Hello, The enzyme methylenetetrahydrofolate reductase (MTHFR) plays a crucial role in regulating the levels of homocysteine. Elevated homocysteine level is a risk factor for ischemic stroke, thrombotic and cardiovascular diseases. This genetic condition do not cause bleeding and oozing hemorrhoids. The pain is caused if a blood clot (thrombosis) has formed within an external hemorrhoid.This symptom can be explained with your MTHFR. So,in your circumstances,(with a painful and massive hemorrhoids that ooze fresh red blood), you should seek medical attention because it is necessary to treat the condition. If you were my patient I will first suggest over-the-counter creams, ointments, suppositories or pads that contain ingredients, such as witch hazel, or Hydrocortisone and Lidocaine. These medications can relieve pain and itching, at least temporarily. I would refer you to a proctologist because you may need specific minimally invasive procedures like rubber band ligation, schlerotherapy or laser therapy to definitively treat the hemorrhoid problem. Hope I have clarified your doubts. Let me know if i can assist you further. Regards, Dr. Elona Xhardo Endocrinologist