Understanding Piles in Women: Causes, Symptoms, and Treatment

Haemorrhoids, commonly called “piles”, are a common condition affecting millions of women worldwide, yet they are rarely discussed openly. Globally, about 4.4% of the population experiences piles, with women being at a higher risk due to factors such as pregnancy, childbirth, and hormonal changes. In India, the prevalence is significant, with nearly 40% of adults potentially affected, with women facing increased risk of piles during and after pregnancy. Understanding haemorrhoids in women is essential for effective prevention and treatment. Read on as we provide all the information needed to manage and alleviate this condition. Let’s first understand the basics.

What does ‘Piles’ mean for Females?

Piles is a common term for haemorrhoids, which are swollen veins in the lower part of the rectum and anus. Haemorrhoids in women can lead to discomfort, pain, and bleeding, particularly during bowel movements. Female haemorrhoids may be linked to factors such as pregnancy, childbirth, and hormonal changes, making it a frequent issue among women.

What are the Different Types of Piles in Women?

There are two main types of haemorrhoids in women:

1. Internal Piles

These occur inside the rectum and are usually not visible. They are generally painless but can cause bleeding during bowel movements. In some cases, internal piles may prolapse, meaning they extend outside the anus, which can cause discomfort or pain.

2. External Piles

These develop under the skin around the anus and are visible as lumps or swelling. External piles can be painful, especially during bowel movements or when sitting. They may also cause itching, irritation, and sometimes bleeding.

In addition to these two main types, piles can also be classified based on their severity:

• Grade 1: Small internal piles that bleed but do not prolapse.
• Grade 2: Piles that prolapse during bowel movements but retract on their own.
• Grade 3: Piles that prolapse and require manual pushing back into the anus.
• Grade 4: Large piles that remain prolapsed outside the anus and cannot be pushed back in.

Understanding the type and severity of piles is important for determining the most effective treatment and management options.

What are the Symptoms of Piles in Women?

The symptoms of piles in females can vary depending on the type and severity of the condition. Common symptoms include:

• Bleeding: One of the most common symptoms of piles in females is bright red blood during or after bowel movements. This is usually painless and may be noticed on toilet paper or in the toilet bowl.
• Pain or Discomfort: Haemorrhoids in women may cause pain, discomfort, or a burning sensation around the anus, especially during bowel movements. External piles tend to be more painful.
• Itching and Irritation: The area around the anus may become itchy or irritated, which can be particularly bothersome and may lead to further discomfort.
• Swelling or Lumps: Swelling or the presence of lumps around the anus can indicate external female haemorrhoids. These lumps may be tender or painful to the touch.
• Mucous Discharge: Some women with piles may notice a slimy or mucous discharge from the anus, which can lead to irritation of the surrounding skin.
• Prolapse: In more severe cases, internal piles may protrude outside the anus, leading to a prolapse. This can cause significant discomfort, pain, and difficulty in sitting or walking.
• Feeling of Incomplete Evacuation: Some women may feel as though they have not completely emptied their bowels, even after a bowel movement, which can be uncomfortable and frustrating.

The symptoms of piles in females can vary in intensity and may worsen with certain activities, such as straining during bowel movements, sitting for long periods, or during pregnancy. 

What are the Causes and Risk Factors for Piles in Women?

Female haemorrhoids can be caused by various factors that lead to increased pressure on the veins in the rectum and anus. Some of the common risk factors and causes of piles in females include:

• Chronic Constipation: Straining during bowel movements due to constipation is one of the major causes of piles in females. When women strain to pass hard stools, it increases pressure on the rectal veins, leading to swelling and inflammation.
• Pregnancy: During pregnancy, the growing uterus puts extra pressure on the veins in the pelvic area, which can lead to the development of piles in women. Hormonal changes during pregnancy can also relax the walls of blood vessels, making them more prone to swelling.
• Childbirth: The strain and pressure exerted during labour and delivery can cause or worsen female haemorrhoids. The pushing during childbirth can increase pressure on the rectal veins, leading to haemorrhoids in females.
• Prolonged Sitting: Sitting for extended periods, particularly on the toilet, can cause or exacerbate piles. This is because prolonged sitting increases pressure on the rectal area.
• Obesity: Excess body weight, especially around the abdomen, can increase pressure on the pelvic and rectal veins, making women more susceptible to developing piles.
• Lack of Fibre in Diet: A diet low in fibre can lead to constipation, which in turn can cause straining during bowel movements and increase the risk of piles.
• Heavy Lifting: Regularly lifting heavy objects or engaging in activities that involve straining can contribute to the development of piles by putting additional pressure on the rectal veins.
• Diarrhoea:Chronic diarrhoea can irritate the anal and rectal area, leading to inflammation and the development of piles.
• Genetic Factors: Some women may be more prone to developing piles due to a family history of the condition, as genetic factors can influence the strength and elasticity of the vein walls.

Understanding these causes can help take preventive measures to reduce the risk of developing piles and effectively manage existing symptoms.

How are piles in women diagnosed?

Diagnosing haemorrhoids in women typically involves a combination of medical history, physical examination, and sometimes additional tests. Here’s an overview of the diagnostic process:

• Medical History: The doctor will ask about symptoms, their duration, and any factors contributing to the condition, such as pregnancy, recent childbirth, or chronic constipation.

• Physical Examination:

• Visual Inspection: The doctor will examine the anal area for visible signs of external piles, such as swelling, lumps, or irritation.
• Digital Rectal Examination (DRE): A gloved, lubricated finger is gently inserted into the rectum to check for internal piles, tenderness, and any abnormalities.
• Anoscopy: This procedure involves using a small, tubular instrument called an anoscope to view the inside of the anal canal and lower rectum. It allows the doctor to see internal piles and assess their severity.
• Sigmoidoscopy: If internal piles are suspected or need to examine a larger portion of the rectum, a sigmoidoscopy may be performed. This involves using a flexible tube with a camera (sigmoidoscope) to inspect the rectum and lower colon.
• Colonoscopy: In some cases, especially if there is significant bleeding or other concerns, a colonoscopy may be recommended. This procedure allows for a thorough examination of the entire colon and rectum using a long, flexible tube with a camera (colonoscope).

These diagnostic tools help differentiate piles from other conditions that might cause similar symptoms, such as anal fissures, infections, or colorectal cancer.

What are the Treatment Options for Piles in Women?

Treatment options for piles in women can vary depending on the severity of the condition. Here are some common approaches:

Over-the-Counter Medicines

• Topical Creams and Ointments: Products containing ingredients like hydrocortisone or witch hazel can help reduce itching, swelling, and discomfort.
• Suppositories: These can provide relief from internal piles and help reduce inflammation.

Medical Treatments

• Rubber Band Ligation: A procedure where a rubber band is placed around the base of an internal pile to cut off its blood supply. The pile eventually shrivels and falls off.
• Sclerotherapy: Involves injecting a solution into the pile to shrink it by causing the blood vessels to constrict.
• Infrared Coagulation (IRC): Uses infrared light to burn the blood vessels of the pile, causing it to shrink and fall off.

Surgical Options

• Hemorrhoidectomy: Surgical removal of the piles. This is usually reserved for severe cases or when other treatments have not been effective.
• Stapled Hemorrhoidopexy: A less invasive surgery that involves stapling the piles back into place and cutting off their blood supply.
• Laser Treatment: A minimally invasive procedure where laser energy is used to shrink hemorrhoidal tissue and reduce symptoms. This technique is associated with less pain, quicker recovery, and minimal bleeding compared to traditional surgical methods.

Preventive Measures

• Regular Check-ups: Routine examinations with a healthcare provider can help monitor and manage the condition.
• Avoid Heavy Lifting: Minimise activities that increase pressure on the rectal area.

The choice of treatment depends on the severity of the piles, the symptoms experienced, and individual health considerations. Consulting a healthcare professional is essential to determine the most appropriate and effective treatment plan.

What are the Natural Remedies for Piles in Women?

Natural remedies for haemorrhoids in women can provide relief from symptoms and help manage the condition. Here are some effective natural approaches:

Warm Sitz Baths

Soak the affected area in a warm sitz bath for 10-15 minutes several times a day, especially after bowel movements. This can help soothe irritation, reduce swelling, and relieve pain.

Cold Compresses

Apply a cold pack or ice wrapped in a cloth to the anal area for 10-15 minutes at a time. Cold compresses can help reduce swelling and numb the area, alleviating pain.

Aloe Vera

Apply pure aloe vera gel directly to the affected area. Aloe vera has anti-inflammatory and soothing properties that can reduce irritation and promote healing.

Witch Hazel

Apply witch hazel extract to the anal area using a cotton ball. Witch hazel acts as an astringent, reducing swelling and itching.

Coconut Oil

Apply a small amount of organic coconut oil to the affected area. Coconut oil has moisturising and anti-inflammatory properties that can soothe and protect the skin.

Apple Cider Vinegar

Dilute apple cider vinegar with water and apply it to the affected area with a cotton ball. It may help reduce itching and inflammation, though it should be used cautiously as it can be irritating for some.

High-Fiber Diet

Include fibre-rich foods like fruits, vegetables, and whole grains in your diet. A high-fibre diet helps soften stools and prevents constipation, reducing the strain on the rectal veins.

Hydration

Drink plenty of water throughout the day. Staying hydrated helps maintain soft stools and supports overall digestive health.

Herbal Remedies

Herbs such as butcher’s broom, horse chestnut, and calendula can be taken as supplements or used in topical treatments. These herbs have anti-inflammatory and venotonic properties that may help improve circulation and reduce symptoms.

Exercise

Engage in regular physical activity, such as walking or swimming. Exercise helps maintain healthy bowel function and reduces the risk of constipation.

These natural remedies can offer relief from symptoms and support overall health, but they may not replace medical treatment for severe or persistent cases. Consulting with a healthcare provider is essential for appropriate diagnosis and treatment.

How to Prevent Piles in Women?

Preventing piles (haemorrhoids) in women involves adopting habits and lifestyle changes that reduce the risk factors associated with the condition. Here are some effective preventive measures:

Eat a High-Fiber Diet

Include a variety of fruits, vegetables, and whole grains in your diet to ensure adequate fibre intake. Consider using fibre supplements like psyllium husk if you have difficulty getting enough fibre from food.

Stay Hydrated

Aim for at least 8 glasses of water a day to keep stools soft and promote regular bowel movements.

Exercise Regularly

Regular exercise helps maintain healthy bowel function and prevent constipation. If you have a desk job, take breaks to stand up and move around periodically.

Avoid Straining During Bowel Movements

Respond to the urge to go to the bathroom promptly to avoid constipation and straining. Avoid sitting on the toilet for extended periods, and do not strain when passing stools.

Manage Weight

Excess weight, especially around the abdomen, can increase pressure on the rectal veins. Adopting a balanced diet and exercise routine can help manage weight effectively.

Practise Good Hygiene

Use moist toilet wipes or a gentle cleansing agent to clean the area rather than rough toilet paper to avoid irritation. Use mild, fragrance-free soaps to prevent skin irritation around the anal area.

Prevent Chronic Constipation and Diarrhoea

Manage constipation with dietary changes; if necessary, use gentle laxatives under medical guidance. Address diarrhoea with appropriate medications and maintain hydration.

Special Considerations for Pregnant Women

Regular check-ups and following advice from a healthcare provider can help manage risks associated with pregnancy. In addition, it is important to manage weight gain during pregnancy to reduce pressure on the pelvic veins.

By incorporating these preventive measures into daily routines, women can significantly reduce their risk of developing piles and maintain overall rectal and anal health.

Conclusion

While piles in women can be uncomfortable and disruptive, understanding their causes and symptoms allows for effective management and relief. If you or someone you know is struggling with female haemorrhoids or seeking expert guidance on treatment options, Max Hospitals is here to help. Our dedicated team of specialists provides personalised care and advanced treatments for female haemorrhoids. Contact Max Hospitals today to schedule a consultation and take the first step towards better health.