What Causes Hemorrhoids in Women, Including Pregnancy and Birth

What Causes Hemorrhoids in Women, Including Pregnancy and Birth

Hemorrhoids—swollen veins in and around the anus and rectum—are common in women, especially during pregnancy and after childbirth. Understanding what causes hemorrhoids in women can help you take steps to prevent or ease symptoms. Below, we review the main factors that lead to hemorrhoid development, how pregnancy and birth increase the risk, and what you can do to feel better.

What Are Hemorrhoids?
Hemorrhoids (also called piles) form when the blood vessels in the lower rectum or anus become enlarged and inflamed. They come in two types:

• Internal hemorrhoids: Located inside the rectum; often painless but may bleed.
• External hemorrhoids: Under the skin around the anus; can itch, hurt or swell.

General Causes of Hemorrhoids in Women
While anyone can get hemorrhoids, certain factors put women at higher risk:

• Straining during bowel movements
• Chronic constipation or diarrhea
• Sitting for long periods, especially on the toilet
• Obesity or sudden weight gain
• Aging and weakening of supporting tissues
• Genetics (family history of hemorrhoids)
• Poor dietary fiber intake

These factors increase pressure in the pelvic and rectal veins, leading to bulging, inflamed vessels.

Pregnancy-Related Causes
Pregnancy changes a woman’s body in ways that make hemorrhoids more likely:

1. Increased Blood Volume and Hormones

• Blood volume rises roughly 30–50% during pregnancy to support the baby.
• Progesterone relaxes blood vessel walls, making veins more prone to swelling.

2. Uterine Pressure on Pelvic Veins

• As the uterus grows, it presses on pelvic veins and the inferior vena cava (the large vein carrying blood from the lower body to the heart).
• This backup of blood increases pressure in anal and rectal veins.

3. Constipation in Pregnancy

• Hormonal shifts slow intestinal movement.
• Iron supplements, often prescribed during pregnancy, can worsen constipation.
• Straining to pass hard stools adds pressure to rectal veins.

4. Physical Inactivity

• Pregnant women sometimes reduce activity levels or spend more time sitting, which can contribute to hemorrhoid formation.

Hemorrhoids and Birth
The process of labor and delivery can trigger or worsen hemorrhoids:

• Pushing During Labor

• Forceful bearing down increases intra-abdominal pressure.
• Prolonged second stage of labor (“pushing stage”) adds strain to rectal vessels.

• Perineal Trauma

• Tearing or episiotomy can lead to swelling and bruising near the anus.
• Local inflammation may involve hemorrhoidal tissue.

• Epidural Effects

• In some cases, epidural anesthesia leads to decreased mobility after birth, raising the risk of constipation and further venous pressure.

Recognizing the Symptoms
Hemorrhoid symptoms can range from mild discomfort to significant pain and bleeding. Common signs include:

• Bright red blood on toilet paper or in the toilet bowl
• Itching or irritation around the anus
• Pain or discomfort when sitting
• A lump near the anus, which may be sensitive or painful
• Leakage of feces or difficulty cleaning after a bowel movement

It’s important to note that these symptoms overlap with other conditions (anal fissures, infection, or more serious ailments). If you’re unsure, consider a free, online symptom check, using the doctor approved Ubie Symptom Checker.

Prevention Strategies
By addressing risk factors, you can reduce the chance of developing or worsening hemorrhoids:

1. Improve Bowel Habits

   • Aim for regular, unhurried bowel movements.
   • Respond promptly to the urge to go; don’t “hold it.”
   • Avoid straining or sitting on the toilet for long periods.

2. Dietary Changes

   • Increase fiber to 25–30 g per day (fruits, vegetables, whole grains, legumes).
   • Stay hydrated (aim for 8–10 cups of water daily).
   • Consider a fiber supplement (psyllium, methylcellulose) if needed.

3. Stay Active

   • Gentle exercise (walking, swimming, prenatal yoga) improves circulation and bowel function.
   • After birth, start pelvic floor exercises (Kegels) as advised by your healthcare provider.

4. Posture and Rest

   • Avoid prolonged sitting or standing; change positions regularly.
   • Use a cushion or doughnut ring if sitting is uncomfortable.

5. Manage Constipation

   • Use stool softeners or mild laxatives under your doctor’s guidance during pregnancy and postpartum.
   • Include probiotic-rich foods (yogurt, kefir) to support gut health.

Treatment Options
Most hemorrhoids improve with self-care. If home remedies aren’t enough, consider:

At-Home Measures
• Warm Sitz Baths

• Soak the anal area in warm water for 10–15 minutes, 2–3 times daily.
  • Topical Treatments
• Over-the-counter creams, ointments or suppositories (hydrocortisone, witch hazel pads).
  • Cold Compresses
• Apply ice packs wrapped in cloth to reduce swelling and discomfort.

Medical Treatments
• Rubber Band Ligation

• A small band cuts off blood flow to an internal hemorrhoid, causing it to fall off.
  • Sclerotherapy
• Injection of a solution shrinks hemorrhoidal tissue.
  • Infrared Coagulation
• Heat shrinks hemorrhoids.
  • Hemorrhoidectomy
• Surgical removal; reserved for large or persistent hemorrhoids.

When to See a Doctor
While hemorrhoids often resolve, seek prompt medical advice if you experience:

• Heavy, prolonged bleeding or signs of anemia (fatigue, shortness of breath)
• Severe pain unrelieved by home measures
• A lump that remains painful or grows larger
• Fever, chills or other signs of infection around the anus
• Bowel habit changes, unexplained weight loss or family history of colorectal cancer

These could indicate complications or other serious conditions. Always speak to a doctor about anything that could be life threatening or serious.

Key Takeaways
Understanding what causes hemorrhoids in women empowers you to take proactive steps:

• Pregnancy and birth increase venous pressure and weaken vein walls.
• Hormonal changes, constipation and pushing during labor all contribute.
• Simple lifestyle adjustments—diet, hydration, exercise—can prevent or ease symptoms.
• A range of safe, effective treatments is available if self-care isn’t enough.
• Don’t hesitate to consult a healthcare professional about severe or persistent symptoms.

If you’re unsure whether your symptoms are hemorrhoids or something else, consider a free, online symptom check, using the doctor approved Ubie Symptom Checker to guide your next steps. Above all, speak to a doctor about any concerning or life-threatening signs to get the right diagnosis and treatment.