Managing Hemorrhoids and Varicose Veins in Pregnancy
Hemorrhoids and varicose veins might seem to be two different, unrelated problems, but they are actually quite similar. And, they are a discomfort experienced by many women, especially in the third trimester of pregnancy.
What are hemorrhoids and varicose veins?
Both hemorrhoids and varicose veins are swollen, twisted veins. These veins are often in the legs, but they also can form in other parts of your body, including the rectum, where they are called hemorrhoids.
Why do these happen in pregnancy?
Normally, veins have one-way valves to help keep blood flowing toward your heart. Pressure or weakening of these valves allows blood to back up and pool in your veins, causing them to enlarge and swell. In pregnancy, the heavy weight of the growing baby presses on the large blood vessels in your pelvis. In addition, hormone changes affecting blood vessels can slow the return of blood to your heart and cause the smaller veins in the pelvis and legs to swell. Hemorrhoids result when rectal veins enlarge, and varicose veins occur when veins of the legs swell.
Hemorrhoids can get worse with pushing or straining, especially with constipation. Being overweight and having hemorrhoids before pregnancy can also make them worse. And, unfortunately, pushing during delivery tends to worsen hemorrhoids.
Varicose veins tend to run in families. Sitting or standing in one position for a long time may force your veins to work harder to pump blood to your heart. This can result in swollen, varicose veins and can aggravate hemorrhoids you already have.
What are the signs and symptoms?
Hemorrhoids can be internal, forming inside the rectum, or external, located on the outside, around the anal opening. Internal hemorrhoids can sometimes protrude through the opening. The most common symptom is bright red blood passed with a bowel movement. External hemorrhoids can be painful or itch, and may bleed if irritated by straining or wiping.
Varicose veins often appear as large blue veins on the legs. You may have mild swelling in your ankles and feet or feel aching, heaviness, or throbbing in your legs. You may also have leg cramps.
What can I do about them?
Fortunately, hemorrhoids in pregnancy are a temporary problem, but there are some things you can do to relieve the discomfort:
To relieve pain, sit in a tub or sitz bath several times a day in plain, warm water for about 10 minutes each time. When you use a sitz bath, don’t fill the tub all the way. Just put in enough warm water to sit in. That will direct blood flow to your rectum.
Use ice packs or cold compresses to reduce swelling.
Ask your health care provider about creams or other medications that are safe to use during pregnancy.
It’s important to prevent constipation by including lots of fiber and fluids in your diet. In addition, try not to strain with bowel movements, and avoid sitting for a long time. Regular Kegel exercises, which involve squeezing and relaxing the muscles in your vaginal and rectal area, can help improve muscle tone.
Most varicose veins that develop during pregnancy get better within the first year after birth. But for now, limit standing or sitting for a long time without a break, and try not to cross your legs. Avoid tight clothing around your waist, thighs, and legs, as it can worsen varicose veins.
Be sure to check with your health care provider if your symptoms worsen or you have excessive bleeding from hemorrhoids. And remember that these problems are usually temporary and improve with time and treatment.
- Moloney Johns, Amanda, PA-C, MPAS, BBA
- newMentor board-certified, academically affiliated clinician