The Connection between Hemorrhoids and Pregnancy

Hemorrhoids are common during pregnancy and it's best to prevent them through a diet rich in fiber, continuous hydration, and frequent exercise. It's also essential to treat them as soon as possible.
The Connection between Hemorrhoids and Pregnancy

Written by Edith Sánchez

Last update: 27 May, 2022

Hemorrhoids are an uncomfortable and distressing condition that often afflicts women during pregnancy. They’re also known as piles and are due to a dilation of the veins in the rectal area.

Some women only develop hemorrhoids during pregnancy, but others also develop them at other times of life. In any case, they’re much more common during pregnancy. In fact, estimates indicate that up to 50% of pregnant women have hemorrhoids.

This condition usually develops from the second trimester of pregnancy onwards. It tends to appear during and after childbirth and causes extreme discomfort even though it doesn’t endanger a pregnancy. They’re definitely preventable and treatable.

What are hemorrhoids and what’s their connection with pregnancy?

A woman in pain.

These are swollen blood vessels located in the rectal area and look like swollen pads in the anus or lower rectum. Such pads contain many veins and arteries.

The swollen “beads” vary in size and usually cause pain and itching that increase during bowel movements. Hemorrhoids tend to bleed and might be a source of anxiety in pregnant women.

These lesions cause pain and discomfort when sitting or walking. It may even be difficult to find a comfortable sleeping position. Hemorrhoids can be of two types and we’ll discuss them below.

Types of hemorrhoids

These can be internal or external. The former appear inside the anus, in the area where the rectum begins. They can come out of the anus if they’re large and we refer to these as prolapsed hemorrhoids.

Unless prolapsed, internal hemorrhoids are usually less painful than external hemorrhoids but tend to bleed more. External ones arise outside the anus and are usually more painful and uncomfortable.

External ones look like painful lumps around the anus and cause great discomfort when sitting. They may also bleed or become even more painful if they’re strained.

What causes hemorrhoids during pregnancy?

Several factors affect the occurrence of hemorrhoids during pregnancy. First of all, the growing fetus causes the uterus to enlarge and this, in turn, generates more pressure on the blood vessels in the anus and rectum.

In addition, the increase in the hormone progesterone during pregnancy may also play a role. This relaxes the walls of the veins and therefore they’re more prone to swelling.

Estimates also indicate that up to 38% of pregnant women experience constipation. This is due to the growing uterus putting pressure on the intestine and, sometimes, to the consumption of iron supplements. At the same time, pregnancy hormones slow down intestinal transit.

Altogether, the stool becomes harder and puts more pressure on the rectal veins to eliminate it. This leads to inflammation. Most commonly, women who’ve had this problem before pregnancy also develop it during pregnancy.

Available treatments

Hemorrhoids sometimes go away on their own after pregnancy and childbirth, without any treatment. However, it isn’t a good idea to leave them untreated, as they can worsen and either significantly affect the quality of life or cause major complications.

It’s usual to resort to home treatments first, as these are usually effective in most cases. The best thing to do is to go to the doctor to start a more formal treatment if there’s no improvement. So what’s the best way to treat hemorrhoids during pregnancy? Let’s see.

At home

Some of the home measures that may help reduce swelling and relieve symptoms are:

  • Don’t sit or stand for long periods of time and walk a little bit every hour or so
  • A daily exercise session of 30 minutes can activate circulation
  • Use a pillow or a circular cushion to sit on
  • A sitz bath with warm water several times a day helps relieve pain
  • Cold compresses or ice packs applied to the area help reduce swelling and pain
  • Wet wipes are preferable to toilet paper, even better if they contain witch hazel but shouldn’t contain scent or alcohol
  • Lying on the left side is best for sleeping and you can do it several times a day to relieve discomfort
  • Kegel exercises not only help prepare for childbirth but also help relieve hemorrhoids

At the doctor’s office

Always consult a physician when bleeding during pregnancy, even if you’re apparently certain it’s due to hemorrhoids. This professional can help in the management of hemorrhoids.

Usually, they’ll prescribe a laxative or suppositories to treat constipation. They may also prescribe pain medication or ointments that are safe during pregnancy to relieve some of the discomforts.

Your doctor may also prescribe one of the following treatments:

  • Rubber band ligation. A rubber band is placed around the base of the hemorrhoids. This stops the blood flow and the lump falls off in about 10 to 12 days. There’ll be a scar that’ll keep the problem from recurring in the same place.
  • Sclerotherapy consists of injecting a chemical substance into the piles. It helps them shrink and heal, but they may reappear after a while.
  • A hemorrhoidectomy is a surgical procedure to remove hemorrhoids. It’s only recommended for severe cases or those in which there are complications due to the risks involved.
  • Stapled hemorrhoidopexy is a surgical procedure in which staples are implanted to reposition the hemorrhoids inside the anus when prolapsed.

Ways to prevent hemorrhoids during pregnancy

A diet rich in fiber and drinking plenty of water both help prevent hemorrhoids.

Ideally, one must prevent hemorrhoids rather than treat them. The best way to do this is to prevent constipation. To do so, it’s important to drink plenty of water and maintain a diet rich in fiber. Take a fiber supplement if necessary.

Also, try to maintain a stable eating schedule, avoid flatulent and astringent foods, chew food slowly and thoroughly, and exercise frequently. Other appropriate measures are:

  • Skip bicycling
  • Do Kegel exercises as often as you can
  • Don’t wait to go to the bathroom when you feel the need to do so
  • Don’t sit on the toilet for a long time
  • Also, try not to force a bowel movement to avoid straining
  • Skip the iron supplements
  • Lie on your side when you sleep, read, and watch TV
  • Maintain your optimal weight

Final recommendations

It’s important to consult a doctor if the hemorrhoids take on a bluish hue or the symptoms worsen to the point of making daily activities difficult. Also, see your doctor if there’s a lot of bleeding.

In any case, ask the doctor about home treatments before starting them. It’s essential to start treatment early because hemorrhoids can cause many complications if allowed to progress. In addition, pregnant women must maintain preventive measures after delivery.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Barrera, D., Ávila, E., & Díaz, L. (2007). Papel inmunológico de la progesterona en el mantenimiento del embarazo. Revista de investigación clínica, 59(2), 139-145.
  • De la Calle Fernández-Miranda, M. Estreñimiento y embarazo. Solicitada acreditación a la Comisión de Formación Continuada de las Profesiones Sanitarias de la Comunidad de Madrid-SNS, 63.
  • Silva, M. A., León, G., Castillo, V., Hernández, N., Gordillo, B., & Labastida, C. (2009). Enfermedad Hemorroidal como Complicación del Embarazo. Informe Médico, 11(4).
  • Sociedad Española de Ginecología y Obstetricia. (2013). DIAGNÓSTICO Y TRATAMIENTO DEL ESTREÑIMIENTO DURANTE EL EMBARAZO.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.