

[Dr. Will Bulshowitz (Gastroenterologist)]

But there are microbes that have been found to be associated with the production and activation of testosterone.

[Reena (Sexual Health Expert)]

Mm.

[Dr. Will Bulshowitz (Gastroenterologist)]

Specifically, there's one called Clostridium sindens that's been associated. And if we take a look, like if you took a group of a hundred men who have erectile dysfunction, and you ask the question, what's happening in their gut? Right. What's up with their gut microbiome? If we tested them, we Would discover that on average, those men have less gut diversity compared to healthy men that do not have erectile dysfunction issues. There do seem to be these opportunities. I don't want to sit here and make the claim or make it seem like this is a direct the microbes and erections. Right. But I think that the way that in general the body works is that we can elevate our health. And when we elevate our health, we're rising the tide on many different aspects. And that can include sexual health, sexual.

[Reena (Sexual Health Expert)]

Function, and potentially hormonal health. You would say too. Do you think there's.

[Dr. Will Bulshowitz (Gastroenterologist)]

Yeah, definitely.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

I've been thinking about this. So one of the topics that I think a lot of men want to know is what do I take to elevate my testosterone levels? So. And I've seen you tell me what supplements you would recommend. But like, what I've seen is recommendations are things like, for example, zinc. Okay, that's interesting. Zinc definitely repairs the gut barrier.

[Reena (Sexual Health Expert)]

Zinc has a lot of actions on the body, right? Multiple actions.

[Dr. Will Bulshowitz (Gastroenterologist)]

Yes.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

So again, like these things, it's hard to prove that it's exactly this.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

But when you repair. I know for a fact that zinc repairs and restores the gut barrier. When I was at Northwestern for my internal medicine residency, we would treat people admitted to the hospital with hepatic encephalopathy. We would treat them with two things, zinc and antibiotics. And I didn't realize until many years later when I started really studying the gut microbiome, Both of those things that we were doing were actually helping to prepare and restore a healthier gut microbiome, which was preventing them from having this hepatic encephalopathy. So like that. That condition is a gut mediated thing. So zinc is an example of one heard people talk about antioxidants like quercetin. Quercetin is also clearly beneficial to the gut. And gut microbiome, it's a polyphenol and it's prebiotic.

[Podcast Host]

So what I would say that the.

[Reena (Sexual Health Expert)]

Data is not super strong, but if you're talking about minerals, it would be like zinc, magnesium, and boron. If you're talking about other supplements, there are some, like Tongkat Ali and there are a handful. The data's not like super strong.

[Dr. Will Bulshowitz (Gastroenterologist)]

Yeah. And Takadavi, I don't know enough about to say what the effects are on the gut microbiome. I haven't seen a study on that.

[Reena (Sexual Health Expert)]

But I would say that none of the supplements have robust data. And it's very individualized. If you have a deficiency in zinc, magnesium, or boron? Yes, I think it would be helpful. If you don't, then probably not.

[Dr. Will Bulshowitz (Gastroenterologist)]

Testing can be really helpful, I would imagine.

[Reena (Sexual Health Expert)]

Right.

[Dr. Will Bulshowitz (Gastroenterologist)]

Because if a person were wanting to approach using that strategy, ultimately what helps is like, how do you feel and what's happening with your testosterone levels.

[Reena (Sexual Health Expert)]

Right, exactly. So a couple other questions about gut health that are sort of related. We talked about alcohol a little bit in terms of red wine. How does alcohol, marijuana, other drugs. Any yeses and nos in terms of those categories?

[Dr. Will Bulshowitz (Gastroenterologist)]

Yeah, I'm like. I'm like going to ruin everyone's funds. So please, I apologize. The truth is that the data that I've seen has me worried that alcohol is causing harm to the microbiome. With total clarity, if you drink to the point of having a hangover, you have caused harm and damage to your gut microbiome. The spot where it gets quite much more debatable is when we talk about something in the spectrum of one to two drink drinks and potentially not causing any sort of effects on the following day, no hangover effects seen. It's less clear what happens there. But there was an interesting study that sort of changed my perspective on this. And I just came across it in the last few years, and I really tapered back my alcohol consumption after seeing this. So they took a group of people and they had them drink. It was vodka, and it was a significant amount. What they did is then they tracked the blood alcohol level and their blood lipopolysaccharide level. Lipopolysaccharide is something that is leaked into the bloodstream when our gut barrier is damaged and broken. So you find it in your gut, like in your gut microbiome. It's not supposed to be crossing into your bloodstream except when there's damage or injury to the gut microbiome. And what they showed was that basically these were parallel graphs. You could weigh them over the top of one another. When the alcohol level spiked, so did the lipopolysaccharide level. When the alcohol level came down, so did the lipopolysaccharide level. The lipopolysaccharide level did not normalize until the alcohol level normalized.

[Reena (Sexual Health Expert)]

Fascinating.

[Dr. Will Bulshowitz (Gastroenterologist)]

So from my perspective, based upon that, that doesn't answer the question, is one drink harmful? That's not exactly the same question.

[Reena (Sexual Health Expert)]

Right, right.

[Dr. Will Bulshowitz (Gastroenterologist)]

But the fact that the alcohol level on all levels, in all amounts, was concurrently associated with an increase in the lipopolysaccharide and acknowledging just the real world, where if I Have a drink. And it's only one drink at 2 in the afternoon. I'm gonna feel tired in a couple of hours.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

Right. It leads me to believe that the gut. That the alcohol is causing harm and injury.

[Reena (Sexual Health Expert)]

Yeah. Well, I mean, there's also so much data now that no alcohol is good in terms of cancer prevention.

[Dr. Will Bulshowitz (Gastroenterologist)]

A hundred percent.

[Reena (Sexual Health Expert)]

So I've stopped myself too.

[Dr. Will Bulshowitz (Gastroenterologist)]

And REM sleep is clearly disturbed by even one drunk.

[Reena (Sexual Health Expert)]

Right.

[Dr. Will Bulshowitz (Gastroenterologist)]

So there's other aspects as well. Marijuana has emerged, like, as alcohol seems to be becoming less popular, marijuana become much more popular. I have serious concerns about this now. Part of it is the cognitive effects. Used to call them like a pothead. That's real.

[Reena (Sexual Health Expert)]

Right.

[Dr. Will Bulshowitz (Gastroenterologist)]

They've actually studied this and looked at brain size and shown that the brain shrinks with chronic marijuana use. But in. In my space as a gastroenterologist, there's something that happens called cannabinoid hyperemesis syndrome. Let me paint a picture for you. A patient, typically younger patient, comes into my office, says, I've been throwing up around the clock. What's going on? And I ask one question. Do you love taking hot showers? Yeah, I feel so much better. I could take them for, like, an hour straight. That person, like, ultimately, I have to work to, like, get the question directly answered.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

Sometimes the parents are in the room.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

But that person. That's cannabinoid hyperemesis syndrome. The chronic use of marijuana can ultimately lead to the development of chronic nausea and vomiting, sometimes called cyclic vomiting syndrome.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

And the problem is that they feel better when they smoke. So getting them to quit can be quite challenging. And you have to educate, but sometimes you also have to give medication for support.

[Reena (Sexual Health Expert)]

I never learned about that. That's fascinating.

[Dr. Will Bulshowitz (Gastroenterologist)]

Yeah. It used to be a rare thing. It used to be like, you would sound in residency super smart if you brought up this concept.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

Now it's out there all the time.

[Reena (Sexual Health Expert)]

Wow, that's so interesting. I want to touch on toileting habits. Sitting on the toilet for too long. What harm does that cause?

[Dr. Will Bulshowitz (Gastroenterologist)]

I think that my main concern is the effect that it has on the pelvic floor. And specifically hemorrhoids. So hemorrhoids are these three beds of venous tissue that carry blood. Think of them like an airbag for a car. They're there to protect us. And most of the time, they're not filled up with blood. But when you sit down on the toilet and you're about to poop, they fill up with blood. The more time that you spend, the more Time that those tissues are filled with blood, and it can be harder to get the blood out of them afterwards. And this can make people prone to developing hemorrhoids. So hemorrhoids by the age of 50, about 50% of people have these issues.

[Reena (Sexual Health Expert)]

Wow, 50%.

[Dr. Will Bulshowitz (Gastroenterologist)]

Yes.

[Reena (Sexual Health Expert)]

I did not know it was that high.

[Dr. Will Bulshowitz (Gastroenterologist)]

And they wish they did not.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

And one of the reasons that this happens, people classically think of it as being purely constipation. Yes. Bearing down does promote flares of the hemorrhoids. Also, any change in bowel habits, not just constipation, but also diarrhea, can make them more likely to happen. But the fact that you sit on the toilet for too long is problematic. So what I've always advised people is five minutes. So don't force it. Don't push super hard to get it out, but don't sit with your phone. I think this is kind of a guy thing.

[Reena (Sexual Health Expert)]

No, I think it's in everyone's number one thing.

[Dr. Will Bulshowitz (Gastroenterologist)]

Okay.

[Reena (Sexual Health Expert)]

We, like, hide from our kids in the bathroom.

[Dr. Will Bulshowitz (Gastroenterologist)]

Yeah. Kind of. Nice compliment.

[Reena (Sexual Health Expert)]

Although my kids still will still walk in. I'm like, yeah, mine too.

[Dr. Will Bulshowitz (Gastroenterologist)]

Sometimes our nanny as well. But yeah, no, it's. You want to keep it, ideally five minutes, but, like, certainly less than 10 minutes.

[Reena (Sexual Health Expert)]

Yeah. What about using a bidet versus using toilet paper?

[Dr. Will Bulshowitz (Gastroenterologist)]

I'm 100% team bidet.

[Reena (Sexual Health Expert)]

Oh, me too.

[Dr. Will Bulshowitz (Gastroenterologist)]

I love bidet. Oh. I think it's one of the best things you can spend your money on, honestly, like, if you want to.

[Reena (Sexual Health Expert)]

It's not even that expensive.

[Dr. Will Bulshowitz (Gastroenterologist)]

No, it's not.

[Reena (Sexual Health Expert)]

You get on Amazon for, like, I forget. It's so inexpensive. Yeah, yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

Oh, it's the best. And it's also, by the way, a great way to clean the bottle. So one of the issues that exists is many people will use wipes. I would caution you against that because the body has a natural moisture content and also natural sort of oils that are a part of that part of the body. And when we use wipes, we dry them out. And that's actually the number one cause of what we call pruritus ani, which is anal itching.

[Reena (Sexual Health Expert)]

So that's, you know, very similar in women in the vulva, which they'll use wipes or they'll over wash. And I'm sure it's similarly in the rectum, where. Or the anus, where you'll over wash and you develop itching and you develop discomfort and dryness. And for women, oftentimes they'll come in with symptoms like, oh, I Think I have a uti.

[Dr. Will Bulshowitz (Gastroenterologist)]

Yeah.

[Reena (Sexual Health Expert)]

But it's really a lot of over washing and over cleaning the area that naturally doesn't need that much aggressive cleaning.

[Dr. Will Bulshowitz (Gastroenterologist)]

Sometimes the hemorrhoids need to be treated. When people have anal itching, a very large percentage of people, if you quite simply tell them to take a break from washing their bottom, stop using any wipes or any sort of lotions or anything that could dry out the space and then reduce the temperature of your shower, it will get better. And washing with water is still perfectly hygienic.

[Reena (Sexual Health Expert)]

I want to end with talking about anal sex. So a lot of. I mean, certainly anal sex has become more commonplace, I think, more accepted in both heterosexual and homosexual relationships. What are tips? As a gastroenterologist, you would say, knowing, like the health of the tissues, the safety of doing that without injury. What are tips you would have for the average person?

[Dr. Will Bulshowitz (Gastroenterologist)]

So I think that this thing is something that should be entered into with a partner that you feel safe and comfortable and you communicate with. I think it's really important to, like, have that ability to communicate.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

So that you don't rush and you can ease into it. So. And when I say ease, I don't actually even mean like jumping straight into anal sex. I mean like working through what could be a period of time where it's foreplay. Right. Or using toys and starting small and then working a little bit larger over the course of time to get that part of the body used to it. It turns out that these tissues in the bottom, basically, like, there's two things that you'll find there, muscle tissue and skin. And they both kind of need to be adapted before moving forward with doing anal sex.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

So by introducing first smaller things and slowly progressing, it gets the area adjusted to it. It allows you to see how it feels, see whether or not this is something that works for you. And in a way, like in the same way that we develop a callus on our feet by walking on our feet. Right. It sort of helps that skin to get a little bit tougher prior to moving forward with anything. So now once you sort of move beyond that, then I think it's important for people to do this in a way where it's pleasurable, it's comfortable, you can stop it if you want to, using a lot of lube, going slow, and when on the receptive side, breathing.

[Reena (Sexual Health Expert)]

Yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

So, like, I think, like, those are the basic tips. Afterwards, again, like, I don't think that using wipes is advisable. Using a bidet absolutely is Fair game. And then if you have bleeding, fiber supplements can help with anal bleeding. The source of bleeding within that context, the expectation is that it's traumatic. It could be the hemorrhoids that have been traumatized. It could be internal tissues or it could be the development of an anal fissure. Many times resting the bottom, increasing fiber intake, possibly adding a stool softener will allow you to like have soft, comfortable bowel movements. And you do this for about five days just to give the bottom a break to allow it all, allow those tissues tissues to heal.

[Reena (Sexual Health Expert)]

Do you have a preferred stool softener?

[Dr. Will Bulshowitz (Gastroenterologist)]

There's options. So like you want the basics. You could do Colace. Coace is something that's not going to give people diet. Like you don't want diarrhea.

[Reena (Sexual Health Expert)]

Yeah, in this context, yeah.

[Dr. Will Bulshowitz (Gastroenterologist)]

Right. So you just want something that's gonna kind of just keep it soft. So Colace can definitely get the job done. Now, if you have experience using magnesium, I'm a huge fan of magnesium. Specifically magnesium oxide, citrate or sulfate glycinate and threonate are not for pooping. Those are for sleep or other magnesium needs. But citrate, sulfate oxide, those three, if you have experience with them, they're, I think they're wonderful stool softeners.

[Reena (Sexual Health Expert)]

If you guys enjoyed this clip with Dr. Will Bulshowitz, make sure to check out the full episode right here.

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[Reena (Sexual Health Expert)]

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[Dr. Will Bulshowitz (Gastroenterologist)]

Very underwritten by Liberty Mutual Insurance Company affiliates. Excludes Massachusetts.

[Liberty Mutual Advertiser]

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[Reena (Sexual Health Expert)]

Experian.