The women suffering through anorectal pain - and too embarrassed to ask for help
New research suggests stigma and poor education are leaving women with hemorrhoids and anal fissures to suffer in silence - especially after childbirth.
Hemorrhoids and anal fissures are rarely talked about openly, but for many women they are far from rare experiences - particularly during pregnancy and after childbirth.
A new survey from telehealth platform Bummed suggests that women experiencing anorectal conditions are often left navigating pain, embarrassment and inadequate care largely on their own.
The survey, conducted among 533 US women who had already self-identified as having experienced hemorrhoids or anal fissures, found many were relying on over-the-counter remedies while struggling to access specialist support.
Nearly four in 10 respondents said they had experienced the condition three or more times, while 14% considered themselves chronic sufferers. More than half had seen a doctor in person but still felt undertreated, while 87% said they primarily relied on over-the-counter products such as Preparation H.
For Dr Carmen Fong, chief medical officer at Bummed, the findings point to a gap in specialist anorectal care - or what is formally known as proctology, the medical specialty focused on conditions affecting the rectum, anus and pelvic floor.
“For most initial concerns, they're seeing their primary care or an urgent care or an ER with anorectal symptoms, not all of whom are equipped to handle problems such as hemorrhoids and anal fissures.”
“While proctology is an essential part of our training, for most colorectal surgeons it can range anywhere from 5-50% of their practice, so they are not seeing and treating these conditions as frequently.”
The impact on daily life
The report paints a picture of women cycling through creams, wipes and home remedies while trying to manage symptoms that can significantly affect daily life. One respondent described spending “days in debilitating pain”, while another wrote: “Prep H doesn’t work.”
The postpartum experience emerged as one of the clearest themes in the survey. Many respondents said they were never warned during pregnancy that hemorrhoids and anal fissures were common after childbirth, or given guidance on prevention and treatment. Others described pain severe enough to affect their ability to care for newborns or return to work.
“I didn’t even know I developed internal hemorrhoids after the birth of my child until one burst,” one respondent said.
Another wrote: “I experienced this while pregnant and just thought I had to ‘tough it out’. I didn’t even know treatment was an option.”
Education emerged as the single largest theme across the survey’s open-text responses, with 180 women independently raising the need for better information around prevention, treatment options and when to seek medical attention.
“There is no real education,” one respondent said. “Just ‘use this medication, call if it gets worse.’”
The need to tackle the taboo
Fong believes stigma is playing a major role in delaying care.
“I have had patients who have told me that they resisted seeing someone for years because they were embarrassed about having someone look at their butt,” she says.
“Once they’re in the office, most will feel more at ease when they see how comfortable we are with performing these sensitive exams. But still I’ll have patients who come in and they can’t say the word poop or fart.”
That discomfort appeared repeatedly throughout the survey responses, where women described feeling “ashamed”, “awkward” or dismissed by healthcare professionals. Some said they avoided pharmacists entirely because they felt too embarrassed to ask for help.
For Fong, the answer starts with making anorectal health less taboo.
“The more we can talk about our butts, the more we will understand when something is not normal and needs medical attention,” she says.
“Shaming and fear leads people to delay seeking care, and what might have been an easily treatable problem becomes a bigger problem, or something much more malignant, like cancer, may be missed because it was dismissed.”