Well, I as a gay man with UC, can answer your question!
I've had UC for years, and when in remission I have bottomed and for the most part it was okay. Then, after my flares got steadily worse, it became more difficult and painful, even when in those short periods of remission.
The final straw came when I got a fissure! OMG, it was soooooo painful, as anyone here who has had a fissure will tell you. I was in the most intense pain for over 6 months. But, I wasnt sure it was the sex that caused it...so I tried bottoming again...and the fissure re-opened and became a chronic fissure. Cue another 6 months of pain and misery.
So, I decided it was not worth it. And as a consequence, I have not bottomed for over 6 years now. Dont really miss it either. You kind of just forget about it. I am happy being a top now.
Sometimes I wonder how I ever bottomed in the past, as I struggle to get a suppository in my bum these days, LOL.
Pan UC - 9 yrs
Colazide 9x 750mg