11 Things Every Woman Needs To Know About Hemorrhoids

About a month ago, at an event for health journalists, I heard a colorectal surgeon say something that nearly made my eyeballs bug out of my face. "All of us have hemorrhoids, all the time," she said.

Uh, no, nope. There's no way. All these healthy-looking people sitting comfortably on their bums around me have hemorrhoids?! (Here are 5 things your butt is trying to tell you.)

So I called her up after the event and asked her what she meant by that inflammatory (sorry) comment. Never in my life did I think I'd spend 45 minutes on the phone casually throwing around phrases like "anal canal." I also didn't know there was so much to learn about hemorrhoids. Here are the dirty details everyone should know.

YES, IT'S TRUE, WE ALL. HAVE. HEMORRHOIDS.

I know, I'm horrified, too. "I love telling people that," says Alexis Grucela, M.D., the colorectal surgeon who first mentioned this idea, who is also an assistant professor of surgery at NYU Langone Medical Center. "It's usually so shocking to them!" Indeed. But hemorrhoids are totally normal, she explains. "They're anal tissue that gives us extra support in the anal canal," she says. Just like pelvic floor muscles help keep urine from leaking out when you, say, cough or laugh, hemorrhoid tissue does the same for stool and gas. "It's only when they become symptomatic that people start noticing them," Grucela says. "Usually, they just do their job."

OBVIOUSLY, WE DON'T ALL HAVE PAINFUL HEMORRHOIDS.

Something has to go very, very wrong for that normal anal tissue to become the angry, itchy, painful protrusions you're probably picturing by now. The key culprit is abdominal pressure, Grucela explains, whether that's from straining to go to the bathroom because of chronic constipation, excess belly weight, pregnancy, or even lots of long-distance running. (Torch fat, get fit, and look and feel great with Women's Health's All in 18 DVD.) "We think the pressure causes the tissue to stretch out and weaken over time," Grucela says. That stretching causes the blood vessels in hemorrhoids to dilate, bringing more blood to the area, which causes hemorrhoids to swell and potentially bleed. 

BUT A SURPRISING NUMBER OF PEOPLE ARE SUFFERING.

Around one in 20 Americans have symptomatic hemorrhoids, and your risk increases as you age. About half of people ages 50 and up are dealing with this painful problem, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

THERE ARE TWO MAIN TYPES OF HEMORRHOIDS.

That would be internal and external, and they're pretty much exactly what they sound like. External hemorrhoids occur right at the anal opening, Grucela says, and they're covered with skin. Because they're covered with skin, they also have nerves, which means external hemorrhoids are the ones that can come with sensations like pain, itching, and burning. Internal hemorrhoids on the other hand are inside the anal canal. You (obviously) can't see them, and because they're not covered with skin, you won't feel any symptoms from them, either. However, internal hemorrhoids are more likely to bleed, and, if the situation gets really dire, they can prolapse, or fall out of the anus.