What are hemorrhoids?
Hemorrhoids are swollen blood vessels in the rectal area. They typically range in size from as small as a pea to as large as a grape, and they can develop inside the rectum or protrude through the anus.
Hemorrhoids can be itchy and mildly uncomfortable – or downright painful. Sometimes they even cause rectal bleeding, especially when you have a bowel movement.
Why are hemorrhoids more common during pregnancy?
Your growing uterus, constipation, and an increase in the hormone progesterone all make it more likely you'll develop hemorrhoids during pregnancy (as well as varicose veins in the legs and sometimes even in the vulva).
Your growing uterus puts pressure on the pelvic veins and the inferior vena cava, a large vein on the right side of the body that receives blood from the lower limbs. This can slow the return of blood from the lower half of your body, which increases the pressure on the veins below your uterus and makes them dilate or swell.
Constipation (another common problem during pregnancy) can also cause or aggravate hemorrhoids because you tend to strain when having a hard bowel movement, and straining leads to hemorrhoids.
During pregnancy, progesterone relaxes the walls of your veins, allowing them to swell more easily. Progesterone also contributes to constipation by slowing down your intestinal tract.
Hemorrhoids are especially common in the third trimester. Some women get them for the first time while they're pregnant. And if you've had them before pregnancy, you're more likely to have them again now. They may also develop while you're pushing during the second stage of labor.
It's not uncommon to develop a "thrombosed" hemorrhoid, which is a blood clot that forms inside the hemorrhoid, leading to an especially large and swollen lump. This type of hemorrhoid can be quite painful and makes it hard to walk, sit, or have a bowel movement.
Discomfort or bleeding from hemorrhoids is also a common complaint during the early postpartum period. In most cases, however, hemorrhoids that developed during pregnancy go away soon after you give birth, especially if you're careful to prevent constipation.
How can I avoid getting hemorrhoids during pregnancy?
Here are some ways to prevent hemorrhoids when you're pregnant:
- Avoid becoming constipated by eating a high-fiber diet (that includes plenty of whole grains, beans, fruits, and vegetables), drinking about 10 8-ounce cups water a day, and getting regular exercise (as long as your provider says it's okay). If you're already constipated, ask your healthcare provider about taking a fiber supplement or using a stool softener.
- Don't wait to go when you feel the urge to have a bowel movement, and try not to strain.
- Don't sit on the toilet longer than necessary because this puts pressure on your rectal area.
- Do Kegel exercises daily. Kegels increase circulation in the rectal area and strengthen the muscles around the anus, reducing the chance of hemorrhoids. They also strengthen and tone the muscles around the vagina and urethra, which can help your body recover after you give birth.
- Don't sit or stand for long stretches of time. If your job involves sitting at a desk, get up and move around for a few minutes every hour or so. At home, lie on your side when sleeping, reading, or watching TV to take the pressure off your rectal veins and increase blood return from the lower half of your body.
How can I get rid of hemorrhoids while pregnant?
You can try several remedies to treat hemorrhoids during pregnancy:
- Use cold. Cold therapy may reduce swelling and discomfort. Apply an ice pack (with a soft covering) to the affected area several times a day. Some women also find cold compresses saturated with witch hazel soothing.
- Use heat. Soak your bottom in a tub of warm water for 10 to 15 minutes a few times each day. If you don't have a bathtub, you can buy a sitz bath at the drugstore. (This is a small plastic basin that you fill with water and position over your toilet so you can sit down and submerge your rectal area.)
- Alternate. First use cold then warm treatments, and repeat.
- Keep clean. Clean the affected area gently but thoroughly after each bowel movement. Use soft, unscented toilet tissue, which is less irritating than other varieties. Many women find it more comfortable to use unscented wipes rather than toilet tissue. You can also buy wipes moistened with witch hazel, specifically for treating hemorrhoids.
- Medicate. Ask your healthcare provider about medication. Your provider may recommend a topical anesthetic or medicated suppository that's safe to use during pregnancy. Many hemorrhoid relief products are available, but ask your provider before trying one.
Keep in mind that most of these products should be used for no more than a week. (Using a medication for longer than recommended can cause side effects such as skin irritation or thinning.)
When should I call my healthcare provider about hemorrhoids during pregnancy?
Consult your provider if preventive efforts and home treatments don't help, or if you have severe pain or rectal bleeding.
In some cases, you may need to see a specialist for treatment to shrink your hemorrhoids. Rarely, minor surgery is necessary.
- Frequent urination during pregnancy
- Gas and bloating during pregnancy
- Pregnancy symptoms you should never ignore