Introduction
Hemorrhoids symptoms in pregnancy are more common than many people realize affecting up to 35-50% of pregnant women, according to studies published in PubMed. As a doctor, I often see expectant mothers in my clinic concerned about rectal pain, swelling, or bleeding, fearing something serious like cancer.
True? Most of the time, it’s the hemorrhoids swollen veins in the rectal area that are made worse by pregnancy related changes. While they can be uncomfortable, they’re usually manageable and temporary. The key is to recognize the symptoms early and know when to seek medical help.
In this article, I’ll guide you through the exact signs to look out for, explain why they occur during pregnancy, and share clinically safe relief strategies all based on clinical experience and research.
Why are hemorrhoids symptoms so common in pregnancy?
Pregnancy changes your body in incredible ways some wonderful, some not so pleasant. Hemorrhoids fall into the latter category.
The main reasons they develop during pregnancy:
- Increased pelvic pressure: The growing uterus presses on the veins in your lower abdomen, slowing blood flow.
- Hormonal changes: Progesterone relaxes the walls of blood vessels, making them more prone to swelling.
- Constipation: Pregnancy hormones and iron supplements often slow down bowel movements, increasing strain.
- Increased blood volume: More circulating blood means more pressure on already dilated veins.
Medical insight:
I’ve seen in my patients that women who had hemorrhoids in a previous pregnancy develop them earlier in subsequent pregnancies often in the second trimester rather than the third.
Hemorrhoids Symptoms in pregnancy
Recognizing hemorrhoids symptoms in pregnancy early helps prevent worsening and complications.
Pain or discomfort in the rectum
- Often described as a dull ache after sitting for a long time.
- The pain may increase after a bowel movement.
Itching or burning
- Persistent itching around the anus is common due to swelling and mild inflammation.
Swelling or lump
- External hemorrhoids can feel like a small, soft lump near the anal opening.
- Sometimes tender to the touch.
Bleeding
- Bright red blood on the toilet paper or in the toilet bowl.
- Usually occurs during or after a bowel movement.
Mucus discharge
- A slight discharge of mucus can cause skin irritation.
Doctor’s note:
Not all rectal bleeding in pregnancy is due to hemorrhoids. Persistent or heavy bleeding should be evaluated for conditions such as anal fissures or, rarely, colorectal cancer.
Internal vs. external hemorrhoids in pregnancy
- Internal hemorrhoids: Located inside the rectum, often painless but can bleed.
- External hemorrhoids: Found under the skin around the anus, often painful and itchy.
- Thrombosed hemorrhoids: A blood clot inside an external hemorrhoid very painful, can appear blue.
Analogy:
Think of hemorrhoids like varicose veins in your legs but in a more sensitive area.
When to see a doctor.
Seek immediate evaluation if you have:
- Heavy or persistent bleeding
- Home care does not relieve severe pain
- Signs of infection (fever, pus discharge)
- Large, rapidly swelling lumps
Safe self-help tips for hemorrhoids symptoms in pregnancy
Lifestyle and dietary changes
Increase fiber intake: Whole grains, fruits, and vegetables help soften stools.
[Natural remedies for hemorrhoids])
Stay hydrated: Drink at least 8-10 glasses of water daily.
Avoid sitting for long periods of time: especially on the toilet.
Sitz baths
Sitz baths are sitting in warm water for 10-15 minutes 2-3 times daily can help reduce swelling.
Gentle hygiene
Use unscented wipes or warm water after a bowel movement to reduce irritation.
Exercise
A light walk improves circulation and reduces constipation.
Medical insight:
In my practice, I have seen significant improvements when pregnant patients add daily fiber supplements (psyllium husk) mostly safe in pregnancy when approved by a doctor.
Mayo Clinic – Hemorrhoids During Pregnancy
Preventing Hemorrhoids During Pregnancy
- Don’t delay going to the bathroom when you feel the need.
- Use a footrest to elevate your legs during bowel movements (reduces straining).
- Avoid heavy lifting.
- Stay physically active within pregnancy safe limits.
A rarely discussed point
Many women feel embarrassed to discuss hemorrhoids even with their doctors. In my experience, ignoring symptoms due to embarrassment often delays treatment, which causes more pain.
Remember: hemorrhoids are common, temporary, and nothing to be ashamed of.
Could hemorrhoids indicate something else?
Most cases are harmless, but should be evaluated to rule out permanent symptoms:
- Anal fissures
- Inflammatory bowel disease
- Rectal polyps or tumors
[Hemorrhoids vs. Colon Cancer Symptoms])
CDC – Colorectal Cancer Symptoms
Summary Table – Hemorrhoids Symptoms in Pregnancy
Symptoms When to Be Concerned
- Pain Swelling of external hemorrhoids Severe or persistent pain
- Bleeding Straining, tender veins Heavy, black, or persistent
- Itching Skin irritation, mucus discharge if skin is broken or infected
- Lump/swelling External or thrombosed hemorrhoids Rapidly enlarging or turning blue
Hemorrhoids and Childbirth: Understanding the Connection
Hemorrhoids and childbirth are closely linked, and for many women, pregnancy is when hemorrhoids first appear or worsen. The connection lies in two main factors the changes that occur during pregnancy and the intense pressure during delivery.
1. Pregnancy sets the stage.
By the time labor begins, many expectant mothers already have swollen rectal veins due to:
- Increased pressure from the growing uterus
- Constipation from hormonal changes and iron supplements
- Decreased physical activity in late pregnancy
These changes weaken the walls of the veins, making them more likely to swell during labor.
2. Labor and pushing accelerate hemorrhoids.
During a vaginal delivery, the Valsalva maneuver (holding your breath and pushing down) dramatically increases pressure in the pelvic veins. This:
- Forces more blood into the veins of the rectum.
- Can enlarge existing hemorrhoids.
- Can cause new hemorrhoids to form.
- Sometimes leads to thrombosed hemorrhoids (painful clots inside a swollen vein).
Doctor’s Note (Medical Insight):
I have seen patients who had mild, symptom free hemorrhoids during pregnancy suddenly experience severe, swollen hemorrhoids within 24 hours of giving birth especially after a long second stage of labor.
3. Postpartum Recovery
Hemorrhoids are common after childbirth and often peak in the first week after delivery. Swelling usually improves within a few weeks, especially with:
- Proper hydration
- A high-fiber diet
- Sitz baths
- Gentle bowel habits
However, if hemorrhoids persist in pain or are bleeding heavily, medical evaluation is needed.
Final thoughts
Hemorrhoids symptoms in pregnancy are uncomfortable but usually temporary and manageable. Early detection, simple lifestyle changes, and safe home remedies can make a big difference.
As a doctor, my advice is to never ignore rectal bleeding or severe pain during pregnancy even if you think it’s “just hemorrhoids.” A quick checkup provides peace of mind and ensures that nothing more serious is going on.
Call to Action
Have you experienced hemorrhoids symptoms in pregnancy? Share your questions or experiences in the comments below your story may help another mom. If your symptoms are bothering you, don’t hesitate to consult your doctor.
FAQS
Straining during labor can worsen hemorrhoids, but they typically improve postpartum with proper care. Inform your healthcare provider if you have severe hemorrhoids before delivery.
Yes, most hemorrhoids improve or disappear after delivery as hormonal levels normalize and pressure on the veins decreases. However, they may persist if constipation continues postpartum.
Hemorrhoids during pregnancy often cause:
Itching or irritation around the anus
Pain or discomfort, especially when sitting
Swelling or a lump near the anus
Bleeding during bowel movements (bright red blood on toilet paper)
A feeling of fullness or pressure in the rectal area
Hemorrhoids are most common in the third trimester due to increased pressure from the baby’s weight, but they can develop at any stage, especially if constipation is an issue.
Hemorrhoids are more likely during pregnancy due to:
Increased pressure on the pelvic veins from the growing uterus
Hormonal changes that relax blood vessels, leading to swelling
Constipation (common in pregnancy), which can strain bowel movements
🧑⚕️ About the Author
Dr. Asif, MBBS, MHPE
Dr. Asif is a licensed medical doctor and qualified medical educationist with a Master’s in Health Professions Education (MHPE) and 18 years of clinical experience. He specializes in gut health and mental wellness. Through his blogs, Dr. Asif shares evidence-based insights to empower readers with practical, trustworthy health information for a better, healthier life.
⚠️ Medical Disclaimer
This blog is intended for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard or delay medical advice based on content you read here.
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