Tales from the Tail — To Bloom or not to Bloom? 🌸

Client’s Tale

I should start off by first asking if crowning, blooming, or pushing out all of your insides turns you on? Most know this as a rosebud 🌹(if you don’t know, Google with caution — preferably on an empty stomach). Well, for my boyfriend, nothing gets him harder. One day, he became quite worried when I started to develop pain and bleeding. He wasn’t necessarily concerned for my ailing health or over all well being, but more so because it meant he couldn’t get off on his fetish.

Recently, we had an extremely long and intense session. Both of us were fucking rock hard and he was in me for quite some time. Through many moans and groans and different positions, along with us edging until precum was running down both our shafts, we proceeded to finish in our usual position… me in doggy, fully bloomed (anal veins — a.k.a. hemorrhoids — bulging), with him behind me, jerking himself into total bliss and ecstasy… until something suddenly didn’t feel right.

Saving you the gory details, one of my hemorrhoids ruptured. I was fucking mortified. At that moment, I realized something needed to be done on my end (pun intended) beyond just cleaning up — it was time to call Dr. Goldstein at Bespoke Surgical.

I met Dr. Goldstein in his New York office and after he educated me on my current medical condition, which had been making both defecation and anal intercourse excruciatingly difficult, we spoke of all the medical and surgical options available. We reached a happy medium that would satisfy myself and all parties who appreciated my ass. During the exam, as I was blooming, we noticed one particular hemorrhoid being more prominent than the others. That one seemed to be the one that was irritated and causing the bleeding. Luck would have it — it was an internal hemorrhoid only. This allowed for a quick rubber band to be placed on it — painless, though with some pressure — and within a week, it fell off. Now, I could go back to fully engaging without any bloody, uncomfortable consequences.

The one thing that we did openly discuss was how hemorrhoids impact the quality of life and when it’s time to see a doctor. Dr. Goldstein made sure I was comfortable discussing blooming because, for some, blooming can be a fetish, whereas others see it as a condition that needs to be medically corrected. Bespoke Surgical supports everyone’s wants and desires without judgement. Dr. Goldstein helps his patients analyze the risk (for both oneself and one’s partners) behind certain acts and provides guidance to determine when it’s OK to push forward (pun intended) vs. when one should stop and explore treatment options.

That being said, Dr. Goldstein did see some other hemorrhoids, but since they weren’t affecting my quality of life, he decided they were OK to leave alone (for now). I am sure I will at some point need more work or corrective surgery done. But for the moment, my partner and I are both happy with how everything is *blooming*. Now we’re able to enjoy spring as fully as one should. 😉 While it’s a completely different take on Troye Sivan’s new song, Bloom, I’m glad my partner can once again “take a trip into my garden” because “I’ve got so much to show ya… Yeah, I bloom, I bloom just for you”.

Oh, the things we do for love.

My Discussion: How To Prevent Hemorrhoids

What Are Hemorrhoids?

First off, we all have ‘em — hemorrhoids that is. Their mechanism and function is to cushion the anal region due to the increased pressures occurring with both defecation and anal play, all in the hopes of preventing injury. However, when hemorrhoids become symptomatic from repetitive increased pressure in the veins of the anus, it causes them to bulge and expand, which leads to significant pain, swelling, and/or bleeding. That’s what we don’t want to happen. Two different types of hemorrhoids can occur: external or internal. More than 90% heal without surgery and instead by adjusting to an appropriate bowel regimen, epsom salt baths, and topical creams to provide relief as they heal. However, hemorrhoids that become chronic, impacting quality of life with normal bowel functions and/or limiting anal intercourse, may require surgical treatment.

The most common causes of hemorrhoids are:

  • Constipation and straining during bowel movements
  • Sitting for prolonged periods of time
  • Heavy lifting
  • Squat work
  • Anal intercourse

The key is to understand all of the above and to work on how one can prevent hemorrhoidal occurrence with this knowledge in mind.

Preventing Hemorrhoids Through Diet

A high fiber diet is key and in the western world, this is quite limited. If you see a dog take a shit on the street, most are perfect, easy, with minimal to no wiping needed. Their diet is strictly fiber and the goal should be similar for us humans. Supplementation is a convenient way to get enough fiber. We at Bespoke Surgical love Take Two or Pure for Men, both geared towards our community and with the goal of full, complete, and easy evacuation. Please remember our overall water intake is usually lacking as well. Tons of water is needed daily and especially in tandem with fiber supplementation, it is a must. I like taking the fiber at night with two large glasses of water (all this liquid will be absorbed in the stool to improve transit as we sleep). When standing up in the morning, this creates a change in the pelvic angle, which is a signal to your body to start the defecation process. With the addition of fiber supplements, your bowls are primed and ready.

Prolonged Sitting and Heavy Exercise

It’s important to understand that the more localized and prolonged the pressure in the anal canal is, the more redirected the blood flow is to that region. It makes sense that in both sitting and/or exercising, which engages that musculature, this can indeed be a problem. For instance, with bowel movements, the days of reading the newspaper or now checking all your social media accounts should be limited. Less time, less force, and less pressure will minimize the blood flow to your anus and/or will allow the proper mechanism to function. Actually, the act of wiping in a standing position, re-directs the blood flow out of hemorrhoids, which will decrease the distention. Just a reminder that the more blood flow there is, the more stretching of the skin or hemorrhoids, which means the more sequelae can occur, like bleeding, clotting, and pain — all leading to difficulty during both defecation and anal intercourse.

So How Do We Remedy the Situation?

Cushioned seating or frequent standing and walking. Standing desks or the ability to do both (sitting and standing) are revolutionary in assisting with appropriate blood redistribution. Understanding the formal medical concepts allow for life alterations that assist with prevention or at least worsening. We spoke of limiting toilet bowel defecation times, as well as standing during wiping. The squatty potty is a hot thing right now because it changes the pelvic angle in a way that optimizes defecation, which limits pressure in the anal area and thus should limit anal pathologies, too.


Squats may be good for your tight booty or glutes, but problems exist with most people not being able to truly isolate those muscles from their anal sphincter. With this, over time, one gets hypertrophied anal muscle and contracture, which leads to a ‘tight ass’. Where we get in trouble is that sometimes too much muscle may lead to limited relaxation or improper function, which causes hemorrhoids and fissures. It is quite common in weight lifters and can totally be avoided. The key is isolation of the glutes only and proper breathing mechanics to lower one’s pressure and therefore help to prevent hemorrhoids from developing. No one said it was easy, but being able to understand the mechanism is critical.

Anal Play

Tight sphincters actually can be the culprit of hemorrhoids. It’s purely physics when you think about it in terms of the smaller the exit, the more pressure is needed to defecate. It’s like blowing out of a small straw — it’s hard work! Because of that increased pressure, one can have hemorrhoids or other anal pathologies develop. So gaining control of the anal opening through anal play can actually allow for more relaxation in the area when needed. The greater the opening, the less pressure or force needed. See the correlation? Have you ever topped anyone and they can open their anus as wide as they want with precision? With this control happening during intercourse, it can indeed happen similarly with defecation, which decreases trauma in the region and helps to prevent hemorrhoids. Dilating with plugs is imperative, specifically for anal engagement, but again for individuals with tighter muscles in the anal region, which can be the real culprit for developing hemorrhoids. So play, play, play! It helps everything in life.


The key to betterment and preventing hemorrhoids is understanding the complete science behind the normal mechanics of proper defecation and anal intercourse, the pathological development of symptomatic hemorrhoids, and, of course, the preventative measures one can implement. Again, all in the name of bottoming. Please check out the original post on our website.

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