Haemorrhoids in women: causes, special features and delicate questions

2026-10-22

Pregnancy, childbirth and constipation are the main reasons haemorrhoids in women are so common.
Bleeding from the back passage should never be put down to your period or 'just piles': get checked.
A proctology examination takes a few minutes, and you can talk openly about delicate details.
Fibre, water, not straining and gentle hygiene help at any age.
During pregnancy and breastfeeding, any haemorrhoid remedy should only be used on a doctor's advice.

Your baby is six months old, life is settling into a new rhythm, yet the discomfort after going to the toilet has not gone away. It feels awkward to mention it to your husband, and to your mother too, who will probably say, 'Everyone has that after giving birth, just put up with it.' And so, month after month, you quietly endure itching, burning and traces of blood on the paper.

If this sounds familiar, you are far from alone. Haemorrhoids in women are a very common and well-understood problem, and there is no more reason to be embarrassed about them than about a cold. Let's look at why they develop, what to watch out for and how to discuss delicate questions calmly with your doctor.

Why are haemorrhoids so common in women?

Everyone has haemorrhoidal tissue: these are cushions of blood vessels in the anal canal that help with continence. They become a problem when they swell, become inflamed, bleed or prolapse. Women have some extra reasons for this:

Pregnancy. The growing womb presses on the pelvic veins, while hormones relax the vessel walls and slow down the bowel.
Childbirth. Strong, prolonged pushing sharply raises the pressure in the rectal veins.
Constipation. Women experience it more often than men overall, especially with desk jobs, strict weight-loss diets and too little water.
Some medicines, such as iron supplements, can make stools harder. Do not stop them on your own; talk to your doctor instead.
Long hours sitting or, on the contrary, standing: in the office, behind a shop counter, or at the stove preparing for a big family celebration.

Pregnancy and childbirth: the most common starting point

Symptoms most often first appear in the third trimester and in the weeks after birth. Many women feel better on their own once the baby is born, but in some the swellings remain and flare up from time to time.

During pregnancy, simple measures remain the basis of prevention: more vegetables, fruit and water, a daily walk, resting on your left side, and avoiding long periods of sitting and straining. You can read more about how carrying a baby affects the veins in our article on how pregnancy and vein disease are closely linked.

After giving birth, many women dread their first bowel movement, especially if they had stitches, and put off going to the toilet. The stool then becomes harder, and a vicious circle begins. Soft stools are especially important in these days, so talk to your doctor if you cannot manage it.

What are the symptoms of haemorrhoids?

The symptoms are the same in women and men. Watch out for:

bright red blood on the toilet paper, on the surface of the stool or as drops in the toilet;
itching, burning or a feeling of dampness around the anus;
a feeling of something there, or of not having fully emptied your bowel;
lumps that come out when you strain and then go back by themselves or have to be pushed back;
sudden pain with a firm, tender lump outside, which is often how a thrombosed external haemorrhoid shows itself.

Read more about the early signs in our article on the first signs of haemorrhoids.

What can haemorrhoids be confused with?

Self-diagnosis is particularly unreliable here. For women, there are several situations that are easy to mistake for haemorrhoids, or to overlook:

Bleeding during your period. On those days it is hard to tell where blood is coming from. If in doubt, watch after your period ends, and always show recurring blood from the back passage to a doctor.
Anal fissure. It often appears after childbirth and causes sharp, cutting pain during and after a bowel movement.
Weak pelvic floor muscles. A feeling of bulging in the vagina, difficulty emptying your bowel, or needing to 'help' with your fingers are reasons to see a gynaecologist or proctologist.
Itching from irritation. Scented wipes, soap, a fungal infection or an allergy can cause itching similar to that of haemorrhoids.
Bowel polyps and tumours. These can also bleed, so your doctor will decide whether further bowel tests are needed, especially if you are over 45 or have relatives who had bowel cancer.

There is one more point specific to women: heavy periods combined with regular bleeding from the back passage can lead to iron-deficiency anaemia. Weakness, pallor and breathlessness on the stairs are reasons to have a blood test.

How can you see a proctologist without embarrassment?

Many women delay their visit precisely because they fear the examination. In reality it is short and usually painless. Here is what to expect:

A conversation: the doctor will ask about your symptoms, bowel habits, pregnancies, births, medicines and whether you are breastfeeding.
An examination lying on your side with your knees drawn up to your chest, which is more comfortable and less awkward.
A gentle finger examination and, if needed, anoscopy: a short tube with a light lets the doctor see the haemorrhoids from inside.
If necessary, the doctor will refer you for a fuller bowel examination.

You have every right to ask whether the clinic has a female doctor and to request a nurse in the room during the examination. Ask when booking whether any preparation is needed: some clinics require it and others do not.

What helps in everyday life?

According to international guidelines, the cornerstone of treatment and prevention is soft, regular bowel movements without straining. Much of this can be done at home:

Fibre: vegetables, fruit, pulses, wholegrain bread and bran. Increase it gradually and be sure to drink enough water.
No straining and no phone in the toilet: sitting on the toilet for a long time increases blood flow into the haemorrhoids. A low footstool makes emptying your bowel easier.
Gentle hygiene: after the toilet, wash with cool or warm water and pat the skin dry with a soft towel. Avoid scented wipes and harsh soaps.
Comfortable cotton underwear instead of very tight synthetic fabrics.
Warm sitz baths for 10–15 minutes ease itching and discomfort for many women.
Movement: walking and simple exercises help the bowel work. After childbirth, discuss pelvic floor recovery with your gynaecologist.

We explain how to keep your bowels regular safely in our article on constipation and haemorrhoids.

Medicines during pregnancy and breastfeeding

At these times it is especially important not to treat yourself by guesswork: any suppositories, ointments or tablets, including herbal ones, should be chosen by a doctor, who will take into account the stage of your pregnancy or the fact that you are breastfeeding.

Outside pregnancy and breastfeeding, your doctor may also discuss venotonic medicines. Phlebodia 600 (diosmin 600 mg) is indicated for the symptomatic treatment of acute haemorrhoids: according to the instruction leaflet, 2–3 tablets a day are taken with meals. If symptoms persist after several days of treatment, you should see a doctor. The medicine is contraindicated in the first trimester of pregnancy and under the age of 18; later in pregnancy it is used only on a doctor's recommendation, and it is not recommended during breastfeeding.

Full details are in the official instruction. Before use, read the instruction leaflet and consult a specialist.

The main points

Haemorrhoids in women are nothing to be ashamed of, and not 'something normal you have to put up with'. They are an ordinary medical problem that responds well to treatment when you see a doctor in good time. Look after yourself as tenderly as you look after your family: a short visit to a proctologist can give you back your peace of mind and comfort.

Sources: 1. van Tol RR, Kleijnen J, Watson AJM, et al. European Society of ColoProctology: guideline for haemorrhoidal disease. Colorectal Dis. 2020;22(6):650–662. 2. Davis BR, Lee-Kong SA, Migaly J, Feingold DL, Steele SR. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum. 2018;61(3):284–292. 3. Instructions for medical use of Phlebodia 600 (Republic of Uzbekistan).

Why do haemorrhoids often appear during pregnancy and after childbirth?

The growing womb presses on the pelvic veins, hormones relax the vessel walls and slow the bowel, and pushing during labour sharply raises pressure in the rectal veins. All of this encourages haemorrhoids to swell.

Will haemorrhoids go away on their own after childbirth?

Symptoms often ease noticeably in the first weeks and months after birth, especially once bowel habits are back on track. If bleeding, itching or prolapse persist, see a proctologist.

Can I have a vaginal birth if I have haemorrhoids?

As a rule, haemorrhoids alone are not a reason for a caesarean section. The method of delivery is decided by your obstetrician, so be sure to tell them about your symptoms.

Do periods affect haemorrhoids?

Some women notice their symptoms get worse before a period, but there is little scientific data on this. The key thing is not to put bleeding from the back passage down to your period, and to see a doctor.

Can I ask to be examined by a female doctor?

Yes, that is a perfectly normal request. Ask when booking whether the clinic has a female proctologist; you can also ask for a nurse to be present during the examination.