Hemorrhoids during and after pregnancy

Most expectant mothers enjoy sharing the joyful news of a pregnancy. However, many uncomfortable side effects of pregnancy and childbirth often go unmentioned. These include hemorrhoids, which occur in about half of all (expectant) mothers. In this article, we explain what hemorrhoids actually are, why they frequently occur during pregnancy or after childbirth, and why you shouldn't feel embarrassed to talk about them.

What are hemorrhoids?

Hemorrhoids are well-perfused vascular cushions located in the mucous membrane at the end of the intestine. Together with the sphincter muscle, they seal the anus and thus contribute to stool continence. Although everyone has hemorrhoids, you usually do not notice them consciously. This only happens when they cause problems. Therefore, when talking about hemorrhoids, it usually refers to the condition where the vascular cushions are enlarged and may protrude in front of the anus. These "varicose veins around the anus" can lead to various complaints such as itching, pain, bleeding after bowel movements, or soiling. Beyond these physical symptoms, hemorrhoids are also mentally burdensome for many affected individuals.

Hemorrhoids are classified into four grades of severity:

What are the causes of hemorrhoids during pregnancy and childbirth?

Hemorrhoids can affect anyone, but they often occur in women during or after pregnancy. About half of all expectant mothers suffer from hemorrhoids, although often only Grade 1 or 2. The most common time for hemorrhoids to appear is in the last third of pregnancy, facilitated by various circumstances: The hormone progesterone causes tissues, blood vessels, the pelvic floor, and muscles to relax and soften to make room for your growing baby. The vascular cushions in the anus are also affected by this and are more likely to protrude. Additionally, your steadily enlarging uterus exerts pressure on the hemorrhoidal cushions. As a result, blood flow in this area becomes less efficient and may stagnate. Pregnant women are also frequently affected by constipation. The increased straining during bowel movements caused by this puts additional pressure on the blood vessels and further promotes hemorrhoids. Even if you do not suffer from hemorrhoids during pregnancy, they may occur afterward due to pushing during childbirth.

In general, the likelihood of hemorrhoids increases with age and the number of pregnancies. Genetic predisposition for connective tissue weakness and overweight also promote the development of hemorrhoids. They can be quite uncomfortable and painful, but one concern we can alleviate for you: hemorrhoids have no effect on your baby.

How can hemorrhoids be treated and symptoms alleviated?

In most cases, the vascular cushions naturally regress within a few weeks after birth. For example, eight weeks after birth, 30 percent of all women are still affected by hemorrhoids, and after 24 weeks, it is still 13 percent. Even though hemorrhoids usually disappear on their own during this time, they are often experienced as very uncomfortable. If you suffer from hemorrhoids, you can always contact your midwife or your gynecologist without feeling embarrassed. They know how many women deal with these bothersome symptoms during pregnancy and postpartum and can best assess which treatment is most suitable for you. In addition to visiting the doctor, there are several things you can do to prevent, treat, and relieve hemorrhoids.

Prevention

1. Verstopfung vermeiden

During pregnancy, digestion is usually slower and you may suffer from constipation. This often leads to straining during bowel movements and thus promotes hemorrhoids. With a balanced and high-fiber diet as well as adequate fluid intake (one liter more than usual daily), you will get your digestion moving and prevent constipation. You can find out which foods are especially good for you right now in the article ". If you do experience constipation, you should only take laxatives during pregnancy after consulting your doctor and only if absolutely necessary.

2. Viel bewegen und langes Sitzen vermeiden

Another way to stimulate your somewhat sluggish bowel activity during pregnancy is regular exercise. You don't have to engage in competitive sports; even a daily walk works wonders. You can also easily incorporate movement into your workday: for example, if you spend most of your day sitting, try to stand up once an hour and take a walk around the office or use your lunch break for a walk.

3. Entspannung auf der Toilette

To avoid putting additional strain on the blood vessel cushions in your intestine, it is important to avoid straining during bowel movements and ideally to relax only the pelvic floor. It is helpful to take your time and sit in a squatting position if possible. A useful aid for this is a low stool or even two thick books on which you can place your feet while sitting on the toilet. Additionally, you can make your bowel movement easier by applying a fatty cream to the area around the anus beforehand.

4. Beckenbodentraining

The pelvic floor muscle network surrounds not only the uterus and bladder but also your rectum. With you strengthen the muscles that are particularly challenged during pregnancy and childbirth, thereby preventing severe hemorrhoids. Even after birth, you can specifically strengthen the muscles, but you should give your body enough rest during the postpartum period and also allow your pelvic floor a break initially.

Treat and relieve

1. Ärztlich behandeln lassen

If you suspect that you have hemorrhoids, you should discuss your suspicion with your gynecologist/doctor. They will diagnose whether hemorrhoids are indeed the cause of your symptoms. This is important because symptoms like blood in the stool can be caused by serious illnesses, or itching in the genital area by eczema or fungal infections. An anal vein thrombosis can also be the reason for pain around the anus. If diagnosed by your doctor, an anal vein thrombosis can be easily treated in the practice. If it turns out that hemorrhoids are the cause, your doctor can advise you on further treatment and, for example, prescribe an anti-inflammatory medication in the form of suppositories or ointment. For persistent complaints such as severe pain, bleeding, or fecal incontinence, they will probably refer you to a proctological practice that specializes in bowel problems. After childbirth and the postpartum period, additional treatment options are available there, such as sclerotherapy, cryotherapy, or surgical removal of hemorrhoids. But don't worry: these procedures are only really necessary in rare cases; most hemorrhoids can be managed with other treatments or disappear on their own after childbirth.

2. Kühlen

For pain relief, you can target the affected areas with cooling. Simply wrap a cooling pack (from the refrigerator, not the freezer) in a clean cloth and hold it against the anus two to three times daily. Make sure not to hold an ice pack or ice directly against the anus to prevent damage to the sensitive tissue from the cold. Alternatively, you can also use a quark compress or a cooled black tea bag for cooling. Both additionally have anti-inflammatory effects.

3. Auf Hygiene achten

After bowel movements, clean your intimate area with lukewarm water and gently pat dry with fragrance-free toilet paper to avoid irritation and inflammation. If you are using a cream for treatment, you should reapply it after each rinse. Additionally, regular sitz baths have a soothing effect. It is best to use a bath additive containing tannins, such as an oak bark extract from the pharmacy. This has anti-inflammatory and anti-itching properties and helps the blood vessels constrict. You can take a lukewarm sitz bath daily for ten to fifteen minutes. If you still have fresh birth injuries, consult your midwife beforehand to ensure that the wound does not soften too much. The injuries should also not come into contact with fatty creams used for hemorrhoid treatment.

4. Mit Creme behandeln

With external hemorrhoids, there is often friction pain, especially during movement. The uncomfortable sensation can be alleviated with fatty ointments, either for external application or, in the case of internal hemorrhoids, as suppositories. Most contain special hemorrhoid ointments available at the pharmacy, which include witch hazel,
Oak bark, witch hazel, or borage. The natural active ingredients have anti-inflammatory effects, relieve itching, and support wound healing. A
You achieve an additional cooling effect by storing the cream in the refrigerator.

5. Schmerzfrei sitzen

For acute pain when sitting, a Sitzring or a special hemorrhoid cushion can provide relief. However, be careful not to use it for too long at a time, as sitting on the ring can impede blood circulation, which in turn slows down the healing process.

Even if it's difficult to talk about such intimate issues like hemorrhoids: you must absolutely not feel embarrassed about them! If the bothersome vascular cushions are causing you trouble, feel free to confide in your doctor or midwife. They are familiar with these issues and can help you best. Because: the earlier hemorrhoids are diagnosed, the better symptoms can be targeted and uncomfortable difficulties avoided. We wish you all the best!