During pregnancy many obvious changes occur in the body. One big change is the size of your uterus, which expands so large that during the 3rd trimester it no longer fits in your pelvis. This growth helps you bring a human life into the world but it also puts pressure on a structure called the Inferior Vena Cava. This structure is a large vessel located on the right side of your body that carries blood from your lower limbs back up to the heart. Uterine pressure on the inferior vena cava together with higher progesterone levels in pregnancy cause swelling in the veins below that result in hemorrhoids. The increased progesterone also contributes to constipation and straining for a bowel movement also increases the risk and extent of hemorrhoid development.
Hemorrhoids can present as a single lesion or even a cluster of marble shaped structures. It is not uncommon for the hemorrhoids to become a “thrombosed hemorrhoid” which is when a blood clot forms inside the hemorrhoid. A thrombosed hemorrhoid can become painful and swollen and even prevent comfortable walking. Almost every hemorrhoid will be tender to the touch and some can cause rectal bleeding, especially during a bowel movement. Hemorrhoids are more common in later stages of pregnancy, and during birth due to the increased pressure from pushing. Some women get them for the first time during pregnancy, however, if there is a previous history of hemorrhoids, they are more likely to occur during pregnancy. The good news; after birth when the hormones subside and the uterus shrinks to its normal size the hemorrhoids resolve on their own.
With hemorrhoids affecting roughly 35% of the pregnant populationthere are some things you should know. Some tips that may help minimize hemorrhoid formation is incorporating lots of fiber and water to your diet to reduce constipation. If you are constipated, don’t force it! Straining for a bowel movement will only add more pressure to dilated blood vessels and increase the chance of creating a hemorrhoid. Sleeping on your side can decrease rectal pressure, or even taking a few minutes out of your day to lay on your left side if you’ve been standing for long periods of time. If the hemorrhoids do come, you can alleviate some of the symptoms by using ice packs or Witch Hazel, using these can ease the stinging sensation. To reduce discomfort, swelling and promote tissue regeneration you can try herbal remedies like Ma Ying Long Hemorrhoid Ointment, a natural, topical ointment commonly used in Traditional Chinese Medicine. If sitting is a struggle, you can buy a donut pillow to reduce the pressure placed on that area. Lastly, taking a warm bath will help you stay clean and reduce some discomfort to the irritated tissue. If the hemorrhoid does not subside after birth other chemical forms of treatment could be used for removal, however, it is rare for a hemorrhoid to require surgical removal.