For women

Hemorrhoid treatment for women: pregnancy, postpartum and beyond.

Name: Hemorrhoid Treatment for Women: Pregnancy, Postpartum and Beyond
Creator: Lisa L. Johnson, M.D.

Pelvic floor, bladder, bowel — and hemorrhoids — treated together, under one physician relationship. No sedation. Covered by insurance.

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“Hemorrhoids are among the most common anorectal conditions in women — and among the most undertreated, because patients assume treatment means surgery. It does not. I have helped hundreds of women avoid the operating room entirely.”

— Lisa L. Johnson, M.D., F.A.C.O.G., U.R.P.S.

When hemorrhoids occur in women

Pregnancy, postpartum, and beyond.

During pregnancy

Why pregnancy triggers hemorrhoids

Increased blood volume, pressure from the growing uterus, and constipation combine to engorge the hemorrhoidal vessels. Many women first develop hemorrhoids in the second or third trimester. Rubber band ligation is generally deferred until after delivery; during pregnancy, the focus is on symptom management, dietary adjustment, and topical relief. We will evaluate you and prepare a postpartum treatment plan so nothing waits longer than it needs to.

Postpartum

The most common window for treatment

Vaginal delivery, especially prolonged pushing, markedly worsens hemorrhoids. Many women who had mild hemorrhoids before delivery have Grade II or Grade III hemorrhoids afterward. Banding is typically appropriate once healing is sufficient — often at or around the postpartum visit. We will assess the tissue and give you a specific timeline. The procedure is the same: in-office, no sedation, drive yourself home.

Perimenopause & beyond

A second common peak

Hormonal changes affect connective tissue throughout the pelvis, including the tissue that supports the hemorrhoidal cushions. Women in their forties and fifties frequently present with hemorrhoids that have been gradually worsening for years and have never been properly evaluated. This is a straightforward case for banding and has nothing to do with childbirth history.

At any stage

Hemorrhoids that have simply grown worse

Not all hemorrhoids are pregnancy-related. Straining, chronic constipation, prolonged sitting, and family history are risk factors at any age. If you have been managing symptoms on your own — with creams, dietary changes, or simply living with it — a consultation will tell you clearly what your treatment options are and what the expected outcome of each is.

The connection most practices miss

Hemorrhoids and the pelvic floor.

Why they co-occur

The pelvic floor supports the bladder, uterus, rectum and anus as a single anatomical unit. Pelvic floor dysfunction — whether from childbirth, surgery, or connective tissue changes — affects all of these structures. Hemorrhoids, urinary leakage, and prolapse often appear together, particularly in women who have had vaginal deliveries. Treating one without evaluating the others is a missed opportunity.

One physician, one plan

Dr. Johnson is a fellowship-trained urogynecologist. Her training covers the pelvic floor, bladder, urethra, vagina, uterus, and anorectal structures as a connected system. If you have hemorrhoids and also experience leakage, urgency, or a sense of pelvic pressure, you can address all of it in a single evaluation rather than building a separate referral chain for each symptom.

When conservative treatment is the right start

Not every patient needs a procedure. Dietary changes, fiber supplementation, sitz baths, and stool softeners resolve mild internal hemorrhoids in many cases. If conservative management is the right starting point for you, we will tell you exactly what to do and when to return for re-evaluation. Surgery-last is not a slogan. It is how this practice runs.

When banding is the right answer

Grade II and Grade III internal hemorrhoids that have failed or are unlikely to respond to conservative management are the standard indication for banding. The procedure is quick, requires no preparation, and does not interrupt normal activity. Most patients treated at PHII avoid surgical hemorrhoidectomy entirely. The banding page covers the procedure in detail.

Your physician

Lisa L. Johnson, M.D.

F.A.C.O.G. · U.R.P.S. · Board Certified OB/GYN & Urogynecology

Dr. Johnson founded PHII to consolidate pelvic floor care — urogynecology, anorectal care, and pelvic floor physical therapy — under one practice. Women who are looking for a physician who treats the pelvic floor, bladder and bowel together, surgery last, will find that approach here.

Women who are looking for a holistic gynecologist — one physician who treats the pelvic floor, bladder and bowel together — will find that approach on this page.

Full biography and credentials →

Questions women ask most often.

Can I be treated while I'm pregnant?

Rubber band ligation is generally deferred until after delivery, when the tissue has normalized. During pregnancy, the focus is on managing symptoms: fiber, hydration, sitz baths, stool softeners, and topical relief. We will evaluate you, make sure nothing is being missed, and have a clear postpartum treatment plan ready so you know exactly what comes next.