Many women first develop varicose veins or find that they get worse during pregnancy. First, your progesterone levels rise, causing the walls of your blood vessels to relax. Secondly, 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:
* The principal cause is the hormonal changes that occur during pregnancy. Increased levels of the hormone progesterone cause blood vessels to relax. This may allow the two halves of the valves in the vein to separate slightly, so that they don’t meet to block the back-flow of blood.
* The enlarged uterus (the organ that holds a developing fetus), pressing against the major veins in the pelvic region, tends to add to the overall problem. The result is an increase in the pressure in the leg veins that are subject to becoming varicose.
* A family history of varicose veins tends to increase the likelihood of varicose veins developing during pregnancy.
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. 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. The majority of women who do develop varicose veins in the legs will retain these varicosities after pregnancy.
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. Here are some simple steps for treating and minimizing varicose veins during pregnancy:
* The major preventive measure is to exercise and walk to stimulate the muscles which can push the blood away from the leg.
* Elevation of the legs at all times is also recommended.
* During pregnancy, one should always lie on the left side with the legs elevated on a pillow. This prevents the fetus from pressing on the leg veins and decreases the chance of developing varicosities.
* Don’t cross your legs when sitting down.
* Avoid standing or 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.
* Buy some pregnancy support hose that provide graduated compression. 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.
* Be sure to gain an appropriate amount of weight. Carrying too much weight can contribute to varicose veins.
* Avoid tight clothing that can compress the waist or groin.
* Eat a low-salt diet (salt does have the ability to retain water).
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.
If you do find your varicose veins are problematic after delivery, you can consult with a qualified surgeon to help decide the best course of treatment. Many veins can be minimized or eliminated using modern treatment methods. If you do decide to have your veins treated you should probably wait until after you are done having children, otherwise you may develop new varicose veins in subsequent pregnancies.
Varicose veins during pregnancy
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