I have had anal fissures on and off for years. They reside when I use a compounded ointment prescribed by my doctor (colorectal surgeon) but have always come back when not using the ointment.
Until this year.
I was on the contraceptive pill for about 20 years and I went off the pill in March. A few weeks later my fissures healed up and stayed gone.
Last week I had the Mirena (a hormonal IUD) inserted.
My fissures have now come back this week. My eating habits have been the same as always, lots of greens, lots of water, lots of roughage.
I cannot find any link between contraception and anal fissures on the net other than one old post on here from last ear which had no responses.
Is there any woman on here who has noticed a difference between fissures on and off the pill?

Hi Melbournegirl
I'm not sure of any direct link between contraceptive hormones and anal fissures, but I do know that the pill made me constipated and caused me to get the AF I was on the pill for about 8 months and basically stopped going regularly as soon as I started it. I guess I must have pushed too hard one time and caused the fissure. I had never had any issues with AFs before the pill.
My doctor told me that estrogen in the pill can cause constipation. Were you constipated at all while on contraception? I tried going back on the pill a month ago but noticed immediately that despite still taking movicol, my BMs weren't coming out smooth anymore and basically, I was back to square 1 :(

My gynecologist told me that contraceptive pills can lower the immune system a little and maybe that can have something to do with the healing process of the fissure. I have had my fissure for about 4 months and it was a pain in the toosh at the beginning but I started birth control this month and I noticed that the pain was a lottt worse with a lot more frequent breakages..I just started using nifedipine and it seems to be helping quite a bit.

av123, I have no issues at all with movements. I'm regular as clockwork twice a day or more, irrespective of birth control or not. My fissures are related to spasming muscles. The muscles stopped spasming and my fissures went away when I was off birth control. They have now started spasming again.
owyyy1990 - Nifedipine helped me brilliantly while I was on it but I was not on it when I stopped birth control. I healed naturally then.

Have you ever thought of the lateral surgery? I was looking into it because I have had mine for months and had to quite a job because of the pain at times. From what I have heard it has a very high success rate.

The colorectal surgeon who prescribed the nifedipine suggested it as an option and I was thinking about it until the fissures wen away of their own accord. Now that they've come back and I suspect the root cause is hormones being added into my system causing the anal muscle to spasm, I think that surgery is not the correct answer.
I am going to chat to my gp tomorrow. I want the opinion of a generalist as specialists are too focussed on their own field and this covers two fields. If it really is the case that the hormones are causing this then it means my body does not want the hormones and I'll get the IUD removed.

Hey melbournegirl,
how did your appointment go? Did you decide it was the hormone?

My gp is pretty curious and said she will do some research and let me know. She'd never heard anything like that before, but according to general internet research there are other women out there asking the same question.
My fissures aren't too bad this week. Lots of massage with hamamelis cream help the poor spasming muscle to relax. (No idea if you ever tried that but it's a muscle like any other and responds like any other)

ive experienced the burning and stinging but I never really understood what spasming is? I use the nifedipine cream twice a day, is that the same as hamamelis cream? And yes keep me updated because I had horrible a horrible time with my AF while on was on this YAZ birth control and now that I stopped 3 weeks ago I noticed a big improvment plus now this week the cream has helped as well.

hamamelis is just witchhazel, so it's natural. A naturopath at my local health food store suggested it as an alternative to prescribed stuff. Nifedipine is brilliant though for relief as it's job is to relax the muscles.
Basically from what I've worked out is when the bum muscle that opens and closes is spasming it doesn't relax properly to open and so causes the skin in front of it to get fissures. Also when it closes it jams shut. When it doesn't spasm it opens and closes gently. This is the muscle that can be massaged. Same as a shoulder muscle, with the right tension it can help relax it.