Hemorrhoids and Pregnancy: Before, During, and After

Hemorrhoids Before Pregnancy

Pre-existing hemorrhoids can worsen during pregnancy because of the extra pressure from a growing uterus and hormonal changes. Seeking treatment before becoming pregnant can help any swollen veins heal beforehand. Addressing risk factors that cause hemorrhoids can help prevent them from developing when pregnant. 

• High BMI: Researchers have found that increased body mass index (BMI) raises the risk of hemorrhoid disease. ²  Talk to your doctor about how much weight you should gain during pregnancy to stay healthy for your body. 
• Chronic constipation: Hard stools and straining during a bowel movement put pressure on anal veins, causing swollen hemorrhoids.³
  
• Eating a low-fiber diet: Increasing fiber intake can prevent constipation and reduce the pressure on veins by encouraging soft, regular stools. Leafy green vegetables, carrots, apples, bananas, berries, oatmeal, brown rice, and nuts are all healthy, high-fiber foods you can include in your diet.
• Living a sedentary lifestyle: Staying active can help support good circulation and prevent constipation. 

Hemorrhoids During Pregnancy

Several factors can cause hemorrhoids during pregnancy:

• The enlarging uterus: There’s extra pressure on rectal veins from carrying around a growing baby and an enlarged uterus. 
• Pregnancy hormones: The body releases more progesterone during pregnancy, causing the walls of veins to relax to make room for increased blood flow to the pelvic area. When veins are more relaxed, they can swell more easily.
• Constipation: Progesterone also causes the bowels to slow down, which can increase constipation. 
• Iron supplements: Your doctor may recommend taking iron supplements during pregnancy. Synthetic iron can cause constipation or diarrhea. 

What Do Hemorrhoids Look Like During Pregnancy?

Internal hemorrhoids develop in the rectum, so they aren’t usually visible. However, you might notice blood in the stool or on toilet paper if you have an internal hemorrhoid while pregnant. Itching, irritation, and discomfort around the anus during a bowel movement are other symptoms. If they progress and become more severe, they can bulge outside of the anus (prolapse). A prolapsed hemorrhoid will look like a small, soft red or pink lump protruding out of the anus. 

An external hemorrhoid forms under the skin around the anus. This type of hemorrhoid will look like a hard lump and feel tender. External hemorrhoids usually disappear after a few days or weeks and don’t require medical treatment.

How Big Can Hemorrhoids Get During Pregnancy?

Hemorrhoids during pregnancy might range from the size of a pea to as large as a grape. They can also appear to grow larger during or right after a bowel movement because of swelling. 

Hemorrhoids that develop during pregnancy often form in the last trimester—after week 28—and they often resolve on their own after birth.²  However, they can start earlier and persist, causing significant discomfort from anal itching, swelling, and bleeding.

Managing Hemorrhoids During Pregnancy

You can help alleviate symptoms at home with the following tips:

• Eat more high-fiber foods.
• Drink more fluids to stay hydrated and help prevent constipation.
• Soak in warm water to help relieve swelling and inflammation.
• Apply cold packs to the affected area to reduce swelling.
• Avoid sitting or standing for long periods.
• When you are sitting, use a donut-shaped pillow rather than sitting on a hard surface.
• Keep the area clean after a bowel movement. If unscented toilet paper isn’t enough, astringent wipes with witch hazel are formulated for hemorrhoids. 

Internal hemorrhoids that don’t go away on their own may require medical treatment. If you notice signs of internal hemorrhoids while pregnant for more than a week or two, it’s important to see a doctor to determine the best way to help you get relief from symptoms and prevent the hemorrhoids from becoming more severe. A hemorrhoid doctor can recommend a personalized non-surgical treatment plan that’s safe for you and your growing baby. 

The right hemorrhoid treatment will depend on how severe the hemorrhoids are and where you are in your pregnancy.

Hemorrhoids After Pregnancy

Pushing during childbirth puts pressure on rectal veins, which can worsen hemorrhoids that develop during pregnancy or create new hemorrhoids. In the postpartum period, you can continue with many lifestyle and at-home care methods used to help prevent hemorrhoids or manage symptoms during pregnancy, including eating a high-fiber diet, drinking more fluids, and using warm baths for relief. 

Regular exercise can also help prevent constipation and promote healing. However, you should talk to your doctor about what exercises you can do and when it’s safe to return to your previous activity levels. 

When to See a Doctor About Hemorrhoids When Pregnant 

Hemorrhoids are normal during pregnancy, with roughly one out of three women getting them either while pregnant or right after, so there’s nothing to worry about if you notice symptoms. They’re also treatable, even during pregnancy. 

If internal hemorrhoid symptoms are impacting your quality of life, consult with a doctor about your treatment options. A hemorrhoid specialist can offer a personalized treatment plan to help you get long-term relief.