Piles in Female (Women): Symptoms, Causes, and Treatment

What Are Piles?

Do you experience pain, itchiness, and swelling in the area of your anal opening? Do you notice blood after you poo and have difficulty sitting? These signs are indicative of piles or haemorrhoids.

The most commonly asked questions include: Why piles occur in females? Reasons of piles in females? Piles, also known as haemorrhoids, occur due to high pressure in the blood vessels.¹ The blood vessels in the rectum are stretched as a result of increased pressure, which causes more swelling and the development of piles. Piles can occur at any age but are more common during pregnancy affecting approximately 25% to 35% of women, especially during the third trimester.²

If you are experiencing piles, book an appointment with a doctor near you and get prompt medical care for your condition.

Read more: Difference Between Piles and Fistula

Symptoms

Around 40% of haemorrhoids are painless and asymptomatic. However, in the remaining 60% of patients, the following early symptoms of piles in females are noticed:

• Inflammation, itching, and discomfort in the anal region
• Persistent swelling in the form of a lump in the anal region 
• Stool containing small amounts of blood

The early symptoms of piles in females are much milder and can be treated easily by a medical professional. As it progresses, the symptoms of piles in females worsen, including:

• Immense pain around your anal opening preventing you from sitting down
• Bright red blood during the passage of stool
• Itchiness around the anal opening and lower rectum
• Mucous discharge, which may stain your underwear
• The feeling of poo even after going to the toilet

Haemorrhoids Can Be Classified Into 4 Grades:

• Type 1: Haemorrhoids are located inside the anal opening and are usually small and painless inflammations. Small amounts of blood may be noticed after a bowel movement.
• Type 2: The swelling is larger than that in Grade 1, and the anal opening is also affected. The swelling may protrude outside during bowel movements, but they usually returns to its place later.
• Type 3: Swelling is noticed outside the anal opening, and a lump will be noticed by the individual. These have to be physically pushed back with the fingertips (Prolapsed Haemorrhoids)
• Type 4: The swelling bulges outward and falls out even if forced back into the rectum. Bleeding may or may not be present. Pain may be present if a clot forms or if the haemorrhoids are strangled by the anal opening.

Even though piles may at times get better on their own in a few days, swollen or inflamed piles warrant a visit to a surgeon for appropriate treatment since, when ignored, it may lead to a fistula (abnormal passage or connection) as a serious complication of untreated piles.

Dr Ashish Bajaj, M.B.B.S M.D. in Clinical Pharmacology and Toxicology

Causes

Reasons for piles in females include: ⁴

• Straining during bowel movements
• Sitting for long periods
• Chronic diarrhoea or constipation
• Overweight
• Advancing age
• A low-fibre diet and low fluid intake are reasons for piles in females.
• Pregnancy: Increased pressure due to the growing foetus, weight gain, and hormonal changes are contributing factors for the development of piles in females

Complications

With the right medical care, piles can be treated. However, any undue negligence could lead to the following: ⁵

• Painful swelling of tissues around the anal opening
• Blood clot formation inside the haemorrhoid
• Gangrene and pain of the protruding tissue (If swelling is not receiving sufficient blood supply)
• Bleeding from your anal region
• Anaemia and generalized weakness
• Drop in blood pressure leading to dizziness

Hemorrhoidectomy is an invasive and sometimes painful treatment option, but it can be an effective, even permanent fix. Complications are rare and not usually serious.

Dr. M.G. Kartheeka, MBBS MD(Pediatrics)

Diagnosis

Medical History and Physical Examination: ⁶

At your first visit to the doctor, he will take your past and present family and medical histories before diagnosing piles or haemorrhoids.  

The anal region will be checked for:

• Swelling or lumps
• Mucous discharge
• Stool leakage
• Irritation of the skin 
• Skin tags
• Tears

Treatment

1. Diet and Lifestyle Modifications:

• High fibre Diet
• Regular exercise
• Increase in fluid intake
• Avoid straining while using the bathroom
• Avoiding medications causing constipation and diarrhoea

2. Medications: 

• Several over-the-counter and prescription drugs may be beneficial. 
• These are available in the form of pills, suppositories, lotions, and wipes

However, medications alone cannot provide complete relief from piles or haemorrhoids. They might help to reduce the symptoms of piles in females but wouldn’t treat the underlying cause.

3. Non-Surgical Management: 

Usually, low-grade piles can be treated non-surgically. This includes

• Rubber band ligation
• Injection sclerotherapy
• Infrared coagulation

4. Surgical Management: 

A proctologist will be able to identify when surgery would be necessary for the treatment of piles. The different methods include:

• Haemorrhoidectomy
• Laser Haemorrhoid Procedure (LHP)
• Stapled haemorrhoidopexy
• Doppler-guided haemorrhoidal artery ligation

Frequently Asked Questions (FAQs)

References:

1. Haemorrhoids | National Health Portal of India [Internet]. www.nhp.gov.in.
   Available from: https://www.nhp.gov.in/haemorrhoids_mtlStaroselsky A, Nava-Ocampo AA, Vohra S, Koren G. Haemorrhoids in pregnancy. Canadian Family Physician. 2008 Feb 1;54(2):189–90. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278306/
2. NHS Choices. Piles (haemorrhoids). NHS Choices. 2020. Available from: https://www.nhs.uk/conditions/piles-haemorrhoids/
3. Piles (haemorrhoids) | Health Information | Bupa UK. Available from: https://www.bupa.co.uk/health-information/digestive-gut-health/haemorrhoids
4. Slauf P, Antoš F, Marx J. [Complications of haemorrhoids]. Rozhledy V Chirurgii: Mesicnik Ceskoslovenske Chirurgicke Spolecnosti. 2014 Apr 1;93(4):223–5. Available from: https://pubmed.ncbi.nlm.nih.gov/24881480/
5. Lohsiriwat V. Treatment of haemorrhoids: A colo-proctologist’s view. World Journal of Gastroenterology. 2015;21(31):9245.Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4541377/

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