Varicose veins during pregnancy are extremely common. 30 to 40 percent of women develop varicose veins during their first pregnancy. And 55 percent will get them during successive pregnancies.

The reason varicose veins often occur during pregnancy is due to three physiological changes. An increase in blood volume to help your baby grow. Your uterus causing pressure on the inferior vena cava. And a surge of pregnancy hormones that make vein walls less rigid and capable of functioning properly. These factors combined can cause the blood in your veins to pool, leading to the formation of varicose veins.

We are familiar with varicose veins forming in the legs however there are also veins in the pelvic area, the uterus, ovaries, vulva and vagina which can be similarly affected during pregnancy. 

Varicose veins in the legs

Our leg veins are responsible for carrying oxygen-rich blood from around the body, back up to the heart. However when vein valves, or vein walls, become damaged they can lead to Chronic Venous Insufficiency. As well as swelling and skin discoloration, one of the symptoms of Chronic Venous Insufficiency is varicose veins.

Many women who develop varicose veins during pregnancy may have never noticed veins before. It is not until they are pregnant that the veins become visible and start to cause issues. Symptoms of Chronic Venous Insufficiency are:

  • Aching or throbbing legs
  • A feeling of tiredness or heaviness in the legs, especially at the end of the day
  • Any swelling in the legs, either around the ankles or around the damaged vein/s
  • Skin discolouration
  • Itchy skin (see more: Why are Varicose Veins Itchy)

Vulva varicose veins

Vulva Varicosities are varicose veins on the outer surface of the female vulva. The vulva is home to a wide range of small and large blood vessels. During pregnancy, increased blood flow and pressure on the genitals can cause varicose veins.

It is estimated that between 4 percent and 10 percent of pregnant women will develop Vulva Varicosities. However, not all women will be able to see them. Some women have visible veins around the vulva or inner thigh. Yet others will will only experience symptoms, such as pain. 

A few common symptoms you can look out for are:

  • Feelings of heaviness, pressure or pain in the vulva.
  • Any pain in the vulva that gets worse after standing, sexual activity, or physical activity.
  • Swelling or itchiness around the vulva.

For more information on how to manage Vulva Varicosities see: How to Manage Varicose Veins of the Vulva

Pelvic varicose veins

20-25 % of the female patients who visit The Vein Institute will have coexisting pelvic veins along with their leg veins. This is due to Pelvic Congestion Syndrome, also known as Ovarian Vein Reflux and is most common in women who have been pregnant. When varicose veins develop in the pelvis, they often cannot be seen and the condition can be difficult to diagnose. In some women, the pain is misunderstood for endometriosis, fibroids, uterine prolapse or urinary incontinence. 

Generally, those with a higher risk of developing pelvic congestion syndrome are those who have a family history of varicose veins. Although it is not a life threatening condition, it does have the potential to significantly impact your quality of life. Symptoms such as chronic pain can lead to a decrease in physical activity, loss of function, and depression. 

Aside from pain, some symptoms of pelvic congestion syndrome are:

  • Abnormal vaginal discharge. 
  • Tenderness around the abdomen.
  • Irritable bowel symptoms. 
  • Swelling in vagina or vulva.  
  • Urinary symptoms such as a need to go to the toilet frequently and urge incontinence
  • Enlarged and distorted veins on the buttocks, external genitals (vulva), or thighs

How to prevent varicose veins during pregnancy

Even with a family history of varicose veins during pregnancy, there are preventative measures you can take to lessen your chances of developing them:

  • Stay active – With a growing belly it can be harder to move around, especially in your third trimester. You may feel tired or less energetic throughout the day. But it’s very important to exercise regularly to ensure proper blood circulation, particularly by moving the muscles that help pump the blood out of your legs. 
  • Stay within your recommended weight – Increased weight puts more pressure on your veins. You may not be able to control all the causes of varicose veins, such as hormone fluctuations and your blood volume, but you can control weight gain. Work with your obstetrician to determine a healthy weight range for your pregnancy.
  • Avoid prolonged standing and sitting – If your occupation requires you to stand or sit for long periods of time make sure to take breaks so you can sit down and put your feet up. Sleep with your legs elevated using pillows to assist with circulation and to help the blood drain out of your leg veins.
  • Wear compression stockings – wearing compression stockings can help promote regular blood flow. It is recommended that the stockings are worn during, and post-pregnancy. Tip: you will get the best results if you put the garments on before getting out of bed in the morning – before gravity has taken effect.

Don’t be afraid to bring up any other concerns and to ask your specialist at The Vein Institute if they have additional tips. They can often recommend strategies that can help make your pregnancy more comfortable at the same time they lower your vein disease risk – both during the pregnancy and afterwards.