Can You Get Vaginal Hemorrhoids? What You Should Know

Hemorrhoids are, by definition, swollen veins in and around the anus and rectum, so there is no such thing as a “vaginal hemorrhoid.” But the search makes perfect sense, because a related condition called vulvar varicosities can produce swollen, painful, bluish lumps in the vulvar and labial area that look and feel remarkably like hemorrhoids. Roughly 4% of women develop these swollen veins at some point, most often during pregnancy, and the experience can be alarming when you have no name for what you’re seeing.

Why People Search for “Vaginal Hemorrhoids”

Hemorrhoids are one of the most widely recognized venous problems, so when a swollen, tender vein appears near the vagina, “hemorrhoid” is the first word many people reach for. The confusion is understandable. Both conditions involve veins that become enlarged under pressure, both can cause a visible bulge, and both tend to ache or throb after standing for a long time. The key difference is location: hemorrhoids develop inside the anal canal or around the anus, while vulvar varicosities form in the veins of the labia or the tissue surrounding the vaginal opening. The underlying mechanism is similar (increased venous pressure causing veins to stretch and pool with blood), but the anatomy is distinct enough that doctors treat them as separate conditions.

Vulvar varicose veins can also be mistaken for Bartholin gland cysts or other masses, which makes getting the right diagnosis important for choosing the right treatment and recognizing any associated problems.¹ If you’ve noticed something that looks like a hemorrhoid but sits on or near the labia rather than around the anus, vulvar varicosities are the most likely explanation.

What Vulvar Varicosities Are and Why They Happen

Vulvar varicosities are dilated, tortuous veins in the vulvar region. They form when the valves inside pelvic and vulvar veins weaken, allowing blood to flow backward and pool. The veins swell, sometimes dramatically, and can appear as soft, bluish-purple clusters just under the skin. They range from barely noticeable to large enough to make sitting uncomfortable.

Pregnancy is the dominant trigger. Blood volume increases substantially during pregnancy, the growing uterus puts direct pressure on the veins returning blood from the lower body, and hormonal changes relax vein walls. These factors combine to make vulvar varicosities a common pregnancy complaint, affecting about 4% of pregnant women, with higher rates in women who have had multiple pregnancies.² That 4% figure likely understates the true number, since mild cases often go unreported or unnoticed.

But pregnancy is not the only cause. Vulvar varicosities also appear in women who have never been pregnant. Pelvic congestion syndrome, a condition where the veins draining the pelvis become chronically dilated, can produce vulvar varicosities as part of a broader pattern of pelvic venous disease.³ In rarer cases, an anatomical compression problem like May-Thurner syndrome, where an artery compresses the left iliac vein, can cause pelvic venous congestion and vulvar varicosities even in teenagers. One reported case involved a 17-year-old with a five-year history of worsening painful vulvar and labial varicosities traced to this compression.⁴

What They Feel Like

Some vulvar varicosities cause no symptoms at all and are only discovered during a routine exam or when someone happens to notice them. When symptoms do show up, they tend to follow a pattern: a dull ache, a sense of swelling, or heaviness in the vulvar area that worsens after you’ve been on your feet for a while.⁵ The discomfort often improves when you lie down, because gravity is no longer pulling blood into the swollen veins.

In many cases, vulvar varicosities are part of a larger picture of pelvic venous problems. A case series of non-pregnant women found that about 72% of those with vulvar varicosities also had varicose veins in their legs at the same visit, suggesting that the venous insufficiency is often not limited to one spot.⁶ If you’re dealing with vulvar varicosities and also have heavy, aching legs or visible leg veins, the same underlying venous problem may be responsible for both.

A useful diagnostic detail: the varicosities often look bigger when you’re standing and shrink when you lie flat, because gravity-dependent blood pooling accentuates them in the upright position.⁵ Clinicians often examine patients in both positions for exactly this reason.

Complications Worth Knowing About

Most vulvar varicosities are uncomfortable rather than dangerous, but they are not entirely benign. The main complications to be aware of are blood clots and pain during sex. Vulvar varicosities have been associated with venous blood clots (both during pregnancy and outside it), superficial pain during intercourse, and chronic vulvar pain.⁷

Thrombophlebitis, where a clot forms inside one of the swollen veins and triggers inflammation, has been documented during pregnancy. In one study, two patients developed this complication during the second and third trimesters, experiencing intense localized pain, redness, and swelling around the affected veins.⁷ If you notice sudden sharp pain, warmth, or redness in the area of existing varicosities, that warrants prompt medical evaluation rather than a wait-and-see approach.

Bleeding is a commonly feared complication, but it appears to be rare. Research on this condition has not documented spontaneous bleeding from vulvar veins during day-to-day life. The bleeding concern becomes more relevant during childbirth, which is a separate question addressed below.

When Vulvar Varicosities Are Part of a Bigger Problem

If vulvar varicosities appear during pregnancy and resolve afterward, they’re usually a standalone issue. But persistent or worsening varicosities outside of pregnancy can be a sign of pelvic congestion syndrome or another underlying venous disorder. Pelvic congestion syndrome involves chronically dilated pelvic veins and tends to cause chronic pelvic pain, pain during or after sex, lower abdominal heaviness, and sometimes menstrual irregularities or urinary symptoms. In one series of patients, about 60% reported lower abdominal discomfort, 45% had pain during or after intercourse, and roughly a third had chronic pelvic pain.⁷

One case involved a woman who first developed vulvar varicosities during pregnancy and was later diagnosed with pelvic congestion syndrome in the postpartum period. She was successfully treated with an endovascular procedure and followed for a year afterward.³ The broader point is that vulvar varicosities are sometimes the visible surface marker of a deeper venous issue, and if they persist or come with pelvic symptoms, further investigation with imaging is reasonable.

How They’re Treated

Treatment depends on whether you’re pregnant, how severe the symptoms are, and whether an underlying condition is driving the problem.

During pregnancy, the first-line approach is conservative management, because most vulvar varicosities resolve on their own after delivery.⁸ Conservative measures generally include wearing supportive compression garments designed for the vulvar area, avoiding prolonged standing, lying on the left side to take pressure off the major pelvic veins, and using cold compresses for relief. These won’t eliminate the varicosities, but they can reduce the aching and swelling while you wait for delivery.

For women who aren’t pregnant, or for those whose varicosities persist after pregnancy, sclerotherapy is a common interventional option. It involves injecting a solution into the vein that causes it to collapse and gradually be reabsorbed by the body.⁸ When the varicosities are part of a broader pelvic venous disorder, treatment may need to address the source of venous congestion higher up. Procedures such as embolization of dysfunctional pelvic veins or stenting of compressed veins have been used with good results in the right patients. In one case series of non-pregnant women treated for pelvic venous disorders, about 89% had complete resolution of their symptoms, and all patients had resolution of their vulvar varicosities on follow-up.⁶

What Happens After Delivery

If pregnancy is the cause, the good news is that vulvar varicosities typically shrink quickly once the baby is born. The drop in blood volume, the relief of uterine pressure on pelvic veins, and the reversal of pregnancy-related hormonal changes all work in your favor. Most cases resolve within a few months postpartum without any treatment.²

In at least one well-documented case, the regression was dramatic: a marked reduction in size was noted shortly after delivery, with complete resolution by four weeks postpartum.⁹ That said, each subsequent pregnancy can bring them back, and in some women they persist or worsen with each pregnancy rather than fully resolving. If varicosities remain prominent months after delivery, that’s a reasonable time to discuss further evaluation with a provider.

Vulvar Varicosities and Childbirth Decisions

One of the most anxiety-provoking aspects of vulvar varicosities during pregnancy is the question of whether vaginal delivery is safe. The fear is that the swollen veins could rupture during labor and cause severe bleeding. Large vaginal varicosities can look alarming on examination, and in some cases they’ve been described as masses large enough to raise concern about whether they could obstruct delivery or hemorrhage.¹⁰

The evidence, however, generally supports allowing vaginal delivery even in severe cases. In one case involving large vulvar varicosities, clinicians found that the varicose veins became compressed by the baby’s head from the inside during crowning and actually diminished in size during delivery. The patient delivered vaginally without complications. The authors concluded that women with vulvar varicosities can attempt vaginal birth regardless of severity.¹¹ That is a case report rather than a large trial, so it doesn’t settle every scenario, but the general position in obstetric literature is that vulvar varicosities alone are not an indication for cesarean section. The decision depends on the individual anatomy, the size and location of the varicosities, and whether other obstetric factors are in play.

The Emotional and Sexual Impact

Something that often gets overlooked in clinical discussions is the emotional toll vulvar varicosities can take. Visible changes to the genital area, combined with pain and limited information about the condition, can cause significant distress. Research on the condition has noted that vulvar varicosities may contribute to psychological and relational difficulties.⁷ Pain during intercourse is one of the most commonly reported symptoms in women with pelvic venous disease, and it’s not hard to see how that would affect intimacy and self-confidence.

Part of the problem is the silence around the condition. Vulvar varicosities are rarely discussed in mainstream pregnancy resources, which means many women encounter them without any framework for understanding what’s happening. The resemblance to hemorrhoids adds to the embarrassment, and the genital location makes it harder to bring up casually with friends or even with a provider during a quick appointment. If you’re dealing with this and finding it emotionally difficult, you’re not unusual, and it’s worth raising directly with your doctor rather than hoping they’ll notice on their own.

How Diagnosis Can Go Wrong

Because vulvar varicosities are not always on a clinician’s radar, misdiagnosis is a real issue. The swollen veins can mimic Bartholin gland cysts, soft tissue masses, or even malignancies on casual visual inspection.¹ A misdiagnosis can lead to unnecessary surgical exploration or, conversely, to missing an associated condition like pelvic congestion syndrome that could be treated.

In non-pregnant women, the diagnosis is especially easy to miss because clinicians may not be thinking about varicosities in the absence of pregnancy. The case of the 17-year-old with May-Thurner syndrome is a good example: she had five years of worsening symptoms before the underlying venous compression was identified.⁴ Duplex ultrasound is the usual first-line imaging tool, and venography or cross-sectional imaging can be used when a deeper structural cause is suspected. If you’ve been told you have a vulvar cyst and the diagnosis doesn’t quite fit, asking about the possibility of varicosities is reasonable.

Vulvar Varicosities Versus Actual Hemorrhoids During Pregnancy

It is entirely possible to have both vulvar varicosities and hemorrhoids at the same time during pregnancy, since the same increase in pelvic venous pressure promotes both conditions. The two problems feel different in some ways: hemorrhoids tend to itch, burn, and sometimes bleed during bowel movements, while vulvar varicosities produce more of a dragging, heavy ache that worsens with standing. Hemorrhoids sit around the anus, while varicosities cluster on the labia and the tissue around the vaginal opening. But when everything in the pelvic area is swollen and uncomfortable, telling one from the other without a careful look can be difficult.

If you’re pregnant and dealing with swelling or discomfort in the general perineal area, there’s no need to self-diagnose. A provider can distinguish between the two conditions quickly with a visual exam. The management strategies overlap to some degree (both benefit from avoiding prolonged standing, staying hydrated, and using supportive measures), but hemorrhoid-specific treatments like topical medications and stool softeners won’t address vulvar varicosities, and vice versa. Knowing which condition you actually have means you can target the right approach.

1
PubMed. Vulvar varices: an uncommon entity in surgical pathology
2
PubMed Central. Severe vulvar varicosities in pregnancy with the detailed sequential clinical course and management considerations: A case report
3
PubMed Central. Selective Embolization in the Treatment of Pelvic Congestion Syndrome: A Comprehensive Case Report and Review of the Literature
4
PubMed Central. May-Thurner syndrome presenting as pelvic congestion syndrome and vulvar varicosities in a nonpregnant adolescent
5
Annals of Phlebology. Vulvar Varicosities: A Comprehensive Review of Pathogenesis, Diagnosis, and Treatment
6
Journal of Clinical Medicine. Vulvar Varicosities and Pelvic Venous Disorders in Nongravid Women: A Case Series
7
International Journal of Women’s Health. Vulvar varicosities: diagnosis, treatment, and prevention
8
PubMed Central. Interventional Treatment of Labial Varices
9
PubMed Central. Severe vulvar varicosities in pregnancy with the detailed sequential clinical course and management considerations: A case report – Section: Discussion
10
PubMed Central. Large Vaginal Varicosities in the Setting of Pregnancy without Known Hepatic or Vascular Risks: A Case Report and Review of the Literature
11
PubMed. Vaginal delivery in the presence of huge vulvar varicosities: a case report with MRI evaluation