Hemorrhoids, alternately called piles, is a condition where the veins situated in the anus and lower rectum appear swollen. When they develop on the skin surrounding the anus, it is external hemorrhoids. When they grow in the inner part of the rectum, they are called internal hemorrhoids.
Though hemorrhoids can occur in both sexes, women are said to report more of this condition than their male counterparts. The pressure of labor during childbirth and the hormonal imbalances in later life could lead to constipation and trigger hemorrhoids.
With menopause, your body goes through several changes due to fluctuating hormones, which affect your body’s functions. Your digestive system gets affected, too, which could lead to issues like bloating, constipation, etc. When you are constipated and have to strain while passing bowels, it could put you at risk of hemorrhoids. So, what has menopause got to do with hemorrhoids? Could menopause make hemorrhoids worse? Read on to know more.
Does Menopause Cause Hemorrhoids?
It’s not that old age causes hemorrhoids. However, when one ages, there could be several alterations in their body due to the tissue changes. Older adults have an increased possibility of constipation  than their younger counterparts. There could even be side effects of medications. All these could serve as trigger points for hemorrhoids.
Now, let’s shift our focus to menopause and hemorrhoids. Firstly, irrespective of gender, with age, individuals are a little more prone to develop hemorrhoids. Women mostly go through menopause when they have crossed their late 40s unless it occurs early or prematurely. Also, there is the functioning of the hormones.
The reproductive hormones estrogen and progesterone fluctuate and start reducing in numbers during the menopause transition or perimenopause stage. By menopause, they fall drastically and impact most organs, including the digestive system. Gastrointestinal intestinal symptoms , like abdominal pain, bloating, changing, and discomfort in bowel movement, are common in perimenopause and menopause.
The estrogens have a whole lot of functions , and one of them is keeping the cortisol levels under check. Cortisols are stress hormones. Low estrogen means high cortisol levels. This impairs the digestion process and lengthens the time for the breaking down of food in the intestine. In this way, high cortisol levels also increase the chances of constipation.
As mentioned, constipation could eventually manifest into hemorrhoids, mainly if it is prolonged and recurring, where you need to strain a lot to pass the bowels. If you are already affected by hemorrhoids, the symptoms could worsen during hormonal changes, be it before your menses or when you are transitioning into menopause.
Types of Hemorrhoids
We’ve already mentioned the two types of hemorrhoids – internal and external. There’s also a third kind, i.e., prolapsed hemorrhoids. So, let us get a more detailed insight into them.
1. Internal Hemorrhoids
As evident from its name, this type of hemorrhoids internally. The swollen veins grow within the rectum. The internal hemorrhoids could trigger internal bleeding, but they aren’t that painful unless prolapsed.
2. External Hemorrhoids
In this case, the hemorrhoids develop in the skin beneath the anus. They could be painful and lead to itchiness. The hemorrhoids resemble tiny lumps formed in the outer parts of the anus. Sometimes, there could even be blood clots, which causes the lump to harden, intensifying the pain. This leads to a thrombosed hemorrhoid that could also lead to inflammation and swelling alongside the intense pain.
3. Prolapsed Hemorrhoids
When the hemorrhoid pushes through the rectum, bulging out of the anus, it results in a prolapsed hemorrhoid. It could be more painful if there’s been a blood clot. Moreover, the pain will even increase when you sit than when you are in a standing or lying posture. Both the internal and external hemorrhoids may prolapse. However, the risk of prolapse is more in the case of internal hemorrhoids than the ones occurring externally.
What are the Symptoms of Hemorrhoids?
If you are often constipated during perimenopause and menopause, you will have to keep a watch on the following symptoms. This will help you understand if you’ve developed hemorrhoids or not due to prolonged constipation.
When you notice one or many of these symptoms, contact the doctor as early as possible. Here are some of the signs of internal, external, and prolapsed hemorrhoids to watch out for:
1. External Hemorrhoids
If you have internal hemorrhoids, you could go through the following symptoms mentioned below:
- Rectal bleeding mostly during bowel movements; you could even spot blood on the toilet tissue
- Itching in the anal area
- Hard lumps near the anus, which could be tender or sore
- Anal pain mostly when you sit
2. Internal Hemorrhoids
The internal hemorrhoids mostly do not come with any other symptoms apart from bleeding. You could spot blood on the tissue after a bowel movement. It’s mostly painless. However, when the internal hemorrhoid has prolapsed, it may lead to irritation and pain.
3. Prolapsed Hemorrhoids
When the hemorrhoid has prolapsed and pushed its way outside the anus, these are some of the symptoms that you may encounter.
- Lumps around the anus that may vary in number from one to many
- Pain during a bowel movement or while sitting
- Irritation, or itching surrounding the anal area
Solutions to Manage Hemorrhoids in Menopause
Hemorrhoids mainly occur in menopause due to frequent episodes of constipation. So, the onus lies on you to find out ways to manage the same, to lessen discomfort and pain. Here are some tips to help you manage hemorrhoids effectively, not just in menopause but at other times.
1. Stay Hydrated
If you are constipated and have trouble with your bowel movements, keeping yourself hydrated by drinking adequate amounts of water is essential. When you drink water  and other fluids beneficial for your system, it will soften the stool and make it pass with ease.
When you have fewer incidences of constipation, you will also be able to control the occurrence of hemorrhoids. Women must have a daily fluid intake  of around 11.5 cups.
If you are at risk of hemorrhoids and are mostly constipated, you could even ask your doctor if you need to increase your fluid intake or not. You must reduce caffeine intake, as excessive consumption may result in dehydration and aggravate constipation.
2. Amend Your Diet
Adding sufficient fiber to your diet is essential for many reasons when transitioning into menopause. If you have constipation, you would require this fiber a lot more to soften your stool and help in its easy passage. So add fruits and veggies to your diet, which have a high fiber content. Here are some of the fiber-rich foods:
- Collard greens
- Sweet potato
- Brussels sprouts
- Beet greens
- Mustard greens
However, consult your doctor before upping your fiber intake, as too much of it could lead to loose stools.
3. Opt for Warm Baths and Ice Pack
If your hemorrhoids are painful, soak the affected area in a warm bath. This facilitates blood flow in the anal tissues. This way, it helps in healing and also lessens inflammation, itching, pain, and irritation. Adding Epsom salt to your warm bath will be a quicker remedy for reducing inflammation.
4. Stop Smoking and Lessen Alcohol Intake
Overconsuming alcohol and smoking are the two no-nos for women in the perimenopause and menopause stages. Studies have also shown that those who drink too much alcohol or smoke are at a greater risk of hemorrhoids.
Smoking negatively impacts vascular health, while increased alcohol intake results in dehydration, making you more susceptible to constipation and hemorrhoids. So, when in menopause and if troubled with constipation, don’t delay in giving up smoking. Also, lessen your alcohol intake to not more than a drink a day.
Besides these, if you are troubled with pain and inflammation, you should consult your doctor for OTC creams or ointments for the area that has been affected. Your healthcare provider may also prescribe anti-inflammatory medications to combat the inflammation and pain.
If you are severely constipated, the healthcare provider might even recommend an enema or laxatives to help you pass stools with ease.
Avoid sitting in the toilet for long and applying too much pressure during a bowel movement. This could make hemorrhoids worse.
When there is a fluctuation in the hormone levels, then that could make your hemorrhoids worse. In the menopause transition phase, there is an uneven increase and decline in the levels of estrogen and progesterone. This could elevate the symptoms of hemorrhoids if you are already suffering from this condition.
If there is increased pain, inflammation, or increased rectal bleeding, contact the doctor at once. In most cases, hemorrhoids aren’t concerning, and sometimes, with proper management, they may even subside in some time.
The doctor would examine your rectum physically. He may also conduct a digital rectal exam. This involves the insertion of a lubricated and gloved finger inside the rectum to examine swollen veins. Tests like anoscopy and sigmoidoscopy may even be conducted to examine the anus, colon, and rectum.
Hemorrhoids aren’t rocket signs, and with proper care and prompt treatment, they’ll resolve quickly. If you already have hemorrhoids, then during and after menopause, you should be double concerned about your lifestyle to ensure that the symptoms don’t intensify. If you haven’t been affected by hemorrhoids, then ensure that you can lessen your risk of the same. Watch out for your diet and exercise needs to stay healthy and avoid hemorrhoids.