Varicose veins are enlarged, tortuous veins found most often in the legs of people with a disorder of their venous valves. Although they are more commonly found in the thigh or leg, they can develop in other places. Varicose veins are often twisted, swollen and enlarged veins that appear blue or purplish on the skin.
For some patients, these tortuous veins are simply a cosmetic irritation, but for some they may cause troublesome symptoms. These veins connect with deeper veins in the leg and play a role in transporting blood from the legs back up to the heart. Varicose veins are more commonly seen in women in their 30s and pregnant women during the 2nd trimester of pregnancy.
Varicose and Swollen Veins During Pregnancy
Varicose veins are linked to increased pressure in the veins. Women gain weight and volume during pregnancy. The average pregnancy results in a 50% increase in circulating blood volume which increasing pressure in the veins. Also the sex hormone progesterone causes smooth muscle dilation the walls of the veins causing them to engorge as they fill with blood.
When the valves of the veins become damaged or overloaded, the blood flows backwards causing engorged, swollen veins. Varicose veins occur frequently during pregnancy as the increase in blood volume and added weight cause veins to work harder to pump blood back to the heart. When the valves are weakened, the added vascular stress caused by pregnancy can often result in visible signs of varicose veins.
Where do varicose veins develop during pregnancy?
While varicose veins are more commonly seen in the thighs or legs, they can develop
near the vulva or vagina as well. While the weight gain and increase in vascular volume may be the major cause of varicose veins during pregnancy, the position of the baby in utero may also play a part.
The weight and pressure of the baby’s position can compress some parts of the lower abdomen which can contribute to the development of varicose veins of the vulva or vagina. Because women are at higher risk for the development of varicose veins during pregnancy, it is important to get screened frequently.
Will varicose veins get worse during pregnancy?
Varicose veins often get worse during pregnancy. As weight and pressure increases, the veins become more prominent and start to swell. With time, the valves become overloaded causing the veins to become engorged with blood. This can cause localized pain and itching near the varicose vein(s). Once varicose veins of the legs or thighs become prominent, it is unlikely that they will resolve without any treatment. However, varicose veins on the vulva often do get better once the baby has been delivered.
Treatment options for varicose veins of the vulva
There is often no treatment required for vulvar/vaginal varicosities. As mentioned above, once the baby is delivered, the vein will usually subside. In some cases, there may be rope-like veins remaining. Like leg vein treatments, it is recommended for treatment to be performed after the pregnancy is over for any remaining varicose or spider veins.
Who is at risk for developing varicose veins during pregnancy?
The biggest risk factor for the development of vein problems during pregnancy is genetics. If you have a family history of varicose veins, it is recommended to be screened frequently. Other risk factors for varicose veins include:
- Extended Sitting
- Prolonged Standing
Varicose veins are more common in females. This is most likely due to a link between varicose veins and the sex hormone progesterone. Weight and fluid retention have also been linked to the development of varicose veins during pregnancy. Multiple pregnancies usually results in the worsening of the size, shape and symptoms of the varicose veins.
How will I know if I have varicose veins?
Varicose veins are notorious for being unattractive and very prominent. Varicose veins of the legs can also cause the legs to swell, sometimes painfully. As varicose veins progress, some women develop discoloration around the ankles and prominent rope like veins along the lower leg and thigh. Women may feel heaviness or tiredness of the
legs, or restless legs.
How are varicose veins diagnosed?
A simple physical examination is used to diagnosis most cases of varicose veins. However when it comes to the legs, a venous ultrasound may be used to rule out the presence of blood clots and confirm the diagnosis of varicose veins. This painless test is also used to determine how much blood is flowing back into the legs by assessing the valve function in the groin.
We do not recommend treatment for veins during pregnancy. Once the baby is delivered, we may treat any veins that do not resolve.