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Can Hemorrhoids Cause Vulvar Pain? – Understanding The Connection


Hemorrhoids are swollen veins that develop in the rectal and anal areas. They can be internal (inside the rectum) or external (under the skin around the anus). Hemorrhoids are very common, affecting nearly 50% of people at some point in their lives. The most common symptoms are rectal bleeding, anal itching, pain, and a feeling of fullness in the rectum. 

While hemorrhoids themselves are rarely serious, they can sometimes be indicative of other conditions. This article will examine the connection between hemorrhoids and vulvar pain. We’ll look at what hemorrhoids are, whether they can cause pain in the vulvar area, risk factors, and tips for prevention.

Understanding Hemorrhoids

Hemorrhoids occur when the blood vessels around the anus and rectum become swollen and inflamed. This swelling is often caused by excessive straining during bowel movements, constipation, pregnancy, obesity, and a low-fiber diet. 

Hemorrhoids And Vulvar Pain

There are two types of hemorrhoids:

  • Internal hemorrhoids occur inside the rectum and are usually not visible. When they enlarge they can protrude through the anal opening.
  • External hemorrhoids develop under the skin around the anus. They are visible and can be felt as soft lumps. External hemorrhoids are more likely to become irritated and itchy.

Hemorrhoid symptoms may include:

  • Bright red blood on toilet paper, in the toilet bowl, or on the stool
  • Anal itching, pain, and swelling  
  • A bulge that can be felt around the anus
  • Leakage of feces
  • Difficulty cleaning after a bowel movement

If a blood clot forms in an external hemorrhoid, it can become a hard and painful thrombosed hemorrhoid.

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Can Hemorrhoids Cause Vulvar Pain?

The vulva refers to the external female genitalia including the labia, clitoris, vaginal opening, and urethral opening. Vulvar pain is discomfort, irritation, or burning in this area.

Hemorrhoids themselves do not directly cause pain in the vulva. However, the vulva and anus are in close proximity. Anal issues like hemorrhoids can sometimes cause referred pain to the vulva. 

Referred pain means pain that originates from one location and is felt in another area, though the two areas are not physically connected. For example, pain from an internal organ like the heart can sometimes be felt or referred to as the arm. 

In the case of hemorrhoids, the swollen anal veins put pressure on neighboring nerves. These nerves may cross over and connect to nerves supplying the vulvar region. The pressure and inflammation can essentially overload the nerves, causing pain signals to be sent to the vulva.

While not common, women with hemorrhoids may experience increased vulvar pain during flare-ups. The pain may feel similar to vulvodynia, presenting as burning, stinging, rawness, and irritation of the external genital area. Vulvar pain from hemorrhoids should subside once the hemorrhoids are treated.

Other causes of referred vulvar pain can include tailbone injuries, low back strains, and endometriosis. Radiating pain to the vulva is more likely if the hemorrhoids are exceptionally large, swollen, or thrombosed.

What Are The Risk Factors For Hemorrhoids?

Some factors that can increase your risk of developing hemorrhoids include:

  • Sitting for long periods of time on the toilet 
  • Pregnancy – pressure from the fetus and hormones that slow digestion can constipate 
  • Obesity 
  • Low fiber diet – leads to small, hard stools
  • Heavy lifting 
  • Persistent diarrhea 
  • Anal intercourse
  • Genetics – some people are more prone to weak veins
  • Age – hemorrhoids become more common as people get older
  • Gender – hemorrhoids are more common in adults aged 45-65 and in women during pregnancy

Making dietary and lifestyle changes can often help prevent and treat the root causes of hemorrhoid flare-ups.

How Can I Prevent Hemorrhoids?

Prevent Hemorrhoids

Some tips to help prevent hemorrhoids include:

  • Increase fiber – eat more fruits, vegetables, whole grains, beans, lentils, and nuts. Fiber softens stool, preventing straining.
  • Stay hydrated – drink plenty of fluids like water and herbal tea
  • Exercise regularly – this can prevent constipation and promote normal bowel movements
  • Avoid prolonged sitting on the toilet
  • Go to the bathroom as soon as you feel the urge 
  • Avoid sitting for long periods without getting up 
  • Don’t delay going when you need to pass a bowel movement
  • Clean the anus gently and avoid aggressive scrubbing 
  • Use moist wipes to clean instead of dry toilet paper
  • Take over-the-counter fiber supplements like psyllium husk if needed
  • Consider a squatty potty to mimic the natural squat position during bowel movements

If you do develop hemorrhoids, treat them promptly to prevent complications like excessive bleeding or thrombosis. See your doctor about options like over-the-counter creams, medicated wipes, stool softeners, or procedures like rubber band ligation.

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While hemorrhoids themselves don’t directly cause vulvar pain, they may contribute to referred pain and irritation in some cases. Hemorrhoid flare-ups can put pressure on neighboring nerves, sending signals of discomfort to the vulvar region. 

Keeping hemorrhoids at bay through diet, hydration, exercise, and other preventive tips can help avoid referred pain. Seek medical treatment for hemorrhoids that are persistent, painful, or bleeding frequently. Relieving them can reduce vulvar discomfort.


Q: Can internal hemorrhoids cause external vulvar pain?

A: Yes, even internal hemorrhoids can sometimes contribute to irritation and referred discomfort in the vulva region. The swollen rectal tissue puts pressure on nerves that may crossover and connect with the vulvar area. 

Q: Is vulvar pain a common symptom of hemorrhoids?

A: Vulvar pain referred from hemorrhoids is not very common. Only a small percentage of women with hemorrhoids experience radiating vulvar discomfort. Those with exceptionally large or thrombosed hemorrhoids are more likely to have referred pain.

Q: How do you know if vulvar pain is caused by hemorrhoids versus something else? 

A: There are many potential causes of vulvar pain like infections, skin disorders, and vulvodynia. The pain with hemorrhoid-referred discomfort should come and go based on the status of the hemorrhoids. If treated, the hemorrhoid-related vulvar pain should resolve. Persistent vulvar pain is more likely due to other medical causes.

Q: Can hemorrhoids increase pain from pre-existing vulvodynia or vaginismus?

A: It’s possible that women with pre-existing vulvovaginal pain disorders like vulvodynia or vaginismus may experience some increased discomfort when hemorrhoids are present or flare up. The added pressure on the nerves can make existing neurological symptoms feel more pronounced.

Q: If hemorrhoids are causing intense vulvar pain should I go to the emergency room?

A: Severe vulvar pain should be evaluated, especially if it comes on suddenly. Extreme pain with hemorrhoids may indicate a serious condition like thrombosed hemorrhoid, anal fissure, or abscess. These require prompt medical treatment. Otherwise, it’s okay to see your regular doctor for persistent vulvar symptoms thought to be related to hemorrhoids.

Dr. Harold Gojiberry is not just your ordinary General Practitioner; he is a compassionate healthcare provider with a deep commitment to patient well-being and a passion for literature. With extensive medical knowledge and experience, Dr. Gojiberry has made a significant impact in the field of healthcare, particularly in the area of liver diseases and viral hepatitis.

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