As to how you can have sex even with piles, try directing the sexual activity in another direction. My sex life did not really begin until a friend told me he has a latex allergy and suggested maybe that was my problem as well. A good lube makes a big difference. I have friends that have used drugs to push their ass boundaries, gone too far, and wound up in the hospital. When I finally tried to carry out these fantasies, I could not take anything bigger than a pinky finger. Improper fisting can cause severe rectal damage and send you to the hospital, so only explore fisting with someone who knows what they are doing and someone who is sober.
Celebrate being a bottom!
17 Tips for Happier, Healthier Bottoming
There are lots of other behaviours you can enjoy without bottoming to anal sex. I did this so that the straight men around me would see me closer to being an equal. But for men on PrEP who make the decision not to use condoms, monthly testing is the minimum degree of self-care that you should practice. Steer clear of injection drugs. Work with your tops.
If you choose to have sex on any drug or mild-altering substance — alcohol being one of them — know that substances can limit your ability to detect pain or know when your butt has had enough. I use a hose — a shower attachment with a short, smooth nozzle — with slightly warm water and low pressure high pressure is not recommended — ouch. Getting tested every month is not a preventative healthcare practice, but a responsive one. I must caution that these are for more advanced bottoms. Try pushing it back inside.