Treatment of haemorrhoids (piles) in pregnancy

Date: September 2020, Version 2

What can I use to treat haemorrhoids?

Haemorrhoids (piles) are common in pregnancy, particularly after the first trimester.

Constipation (also a common pregnancy problem) can trigger haemorrhoids or make them worse. Drinking plenty of fluid (between 1.5 and 2 litres a day), eating foods that are rich in fibre, and taking regular exercise all help to avoid constipation. Iron supplements can also cause constipation. If necessary, your doctor can prescribe a slow release iron tablet which is less likely to cause problems. If you feel you need to use a laxative, your doctor or pharmacist will be able to advise you on which is the most suitable. For more information, see the bump leaflet on constipation. For some women, these measures may be enough to resolve piles.

If you need to treat piles, there is no evidence that any of the available treatments pose any risk to the baby. Paracetamol can be used if pain relief is required, but ibuprofen should generally be avoided in pregnancy, and codeine should not be used as it can cause constipation.


What are the benefits of treating haemorrhoids?

Haemorrhoids can cause pain and discomfort and so treating them can greatly improve symptoms, promote healing, and help stop them returning.


Are there any risks of treating haemorrhoids?

There is no evidence that any of the available prescribed or over-the-counter haemorrhoid treatments cause any problems, particularly as they are used topically so only quite small amounts are absorbed into the bloodstream and reach the baby in the womb. Additionally, most pregnant women develop haemorrhoids in the second and third trimesters when the baby is already fully developed. Use of medicines at this stage of pregnancy cannot cause structural birth defects.


Are there any alternatives to using haemorrhoid treatments?

Possibly. If haemorrhoids are caused or worsened by constipation, lifestyle measures as described above can first be tried to improve symptoms. Some women find that discomfort can be improved with use of cold packs.

No treatment

What if I prefer not to use medicines to treat haemorrhoids?

Haemorrhoids are uncomfortable and sometimes painful, but generally do not pose a significant health risk. Therefore, some pregnant women may choose not to use haemorrhoid treatments. However, if haemorrhoids are affecting quality of life (such as causing pain, affecting sleep etc) then the benefits of treatment may outweigh any worries about hypothetical risks. Your doctor or midwife will be happy to discuss any of your concerns.

Will my baby need extra monitoring?

Most women will be offered a scan at around 20 weeks of pregnancy to check their baby’s wellbeing as part of their routine antenatal care. No additional monitoring is required following use of haemorrhoid treatments.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from  

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.