Hemorrhoid Flare-Ups: Hormones, Diet, and Relief

Understanding the causes, symptoms, and treatments for hemorrhoidal disease in women.

Hemorrhoids,frequently enough misunderstood,play a crucial role in intestinal function,but can become problematic,especially for women during hormonal shifts. A recent survey sheds light on the triggers and remedies women are using too combat this uncomfortable condition.

Hormonal changes and Hemorrhoids

Hemorrhoidal issues can arise during significant hormonal shifts in women’s lives.Such as, during pregnancy, the hormone progesterone softens tissue, while the growing fetus increases pressure in the pelvic region. Similarly,menopause brings a decline in estrogen,leading to dryness and reduced connective tissue strength.

The survey explored which situations women found most problematic regarding hemorrhoidal complaints.

• Younger women (25-34) frequently cited menstruation (84%) and stressful phases (84%) as triggers.
• Women aged 35-44 most often mentioned pregnancy (49%) and postpartum (53%) as causes.
• Older women (45-69) largely pointed to menopause, wiht 69% of 45-54-year-olds and 73% of 55-69-year-olds citing it as the primary factor.

A clinical study supports these findings, noting that hemorrhoids or anal fissures occurred most frequently enough (55%) during the third trimester of pregnancy.

The Gut-Hemorrhoid Connection

Digestive issues significantly contribute to hemorrhoidal complaints. According to the survey, 67% of women linked their hemorrhoid problems to bowel movement difficulties, including:

• Frequent straining during bowel movements (52%)
• Intestinal unrest (39%)
• Prolonged toilet sitting (36%)
• Diarrhea (36%)
• Constipation (34%)

Interestingly, genetic analyses suggest that both constipation and a predisposition to increased stool frequency can elevate hemorrhoid risk.

Common Anal Complaints

The survey highlighted the most frequent anal complaints among women:

• Itching (73%)
• Burning (51%)
• Blood on stool or toilet paper (42%)
• Pain (41%)
• Nodules (33%)

Dietary Habits and Age

Nutritional choices varied slightly across age groups. While 61% of women aged 25-34 aimed for a high-fiber diet,this increased to 70% among women aged 55-69.Older women more commonly included fruits, vegetables, and whole grains in their diets.

Younger women (38%) reported consuming snacks and ready meals more frequently enough than older women (14%). Probiotic foods like yogurt, sauerkraut, and kimchi were also more popular among older women (30% vs. 22%).

Both age groups favored water, juice spritzers, and herbal tea (around 60%). However, about 22% of older women enjoyed wine or beer several times a week, compared to 14% of younger women.

Expert Advice

Insights from Proctologist Dr. Gabriela Popovich

Dr. Gabriela Popovich, a proctologist from Hamburg, shared her expertise on managing anal health during hormonal changes.

1. Similarities between pregnancy/breastfeeding and peri/postmenopause:

Dr. Popovich notes that constipation is common in both phases due to hormonal shifts. Additionally, pressure conditions in the abdominal cavity change, with the growing child during pregnancy and potential weight gain during menopause.

These factors can strain the pelvic floor, leading to incontinence and anorectal issues like enlarged hemorrhoids or anal vein thrombosis. Symptoms include itching, burning, a feeling of a foreign object, emptying disorders, stool lubrication, bleeding, and pain.

2. Impact of Hormonal Changes:

The anal area’s resistance and moisture can decrease due to reduced estrogen-dependent hormone receptors on the skin, vessels, and mucous membranes. The pelvic floor muscles may weaken, affecting continence and sexual function. Strengthening the pelvic floor is crucial to prevent weakness and organ prolapse.

3. recommendations for Anal Health:

dr. Popovich emphasizes a high-fiber, balanced diet to prevent constipation, along with sufficient hydration. Probiotic foods like kefir and buttermilk can support the gut microbiome. Physical activity and proper toilet habits-avoiding straining, limiting time spent, and maintaining a relaxed posture-are also essential. After bowel movements, the anal area should be cleaned gently with soft toilet paper or water.

Self-treatment Trends

Many women (65%) with anal complaints opt for self-treatment or wait for improvement instead of seeking medical advice.Similarly, 64% of pregnant women attempt to manage their symptoms independently.

popular over-the-counter remedies include:

• Hemorrhoid ointments (58%)
• Wound and zinc preparations (69%)

Interestingly, women tend to use wound ointments and zinc preparations more often than specialized hemorrhoid ointments.

Key Features of Creams and Ointments

Women prioritize the following features in creams and ointments:

• Good tolerability (72%)
• Rapid itch relief (62%)
• wound healing and anti-inflammatory effects (62%)
• Swift pain relief (61%)
• Fast burn relief (57%)
• Protection against anal skin irritation (52%)
• Suitability for long-term use (51%)

Dr. Kade Solutions

Dr. Kade offers over-the-counter ointments and suppositories designed for anorectal symptoms associated with hemorrhoidal disease.

• Posterisan® acute: Provides quick relief from severe itching and acute pain with lidocaine.
• FACTU® Lind: Addresses moisture, burning, and itching with Hamamelis distillate, which reduces minor bleeding and inflammation.
• Posterisan® Protect: protects the sensitive anal area, facilitates bowel movements, and guards against irritation.

Clinical studies confirm that regular use of Posterisan® Protect can significantly extend symptom-free intervals.

Posterisan® Akut and Factu® Lind can be used during pregnancy and breastfeeding after consulting a doctor, while Posterisan® Protect can be used without medical consultation.

Acute posterisan® 50 mg/g rectalsalbe

Active ingredient: Lidocaine application areas: application in adults; Relief of pain in the anal area before proctological examination; Symptomatic treatment of itching and pain in the anal area (e.g. due to hemorrhoids).

Contains cetyl alcohol. Read the package insert and ask your doctor, your doctor or in your pharmacy. Dr. Kade Pharmaceutical Fabrik GmbH,Berlin as of: 04/2024

FACTU® Lind hemorrhoid ointment / factu® lind hemorrhoid heels

Active ingredient: hammamelis leaf and branched tedule / hammamelis leaf extract. Areas of application: ointment: To improve the symptoms in the early stages of hemorrhoidal disease. Support: To relieve itching, wet and burn in the early stages of hemorrhoidal disease.

The ointment contains wool wax, butylhydroxytoluole, cetylstearyl alcohol and propylene glycol. Read the package insert and ask your doctor, your doctor or in your pharmacy. Dr. Kade Pharmaceutical Fabrik gmbh, Berlin status: 12/2023

[1] Survey on the subject of hemorrhoidal complaints 2025, Bilendi survey on behalf of Dr. Kade, sample: 1,002 women of the German population aged 25 to 69, survey period 10.01.2025 – 16.01.2025.
[2] Boughton M et al. Prevalence and Risk Factors for Haemorrhoids and Anal Fissures in Pregnancy and the Postpartum Period: A Retrospective Linked Data Study. Cureus. 2024;16(2):e53773. DOI:10.7759/cureus.53773
[3] Yu M, et al. Bowel Habits, Obesity, Intestinal Microbiota and Their Influence on Hemorrhoidal Disease: a Mendelian Randomization Study. Clinical and Experimental Gastroenterology. 2024;17:157-164. DOI:10.2147/CEG.S450807
[4] Williams H, Wolf R, Sand C. Wound and skin protection on the anal canal- experiences with a new product. Current dermatology. 2013; 39 (7): 535-538. DOI: 10.1055/S-0033-1344505

Source / photos: kade.de