Blossoming Bumps and Varicose Veins: A Guide to Pregnancy and Vein Health
Pregnancy is a joyous time filled with exhilarating expectations. However, not all aspects are joyful. Unpleasant side effects of varicose veins often distract from the delight of pregnancy and cause unnecessary discomfort and embarrassment.
Unfortunately, women often discount their suffering and dismiss it, thinking it’s normal. Lisa’s story is one of overcoming these problems.
Pregnancy at 40 caused Lisa to have an enlarged, twisted vein near her right knee. She was thankful for her growing womb but felt uncomfortable and embarrassed in shorts and a bathing suit. Lisa assumed her varicose veins were one of the many motherly sacrifices she would make out of love for her developing child.
Lisa also experienced the typical symptoms of varicose veins: itchy, tired, and heavy legs. These bothersome symptoms caused Lisa to seek medical help. She was thankful that she did!
An ultrasound showed that Lisa had "broken down veins." She suffered from chronic venous insufficiency (CVI), also known as vein disease.
Lisa was shocked to learn that her vein disease was the culprit of her leg discomfort and unsightly varicose veins. The vein specialist provided combination treatments, and Lisa regained confidence in shorts and a swimsuit.
Many women, like Lisa, unknowingly suffer from CVI. They assume enlarged, distorted veins, known as varicose veins, are only a cosmetic issue. They don't realize these twisted veins indicate an underlying problem and are easily treatable. Continue reading to learn more about pregnancy-related varicose veins.
Pregnancy’s Impact on the Vascular System
During pregnancy, dramatic changes in the vascular and hormonal systems of the body often cause vein disease.
With the growing demands of the maturing baby, blood volume increases 30-50 percent. All this extra blood is still confined to the same number of blood vessels, so the added volume increases vascular pressure. This elevation in vascular pressure stretches the veins and strains the valves.
Hormones also play a role in causing varicose veins. With progesterone elevated, veins and vessels relax to allow for extra blood volume. However, the increase in diameter further enlarges the veins and makes the vascular system susceptible to pooling and reflux.
Pooling results when blood becomes sluggish, and efficient circulation is impaired. Reflux ensues when blood flows backward.
Blood vessels use one-way valves to circulate blood against gravity. When functioning correctly, these valves force blood to flow in one direction. With CVI, valves malfunction, causing pooling and reflux.
The growing uterus also presses on the inferior vena cava, the body’s largest vein. These factors make it difficult for valves and vessels to defy gravity and force blood back to the heart and lungs.
Increased vascular pressure, inefficient vein valves, and relaxed vein walls lead to varicose veins, spider veins, hemorrhoids, and other symptoms of venous insufficiency during pregnancy.
Lifestyle changes and time generally prevent significant complications and reduce symptoms, typically resolved after childbirth.
How to Promote Vein Health
Nausea and vomiting are the dreaded side effects of childbearing, but many pregnant women also suffer from varicose and spider veins. With a few tips and tricks, varicose veins are often preventable.
What to do:
Efficient circulation depends on muscle contraction, which pushes and encourages blood to flow back to the heart and lungs. One of the best ways to avoid vein disease and varicose veins is to get blood pumping.
- Low-impact exercises: Later in pregnancy, low-impact exercises are recommended because these activities encourage blood flow without increasing stress on the joints and vascular system. Daily walks promote emotional, physical, and vascular health. Swimming, biking, and yoga are low-impact sports that will aid in varicose vein prevention. Whenever beginning a new exercise routine, talk to your OB/GYN to ensure safety
- Repositioning: Avoid sitting and standing for long periods, restricting efficient blood flow. If life has you sitting for extended times, remember to do toe-heel raises in your chair. Try not to sit with your legs crossed since this is another position that increases vascular pressure and reduces circulation
- Leg elevation: Pregnancy is a tiring process. You will need extra rest. During rest periods, elevate your legs at chest level or slightly above. This position reduces vascular resistance and promotes blood flow
- Left side sleeping: Lastly, sleep on your left side to relieve stress on the inferior vena cava, which lives on the right side of your body
What to wear:
Whatever the daily routine, moms-to-be have busy lives and don’t always have time to prioritize self-care. Compression stockings are easy and time-tested to improve circulation and prevent varicose veins.
These elastic stockings apply gradient pressure, with the most significant force at the feet and ankles. The hose gradually becomes looser further up the leg.
Compression therapy pushes blood out of the feet and ankles and back to the heart. Compression stockings benefit the lower extremities for the following reasons:
- Reduce swelling (edema)
- Relieve aches and pains
- Support relaxed vessels
- Lessen stress on the valves
- Promote effective valve function
- Decrease venous inflammation
- Diminish blood pooling and reflux
Compression therapy supports the blood and lymphatic vessels, decreasing your risk of developing varicose veins, spider veins, and swelling.
Talk to your doctor about a prescription for compression stockings. By getting a prescription for compression stockings, a vein specialist will ensure you receive the proper size and strength for your needs. Maternity-size compression stockings are also available. Ask your vein specialist about insurance coverage for these special stockings.
Loose, comfortable clothing is a must during pregnancy. Avoid tight, restrictive clothing and shoes. Underwear, waistbands, socks, and shoes should be loose enough to promote proper circulation, lessen vascular pressure, and decrease valvular stress.
During pregnancy, the center of gravity shifts. High heels accentuate this shift. Though high heels are tempting to wear, they are hazardous during pregnancy for a few reasons:
- High heels increase back strain
- High heels are a fall hazard, which is dangerous for both mom and baby
- High heels restrict the range of motion and prevent the “pump action” of the calf muscles
What to eat:
Constipation is another cause of vascular pressure. Hemorrhoids are a type of varicose veins resulting from constipation. Often pregnant women think that since they are experiencing swelling in their feet and ankles, they should reduce their fluid intake. This assumption is false.
Adequate water consumption helps improve bowel function and reduce gastrointestinal strain. Without enough water, stools become hard and difficult to expel. Drink a minimum of eight glasses of water daily.
Consuming a diet rich in fiber also helps prevent constipation. Regardless of variety, beans are an excellent source of nutrients and fiber. Nutrient-dense foods, or whole foods, promote fetal development and reduce inflammation.
Aim to eat at least one fruit and vegetable at each meal. A whole food, anti-inflammatory diet also helps you maintain a healthy weight. Talk to your OB/GYN about how much weight gain is appropriate for you.
What are Vulvar Varicose Veins?
Varicose veins usually appear in the legs and feet. However, 18-22 percent of pregnant women experience these enlarged veins on their vulva, the outer tissue layer around the vagina.
Vulvar varicose veins do not impact childbirth or the baby’s health. Sometimes, they are visible; other times, they are not.
Vulvar veins can cause soreness, pressure, and pain in the vulva. These symptoms often worsen with standing, exercise, or intercourse.
If you experience these symptoms, a vein specialist will examine the veins and perform an ultrasound to diagnose vulvar varicosities. These assessment tools help to rule out pelvic congestion syndrome (PCS) and blood clots.
What is Pelvic Congestion Syndrome?
As previously mentioned, blood surges into the body, especially the pelvic region, to provide adequate fluids and nutrients to the growing embryo. Veins in the lower abdomen, buttocks, and ovaries can become distended and painful.
PCS occurs when multiple varicose veins are in the pelvic region, and chronic pain persists. Though no medical treatment is necessary during pregnancy, some tips will help relieve the symptoms:
- Apply cold compresses to the vaginal area to reduce inflammation and discomfort
- Elevate hips during sleep to decrease blood pooling
- Wear compression garments to support veins and boost blood flow
- Avoid pelvic straining exercises, like weightlifting, to avoid internal stress
- Sleep on the left side to relieve pressure on the inferior vena cava
- Use a gentle soap to prevent irritation
"When should I see a vein specialist during pregnancy?"
Many women wonder when they should speak up about their varicose veins. Talk to your OB/GYN or a vein specialist when you notice varicose veins or experience symptoms of vein disease.
Vein specialists don't treat CVI symptoms during pregnancy. However, these physicians are an invaluable resource for monitoring vein disease during pregnancy.
If you notice varicose, spider, or vulvar veins, don't wait. Notify a vein specialist, who will monitor your vein disease and help relieve symptoms.
During and throughout pregnancy, the venous system is in a constant state of change. After childbirth, the increased blood volume and progesterone levels return to normal; therefore, the increased vascular pressure and dilated vessels also resume normalcy.
After birth, many factors that caused the varicose veins resolve themselves, and the symptoms of vein disease disappear. These reasons are why physicians delay medical treatment until postpartum.
The symptoms of venous insufficiency are not usually dangerous to the baby or mother, but they are often uncomfortable, irritating, and embarrassing.
If varicose veins, leg swelling, pain, discoloration, or other vein disease symptoms persist for over three months, talk to a board-certified vein specialist. Treatment is recommended before subsequent pregnancy. Treating ongoing varicose veins provides relief and prevents complications in future pregnancies. If left untreated, symptoms of venous insufficiency progressively intensify with each pregnancy and put you at risk for venous ulcers and blood clots.
Though medical treatment will likely be postponed until after delivery, establishing vein care will ensure adequate support and monitoring throughout the pregnancy and prompt therapy after birth. Some vein centers evaluate vascular function as early as six weeks postpartum.
Talk to a vein specialist if the veins feel stiff or if pain and discoloration continue. Though many women believe varicose veins are merely a cosmetic problem, this is a myth. Varicose veins in the legs, ankles, buttocks, or vulva are indicators of valve malfunction and inadequate blood flow.
Contact your doctor immediately if you notice significant leg swelling or a hardened, tender vein, especially if the edema is rapid or severe. These symptoms may indicate a rare condition called deep vein thrombosis (DVT), which is a blood clot. Remember, bleeding from varicose veins is a medical emergency. If in doubt, reach out!
Postpartum Treatment Options for Varicose Veins
Pregnancy-related varicose veins caused by the many physical and hormonal changes that happen to support and nourish a growing baby are common. Determining the right treatment option for you begins with an assessment and ultrasound to reveal the function of the vein. This information equips vein care leaders to provide the best treatment recommendations for your needs.
Pregnancy-related varicose veins are medically treated with minimally invasive, in-office procedures. These procedures help you regain your healthy body and focus on what matters: your sweet, new baby. After vein treatment, you will look, feel, and live better.
Need Help With Pregnancy-Related Varicose Veins?
Pregnancy's drastic physical and hormonal changes place women at risk of developing unsightly varicose veins. Though these bulging, twisted veins cause embarrassment, more concerning is the fact that they indicate an underlying vein disease.
Lifestyle changes, compression therapy, and time often eliminate pregnancy-related varicose veins, but sometimes medical treatment is necessary.
Center for Vein Restoration (CVR) is the country's largest physician-led practice and has over a decade of experience treating vein disease. Our board-certified physicians specialize in minimally invasive, in-office treatments that get moms back to normal with minimal recovery time.