Pregnancy For Dummies
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No one wants to talk about them, but hemorrhoids — dilated, swollen veins around the rectum — are a common problem for pregnant women. They’re essentially varicose veins of the rectum. The enlarging uterus causes hemorrhoids by pressing on major blood vessels, which leads to pooling of blood, and ultimately makes the veins enlarge and swell.

Progesterone relaxes the veins, allowing the swelling to increase. Constipation makes hemorrhoids worse. Straining and pushing hard during bowel movements puts added pressure on the blood vessels, causing them to enlarge and possibly protrude from the rectum.

Hemorrhoids sometimes bleed. This bleeding doesn’t harm the pregnancy, but if it becomes frequent, talk to your doctor and possibly see a colorectal specialist or general surgeon. If hemorrhoids become very painful, you may want to discuss whether treatment is necessary. Meanwhile, you can try the following:

  • Avoid constipation. Straining to push out hard stool can make hemorrhoids worse.

  • Exercise. Activity increases bowel motility, so the stool doesn’t get too hard.

  • Get off your feet when you can. Doing so alleviates extra pressure on your veins.

  • Try over-the-counter topical medications, such as Preparation H or Anusol, or a steroid cream. Many women find some relief with these medications.

  • Take warm baths two to three times a day. Soaking in warm water can help relieve the muscle spasms that most often cause the pain.

  • Use over-the-counter hemorrhoidal pads (such as Tucks) or witch hazel pads to clean and medicate the area. These pads often provide a cooling, soothing relief.

Pushing during the second stage of labor can make hemorrhoids worse or make them appear where they weren’t before. But, most of the time, hemorrhoids go away after delivery.

About This Article

This article is from the book:

About the book authors:

Joanne Stone, MD, and Keith Eddleman, MD, are Board Certified in Obstetrics and Gynecology, and are Associate Professors at Mount Sinai School of Medicine.

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