hemorrhoids in pregnancy

Overview

Hemorrhoids are swollen veins in the lower part of the rectum and anus. During pregnancy, the growing uterus puts pressure on these veins, and hormonal changes can make them swell. They can be uncomfortable but are usually not dangerous.

Very common. Up to 1 in 3 pregnant women experience hemorrhoids, especially in the later months.

Pregnant women, particularly those in their third trimester. You are more likely to get them if you have had hemorrhoids before, if you have constipation, or if this is not your first pregnancy.

Symptoms

Common symptoms

• Itching or irritation around the anus
• Pain or discomfort, especially when sitting
• Bright red blood on toilet paper or in the toilet bowl after a bowel movement
• Swelling or a tender lump near the anus

Symptoms in children

• This topic is about pregnancy, so it does not apply to children.

Symptoms in older adults

• This topic is about pregnancy-related hemorrhoids, not hemorrhoids in older adults.

Causes

Main causes

• Pressure on the pelvic veins from the growing uterus
• Hormonal changes during pregnancy that relax vein walls
• Constipation and straining during bowel movements
• Increased blood volume in the pelvic area

Risk factors

• Previous hemorrhoids
• Chronic constipation or straining
• Being overweight or gaining a lot of weight during pregnancy
• Carrying twins or multiples
• Prolonged standing or sitting

When to see a doctor

See a doctor urgently if:

• Heavy bleeding
• Sudden severe pain
• Fever or chills

Book a routine appointment if:

• Bleeding that continues after a few days
• Pain or itching that interferes with daily life
• Any new lump or swelling that worries you
• Symptoms that don't improve with home care

Diagnosis

Your doctor or midwife will ask about your symptoms and may do a quick physical exam. This often involves looking at the area around the anus and gently checking inside with a gloved finger.

Tests that may be done

• Visual inspection of the anal area
• Digital rectal exam (a gloved, lubricated finger inserted into the rectum)
• Anoscopy (a small, lighted tube to look at the anal canal) if more detail is needed

What to expect at your appointment

The examination is brief and usually done in the office. You may feel some pressure but not severe pain. Your provider will explain what they find and recommend safe, effective ways to manage your symptoms during pregnancy.

Treatment

Treatment for hemorrhoids in pregnancy focuses on relieving discomfort and preventing constipation. Most people can manage with home care. If symptoms are more bothersome, your healthcare provider can suggest pregnancy-safe options.

Self-care at home

• Take warm sitz baths: sit in a few inches of warm water for 10 to 15 minutes, two to three times a day.
• Apply a cold compress or ice wrapped in a cloth for 5 to 10 minutes to reduce swelling.
• Gently clean the area with warm water and pat dry — avoid rubbing with dry toilet paper.
• Avoid sitting for long periods; take short walks or use a cushion to reduce pressure.
• Use the bathroom as soon as you feel the urge, and don't strain.

Medical treatments

Your doctor or pharmacist may recommend creams, ointments, or suppositories that are safe to use during pregnancy. Always check with them before using any product, because some ingredients are not recommended while pregnant. They can also suggest fibre supplements or stool softeners that are safe for you.

When is surgery considered?

Surgery is rarely needed for hemorrhoids during pregnancy. In most cases, symptoms get better with home care and improve after childbirth. If you still have troublesome hemorrhoids months after delivery, a specialist might discuss simple office-based treatments or surgery at that time.

Living with this condition

You can manage day-to-day by staying hydrated, eating high-fibre foods, and moving regularly. Keep a small cushion or pillow handy for sitting, and try not to stand or sit for too long without a break.

Lifestyle tips

• Take short, gentle walks most days
• Do pelvic floor exercises (Kegels) to improve blood flow in the area
• Avoid heavy lifting
• Sleep on your side to reduce pressure on the pelvic veins

Diet and exercise

Eat plenty of fruits, vegetables, whole grains, and legumes — these help soften stools. Drink at least 8 to 10 glasses of water a day. Gentle exercise, like walking or prenatal yoga, helps keep your bowels moving and improves circulation.

Mental health and emotional wellbeing

Dealing with hemorrhoids can be uncomfortable, frustrating, and sometimes embarrassing. It's completely understandable to feel this way. Remember that hemorrhoids in pregnancy are common and not something to be ashamed of. Talking with your healthcare provider or a trusted friend can help you feel supported.

Prevention

You can lower your chances of getting hemorrhoids by preventing constipation and avoiding straining. Eat high-fibre foods, drink plenty of water, keep moving, and don't delay bowel movements. Sitting on the toilet for too long can also increase pressure, so try not to sit there longer than necessary.

Complications

If left untreated

• In most cases, hemorrhoids don't cause serious problems.
• Rarely, a blood clot can form inside a hemorrhoid, causing sudden pain (thrombosed hemorrhoid).
• Heavy or ongoing bleeding might be a sign of another issue and should be checked.

Long-term outlook

The good news: hemorrhoids usually improve after pregnancy. While they can be uncomfortable, there are safe, effective ways to manage them. With support from your healthcare team, you can get relief and focus on your growing family.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.