Varicose Veins & Pregnancy

Pregnancy is often the first time that women begin to experience varicose veins. The added weight and strain of the pregnancy on the circulatory system increases the likelihood of veins becoming varicose. Women who already have varicose veins may notice an increase in severity of swelling while pregnant.

During pregnancy, your progesterone levels rise, causing the walls of your blood vessels to relax. As your uterus grows, it puts pressure on the large vein on the right side of your body (the inferior vena cava), which in turn increases pressure in the leg veins. (Veins are the blood vessels that return blood from your extremities to your heart, so the blood in your leg veins is already working against gravity.)

The amount of blood in your body increases when you’re pregnant, adding to the burden on your veins. Up to 40% of all women develop varicose veins during pregnancy. There are valves in the veins which prevent the back flow of blood back into the legs. When these valves become damaged or defective, the blood flows backwards and causes swelling and enlargement of the veins. In addition, during pregnancy, there is a gain of weight and volume which causes the baby in utero to compress some parts of the pelvis (lower abdomen) and lead to an engorgement of the veins in the vulva/vagina. Varicose veins commonly occur on the legs and thighs but may also occur in the vulva or vagina. If a female has varicose veins of the vulva during pregnancy, she will always have varicose veins in the legs.

There are three main causes for the development of varicose veins during pregnancy:

  1. Hormonal changes: Increased progesterone levels cause blood vessels to relax which may contribute to the one-way valves within the veins to separate, thus allowing back flow and pooling of blood inside the veins.

  2. Enlarged uterus: The pressure of the uterus on the major veins in the pelvic area increases pressure on leg veins, thus making varicosities more likely.

  3. Genetics: A predisposition for developing varicose veins is compounded by the added strain of pregnancy on the circulatory system.

Unfortunately, in the majority of cases the varicose veins of the legs worsen with time. The varicose veins start to become more prominent and swell and with time, the veins become engorged with blood and cause localized pain and itching. The majority of women who do develop varicose veins in the legs will retain these varicosities after pregnancy. Once the leg veins become prominent, it is very unlikely that they will spontaneously resolve without any treatment. However, varicose veins on the vulva/vagina often do get better once the baby has been delivered.

You may or may not be able to prevent varicose veins during pregnancy. Fortunately you can take steps to minimize the severity of varicose veins and treat the veins you do have during pregnancy. If one starts early in pregnancy, varicose veins can be prevented. Steps To Treat and Minimize Varicose Veins During Pregnancy:

  1. Exercise and walk to stimulate the muscles which can push the blood away from the leg.

  2. Elevate the legs whenever possible. This allows gravity to assist in the return flow of blood from the legs to the heart and reduces the likelihood of venous reflux and blood pooling within the veins.

  3. Lie on the left side with legs elevated on a pillow. This prevents the fetus from pressing on the leg veins and decreases the chance of developing varicosities.

  4. Refrain from crossing the legs at the knees and ankles.

  5. Avoid standing and sitting still for long periods of time. Take frequent breaks to stretch while at your desk and shift your weight while standing. This can help decrease the amount of pressure on your legs and help keep your circulation moving. Wiggle your toes regularly and flex your muscles to also promote better circulation in your legs.

  6. Purchase a pair of pregnancy compression hose. Also known as support hose, these special stockings provide graduated pressure on the ankles and legs. This will not only help reduce bulging but will also help reduce any swelling you experience in your extremities during pregnancy. You can get these online or from a medical supply store or pharmacy. These stockings, unlike normal pantyhose, are quite thick and help maintain blood circulation. They can also help prevent blood from pooling in your legs if you put them on first thing in the morning.

  7. Monitor weight gain. Eat healthily and do not try to prevent weight gain, however it is also wise to avoid carrying too much extra weight. Carrying too much weight can contribute to varicose veins. Your doctor can advise you on the appropriate amount of weight to gain during pregnancy.

  8. Eat a diet low in sodium. Salt causes retention of water, which contributes to swelling.

  9. Avoid wearing tight clothing that puts pressure on the waist or groin area.

For many women varicose veins become much less severe after pregnancy. For others they may find they are still uncomfortable after pregnancy. A small number of women are more at risk for developing blood clots in their veins. This condition should be monitored by a doctor. In some cases a clot may need to be treated.