People with endometriosis can experience hemorrhoids, a painful condition caused by swollen blood vessels in the anus and rectum. Hemorrhoids can arise from diarrhea, constipation, and even from frequently lifting heavy objects — all of which can increase abdominal pressure. However, hemorrhoids are not a symptom of endometriosis itself.

There are two types of hemorrhoids: external and internal. External hemorrhoids are usually visible, hard, tender lumps near the anus that can cause anal itching, anal discharge, and anal pain when sitting. People with external hemorrhoids are most likely to feel pain or discomfort.

Internal hemorrhoids are found in the lining of the anus and lower rectum. People with internal hemorrhoids may experience rectal bleeding, which can show up as blood on the stool or on toilet paper after a bowel movement. Usually, internal hemorrhoids are not painful unless they prolapse, or slip out of the anal canal, which can cause rectal pain.

For MyEndometriosisTeam members already struggling with other endometriosis symptoms, hemorrhoids present another worry. “I’m in so much pain when I have a bowel movement. Does anyone know about hemorrhoids?” asked one member. “I suffer from hemorrhoids, and I feel like it’s getting worse with endo belly,” wrote another.

How Common Are Hemorrhoids?

According to the National Institutes of Health, hemorrhoids are fairly common and affect about 1 out of every 20 Americans. The incidence increases as people age, with about half of adults over the age of 50 experiencing hemorrhoids. Although hemorrhoids are not a symptom of endometriosis, given the high rates of hemorrhoids in the United States, it is not abnormal for those who have endometriosis to also have hemorrhoids.

Possible Links Between Hemorrhoids and Endometriosis

Endometriosis is a disease in which the endometrium, the tissue that normally lines the uterus, grows outside of the uterus and over pelvic organs, such as the fallopian tubes and ovaries. The most common symptoms of endometriosis include pelvic pain during menstruation, intercourse, or during bowel movements or urination, and excessive bleeding. Many people with endometriosis can also have severe bowel symptoms that resemble irritable bowel syndrome (IBS), such as diarrhea, constipation, bloating, or abdominal cramping.

Some individuals have bowel endometriosis, where the endometrial tissue grows as lesions on the outside of the bowel wall. The endometrial lesions that grow outside the uterus respond to hormonal changes during the menstrual cycle and shed. For those who have bowel endometriosis, the endometrial tissue on the bowel can also release prostaglandins (a hormone normally released in the uterus during the menstrual cycle) that can cause the bowel to contract. This can result in diarrhea, constipation, intestinal cramping, and other bowel symptoms that add pressure in the rectum. As a result of that added pressure, people with bowel endometriosis may be even more prone to hemorrhoids during their periods. “Mine severely flare up and bleed when on a period,” wrote one member.

Some MyEndometriosisTeam members believe surgery and pain medications may be the cause of hemorrhoids. “I ended up with hemorrhoids from being constipated from the pain meds,” reported one member. “It has only been five weeks since surgery, and I think that I pushed them out. What kind of doctor should I see? Will it go away on its own? I’m so scared,” wrote one member. Although surgery is unlikely to cause hemorrhoids, studies have shown that constipation after surgery is quite common. Up to 30 percent of women will experience severe constipation after surgery. Opioids, which may be prescribed to treat post-surgery pain, have also been well documented to cause constipation. Constipation is one of the causes of hemorrhoids.

Hemorrhoid Relief

Treatment options for hemorrhoids are aimed at reducing pain. Some at-home treatments include:

• Ice packs to reduce the inflammation and swelling
• Sitting in plain, warm bathwater or taking a sitz bath
• Using hemorrhoid cream on the lumps
• Using suppositories to insert medication into the rectum

Members of MyEndometriosisTeam also share their tips: “I’m taking fiber meds and stool softeners to prevent constipation,” one member wrote. “I eat as many fruits and veggies as possible,” another commented.

“I’ve resorted to witch hazel, Epsom salts, hot baths, and creams,” shared one member. “Suppositories from the pharmacy are really effective,” another member reported.

One member’s hemorrhoids were so bad, they opted for painful surgery: “Still recovering from my hemorrhoidectomy, which is the worst pain I’ve ever been in.”

Another member’s friend found relief in a supplement that contained horse chestnut extract. Some studies have found that this plant-derived extract has anti-inflammatory properties that can relieve pain and swelling from varicose veins and hemorrhoids. Horse chestnut extract may be safe if used for short periods of time. Unprocessed horse chestnut or improperly processed horse chestnut can result in the risk of increased bleeding.

Always consult with your physician before taking horse chestnut extract or any other dietary supplements. Supplements may interact with medications and be unsafe when taken at the wrong dosage. Nutritional supplements are not regulated by the U.S. Food and Drug Administration (FDA), so their safety and effectiveness have not been evaluated. As a result, the strength and purity of the ingredients may vary from brand to brand or batch to batch.

Tips for Preventing Hemorrhoids

It may not be possible to prevent hemorrhoids altogether, but you may be able to reduce your risk by doing the following:

• Avoid straining during bowel movements.
• Avoid sitting on the toilet for long periods of time.
• Maintain a healthy diet that is high in fiber.
• Drink plenty of water.
• Use stool softeners or laxatives occasionally to minimize episodes of constipation.

One member, while comforting a member who prayed that her endometriosis pain was caused by treatable conditions, remarked, “Ah endo, one of the only diseases in which people hope for hemorrhoids.” The consensus: “A real pain in the ass,” summed up one commenter.

Endometriosis can mimic gastrointestinal disorders such as irritable bowel syndrome. It’s important to discuss any new symptoms with a health care professional to determine the best treatment options for dealing with endometriosis symptoms or hemorrhoids.

Talk With Others Who Understand

MyEndometriosisTeam is the social network for people with endometriosis and their loved ones. On MyEndometriosisTeam, more than 119,000 members come together to ask questions, give advice, and share their stories with others who understand life with endometriosis.

Have you experienced endometriosis and hemorrhoids? What has helped you? Share your experience in the comments below, or start a conversation by posting on your Activities page.