How to Treat Hemorrhoids During Pregnancy

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You’ve likely discovered that pregnancy isn’t all unicorns, rainbows, and “You’re positively glowing!”

As if “morning” sickness, tender breasts, and round ligament pain weren’t enough, pregnancy can also be a real pain in the butt. Literally.

Yes, my friends, today we’re talking about hemorrhoids.

What Causes Hemorrhoids to Flare Up in Pregnancy?

I know hemorrhoids can be an embarrassing topic, so it might help to know you’re definitely not alone. According to the Cleveland Clinic, 30-40% of pregnant people get hemorrhoids!

Also called piles, hemorrhoids are swollen (varicose) veins in your anus (butthole). They can be as small as a bead to as large as a nickel. 

You might have hemorrhoids if you notice the following:

  • Itching or irritation around your anus
  • Bright red blood on the toilet paper when you wipe
  • Blood when you poop 
  • An uncomfortable lump near your anal opening

 

Hemorrhoids in pregnancy have several causes:

  • Increased blood flow to your pelvic area
  • Pelvic pressure from your growing uterus and growing baby
  • Constipation or straining
  • High progesterone levels

All of these factors create a perfect storm that cause your veins to swell and eventually create those beloved hemorrhoids.

Note: Bleeding related to hemorrhoids is minimal and only occurs during bowel movements. If you’re pregnant and experiencing any sort of bleeding, it’s best to check in with your medical provider.

Internal v. External Hemorrhoids

There are two different kinds of hemorrhoids: internal and external.

Internal hemorrhoids form within the rectum. If you’re experiencing rectal bleeding without pain, they’re likely internal hemorrhoids. That’s because they form where nerve endings aren’t present.

External hemorrhoids form outside the anus. The skin gets extra-sensitive and inflamed, which causes pain. If you’re more often experiencing pain and itchiness, they’re likely external hemorrhoids. But don’t worry, we’ll talk about how to treat external hemorrhoids during pregnancy in a moment!

How Long Do Hemorrhoids Last?

Hemorrhoids are most common in the third trimester—starting around week 28—and can last for several weeks postpartum.

Especially if you have a vaginal birth, the pressure of pushing out your little one can continue to aggravate your rectal veins. This means your hemorrhoids might get worse before they get better.

Sometimes, though, hemorrhoids can disappear after childbirth without treatment as your hormone levels, blood volume, and abdominal pressure return to normal.

How to Avoid Hemorrhoids During Pregnancy

The fastest way to treat hemorrhoids during pregnancy is to avoid them in the first place. Use these tips to keep hemorrhoids at bay.

#1 Avoid constipation.

Constipation—and the straining of going #2—puts extra pressure on your rectum, causing vein inflammation. The tips will help you avoid constipation:

  • Eat a high-fiber diet, including veggies, fruits, and whole grains.
  • Use the bathroom when you need to, rather than stalling or waiting.
  • Stay on the toilet only as long as you need to.
  • Choose a food-based prenatal vitamin to avoid constipation related to synthetic iron.
  • Drink plenty of water.
  • Ask your doctor for a stool softener or fiber supplement.

Americanpregnancy.org also recommends pregnant people:

#2 Get moving.

Exercise is not only safe in pregnancy, but it’s also really healthy for both you and your growing baby! If your provider says it’s okay, exercising in pregnancy can keep things moving on the inside, preventing hemorrhoids on the outside. Walking or running can be especially helpful.

If you already have hemorrhoids, avoid movements that put pressure on your anal area, including:

  • Situps
  • Squats
  • Weighlifting
  • Rowing
  • Cycling

#3 Relax effectively.

Learning how to properly “bear down” during bowel movements can help minimize pressure on your pelvic floor and hemorrhoids. When you are pushing during poops, make sure you exhale and breathe out instead of holding your breath. If your pelvic floor muscles are too tense, you will want to focus on relaxation and lengthening your pelvic floor, instead of strengthening. SO pause the kegels if you are doing them.  

How to Treat Painful or Itchy Hemorrhoids During Pregnancy

Try these remedies to treat hemorrhoids during pregnancy so you can get on the road to recovery:

  • Apply an ice pack to the affected area.
  • Do a sitz bath two or three times/day for 10-15 minutes.
  • Sit on a donut-shaped pillow to ease the pressure.
  • Apply witch hazel or baking soda (wet or dry) to decrease itching.
  • Try TUCKS Medicated Cooling Pads.
  • Use coconut oil or pure aloe to relieve pain and inflammation.
  • Switch to soft, unscented toilet paper or wet wipes.

When to See Your Provider about Hemorrhoids

Rectal bleeding from internal and external hemorrhoids is usually harmless. But go ahead and check in with your OB/GYN or colorectal surgeon (just to be safe). Also, be sure to consult with them before starting any medications to ease your symptoms.

The V-Hive: Pregnancy-Safe Exercises to Keep Hemorrhoids at Bay

Moving your body has many benefits for your pregnancy and postpartum experience. One of those is preventing and treating hemorrhoids. 

If you’re nervous about working out during pregnancy, I get it! That’s why I created the Pregnancy Series for V-Hive members. The Pregnancy Series offers week-by-week support to help you feel strong from the inside out. Included in this series are:

  • Three pelvic floor and core workouts each week.
  • Exercises designed and modified specifically for pregnant bodies.
  • A library of pregnancy and childbirth tips for managing lightning crotch, constipation, rib pain, leg cramps, breast changes, and lots more.

You also get access to my Pelvic Floor Relaxation Series which teaches you the proper way to pee and optimize pelvic floor relaxation for awesome poops. Become a V-Hive member today.

Join The V-Hive

Online pelvic floor fitness programs from a board-certified Women’s Health Physical Therapist.

Meet Dr. Sara

Sara Reardon PT, DPT, WCS is the owner of NOLA Pelvic Health and founder of The Vagina Whisperer.

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