Haemorrhoids in Women: Causes, Symptoms and When to Get Help

Haemorrhoids in Women: Causes, Symptoms and When to Get Help

Are Haemorrhoids Common in Women?

Yes. Haemorrhoids affect men and women in broadly similar numbers across a lifetime, and by middle age a large proportion of adults will have had symptoms at some point. Women, however, face a few additional pressures on the pelvic veins at particular life stages, and they are also more likely to put off getting symptoms looked at, whether from embarrassment or because bleeding and discomfort around the pelvis can be put down to periods or childbirth. If you are a woman with symptoms, you are far from alone, and a short examination is usually all it takes to find out what is going on.

Why Women Can Be Prone to Piles

The causes are mostly the same as in men: straining with hard stools, long periods of sitting, a low-fibre diet, heavy lifting and a family tendency to weaker vein walls. For women there are some extra factors. Pregnancy raises the pressure in the pelvic veins as the womb grows, and the hormone progesterone relaxes vein walls and slows the bowel, which encourages constipation. Vaginal delivery, particularly a long second stage, can bring haemorrhoids on or make existing ones worse. Constipation is also reported more often by women than by men, and pelvic floor problems can make it harder to empty the bowel comfortably. Our guides on piles during pregnancy and haemorrhoids after childbirth cover those two stages in detail.

Hormones, Periods and Menopause

Many women notice that their symptoms shift with their cycle. In the days before a period, higher progesterone can slow the gut and make stools harder, and some women find that haemorrhoids feel more swollen or itchy at that time. Around the menopause, falling oestrogen affects the strength and elasticity of connective tissue, including the tissue that supports the anal cushions, and that can make prolapse of haemorrhoids more likely. Constipation also tends to become more common with age. None of this means haemorrhoids are a hormonal condition, but it explains why a woman with no symptoms for years may find they flare in the perimenopause. Our article on haemorrhoids in older adults explains how age changes the picture.

Symptoms to Look For

The usual signs are bright red blood on the toilet paper or in the bowl after a bowel movement, itching or irritation around the anus, a feeling of fullness or incomplete emptying, a soft lump that comes down when you strain and may go back by itself, and a mucus discharge that can leave the area damp. Internal haemorrhoids are often painless, so bleeding may be the only sign. External haemorrhoids and thrombosed ones, where a clot forms, can be tender and make sitting uncomfortable. Our early signs of haemorrhoids guide lists the symptoms in full, and the article on haemorrhoid types explains how internal and external ones differ.

Could It Be Something Else?

Because of the anatomy, symptoms in women can be mistaken for other conditions, and the reverse is also true. Pelvic pain or pressure can come from the pelvic floor, the bladder, endometriosis or a rectocele, where the rectum bulges into the back wall of the vagina and makes emptying the bowel harder. Anal fissures cause a sharp, cutting pain with bowel movements and are common after childbirth, and our guide on haemorrhoids or anal fissure explains how to tell them apart. Itching can come from skin conditions, thrush or lichen sclerosus. A lump may be a skin tag, a prolapse or something else, and our guides on anal skin tags and a lump near the anus set out the possibilities. An examination is the only reliable way to separate them.

Bleeding: What Is Usual and What Needs Checking

Small amounts of bright red blood on the paper are the classic haemorrhoid sign. Bleeding that is heavier, dark, mixed through the stool, that comes with a change in bowel habit lasting more than a few weeks, unexplained weight loss, tiredness or a lump you can feel in the abdomen should be assessed by a doctor, since these can point to a cause other than piles. It is also worth working out whether blood is coming from the back passage or the vagina, which can be hard to tell. Our articles on bleeding haemorrhoids and haemorrhoids or bowel cancer explain what to look out for and why bowel symptoms should not simply be assumed to be piles.

Self-Care That Helps

The foundation is keeping stools soft and easy to pass. Build up fibre gradually from vegetables, fruit, pulses and wholegrains, drink enough that your urine is pale, move regularly, and go when you feel the urge rather than holding on. Avoid straining, and avoid sitting on the toilet for long periods, so leave the phone outside. Warm baths and short sitz baths can ease soreness, and a pharmacist can advise on creams or a stool softener, including which are suitable if you are pregnant or breastfeeding. Our articles on how to shrink haemorrhoids and on straining on the toilet have practical detail. Pelvic floor exercises are good for general pelvic health, but if you struggle to empty your bowel or feel a bulge, ask for an assessment rather than assuming more exercises will help.

Treatment Options

Treatment depends on the type and grade of the haemorrhoids. Mild cases often settle with diet and bowel habit changes. Persistent internal haemorrhoids can be treated in a clinic with rubber band ligation, injection sclerotherapy, infrared coagulation or electrotherapy, and larger or prolapsed ones sometimes need surgery. Our guide to non-surgical haemorrhoid treatments compares the main options, and the NHS versus private article explains waiting times and cost. Treatment choice matters for women who may be planning a pregnancy, so tell your clinician if that applies to you.

What We Offer at Our Clinics

At our clinics in Glasgow and London we treat internal haemorrhoids with eXroid electrotherapy, which applies a low-dose direct current to the base of the haemorrhoid so that it shrinks over the following weeks. It is done without cutting or a general anaesthetic. Of 116 patients treated at our clinics since January 2025, 84% needed only one session, although individual results vary and some people need a follow-up. A consultation with examination is £365, consultation and treatment on the same visit is £1,095, and a follow-up treatment, if needed, is £795. If what we find is not something we treat, such as a fissure, a pelvic floor problem or a symptom that needs a specialist, we will say so and tell you who to see.

Next Steps

If you have had bleeding, discomfort or a lump for more than a couple of weeks, or symptoms that keep returning, it is worth getting a clear answer rather than guessing. Our severity test takes a couple of minutes and can help you think through your symptoms, although it is not a diagnosis. You can read about our procedure or book an appointment at our Glasgow or London clinic, where you will be seen by a clinician who does this every week.

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