Hemorrhoids, also known as piles, are not something you often think about unless you deal with the symptoms. One in every 20 adults has symptomatic hemorrhoids, and it's more prevalent in older ¹
Hemorrhoid occurrence in women is often due to pregnancy and childbirth, family history, constipation, and anal intercourse. Women who experience premenstrual syndrome (PMS) and irritable bowel movement (IBS) complain of increased rectal sensitivity and pain during menstrual periods.
Understand how hemorrhoids flare up during your period to ease the symptoms during your menstrual cycle.
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Hemorrhoidal tissue is a normal part of the human body. They are blood vessels in the anal canal or rectum, composed of connective tissues, blood vessels, and some muscles.
However, the tissue can enlarge during your menstrual cycle due to increased progesterone. This relaxes your pelvic floor muscles and increases pressure on your anal veins.
Hemorrhoids can be internal or external, and you may experience both simultaneously.
These occur around the anus and are often visible. They can become uncomfortable and be itchy, painful, and lumpy. External hemorrhoids can occasionally bleed or fill with blood that clots. The clots are not dangerous but result in swelling and pain.
This type of hemorrhoid develops inside the rectum and may bleed, but often are painless. They are not visible but may sometimes be felt. In some cases, internal hemorrhoids can protrude through the anus, becoming visible. When this happens, you can push them back in or wait for them to shrink back into the rectum on their own.
Various factors cause both types of hemorrhoids, which include:
Straining while pooping, especially when constipated or having diarrhea
Pregnancy or obesity, due to the extra pressure and weight on the bowel
Hereditary factors such as genetics can affect the integrity of the muscles and ligaments
Heavy manual labor, including prolonged periods of sitting
Childbirth puts extra pressure on the blood vessels
Aging as the connective tissues in the anus and rectum become weaker, resulting in bulging hemorrhoids
Internal hemorrhoids can't be felt and rarely cause pain unless they prolapse (pop out of the anus). The main symptoms of internal hemorrhoids include rectal bleeding, where the blood is visible on the toilet paper or in your stool, and a feeling of fullness after a bowel movement.
For external hemorrhoids, the symptoms may include the following:
Hard lumps near the anus that feel tender or squishy
Ache or pain in the anus, especially when sitting
For prolapse hemorrhoids, they are uncomfortable and painful, as you can feel them bulging outside the anus.
Your uterus contracts during your menstrual period to help expel the lining. Prostaglandins, hormone-like substances, are involved in the inflammation and pain that triggers uterine muscle contractions. Higher levels of prostaglandins in the body result in severe menstrual cramps.
Prostaglandins cause troublesome muscle contractions around your anal canal, causing spasms or pain around the anus. For this reason, you will feel like you have hemorrhoids during your period.
Women with irritable bowel syndrome (IBS) and premenstrual syndrome are at a higher risk of experiencing piles during their periods. These conditions cause hemorrhoids to feel worse before your periods because of hormones.
Progesterone and estrogen levels fluctuate throughout your menstrual cycle, and this shift can intensify your IBS and PMS symptoms. Changes in your hormones can stimulate prostaglandins to be released to your anal tissue.
This causes the veins in the rectum to become painful, irritated, and itchy before, during, and after your periods.
Hemorrhoids flare up during periods and can interrupt your daily activities. In this case, try any of these remedies to get fast relief.
Rest in a warm bath, preferably a sitz bath, which is a shallow bath of bicarbonate of soda and salt that helps you cleanse the perineum, relieving pain and the itchy feeling.
Take non-steroidal anti-inflammatory drugs (NSAIDs) to reduce the amount of pain-causing prostaglandins.
Use a water bottle, blanket, or heating pad, as the heat can help relax your anal muscles.
Treating and preventing hemorrhoids primarily relies on eliminating constipation. A diet high in fruits, vegetables, cereals, and water will help your body produce softer stool for an easy bowel movement that's passed regularly.
Apart from improving your diet, other treatments for hemorrhoids include the following:
Soak in warm salty water for around 15 minutes to reduce itchiness and swelling. Do this two to three times per day and after every bowel movement. If you desire to wash the anal area, use unscented soap and clean water. Gently pat the area with a dry towel to avoid being moist, which can result in anal itching (pruritus ani).²
Oral pain relievers, such as aspirin, ibuprofen, acetaminophen, and creams, can help treat hemorrhoid symptoms.
You can also use pads with witch hazel. Witch hazel contains antioxidant compounds that relieve skin irritation or lessen bleeding caused by hemorrhoids.
You can also settle for pads or creams with hydrocortisone or lidocaine to numb the area, reducing itching and swelling of the anal tissue.
To prevent hemorrhoids from worsening during your menstrual period, increase your fiber intake, including fruits, cereals, or supplements. You should also wear loose clothing with a breathable material like cotton to ease discomfort.
Stay hydrated by drinking seven to eight glasses of water per day. You should also increase your water intake if you lead an active lifestyle or stay in a hot area.
It is also important to avoid straining and sitting on the toilet for too long. Go to the toilet when you feel the urge to go (delaying may cause the stools to dry out).
Hemorrhoids occur when the veins in or around the anus become inflamed and swollen, causing your external anal tissue to become itchy and painful. Internal hemorrhoids can often not be felt but may result in some bleeding.
During your periods, hormonal changes affect hemorrhoid symptoms, which often feel worse. Reduce or prevent hemorrhoids during your periods by staying active and hydrated and eating foods rich in fiber to help prevent constipation.
During your periods, you experience hormonal shifts that can affect piles, making the symptoms feel worse.
Period butt pain, also known as proctalgia fugax, refers to butt hole cramps during your period due to prostaglandin that causes muscle spasms in the anal sphincter, pelvic floor muscles, or rectum muscles.
Definition & facts of hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Pruritus ani (2008)
Symptoms & causes of hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Hemorrhoids and other anal disorders | American College of Gastroenterology
Hemorrhoids: Expanded information | American Society of Colon and Rectal Surgeons