Updated:
by
Omofolarin Arthur, DO, DABVLM
If you've been living with Ehlers-Danlos syndrome (EDS), you probably know the drill. EDS is an inherited condition that weakens the connective tissues that hold your body together, and according to WebMD, its effects reach far beyond your joints and skin; it can also cause problems with your blood vessels and organs.
Hypermobile joints, fragile skin, chronic pain, and a body that seems to follow its own set of rules. What you might not know is that, depending on your EDS subtype, the same underlying connective tissue defects that affect your joints are also compromising your vascular system, making you significantly more vulnerable to venous insufficiency, varicose veins, and serious circulatory complications, according to the National Library of Medicine (NIH).
The connection between EDS and vein disease isn't just theoretical. It's structural, genetic, and increasingly well-documented. And for many people with EDS, recognizing and addressing the venous component of their condition can make a real difference in how they feel every single day.
We spoke with Omofolarin Arthur, DO, DABVLM, a board-certified vein specialist at Center for Vein Restoration's Greensboro, North Carolina, vein clinic, about what's really happening inside the veins of EDS patients and why addressing the vascular side of this condition is just as important as managing the joints.
Here's what you need to know.
Ehlers-Danlos syndrome is not a single disease. It's a group of heritable connective tissue disorders, currently classified into 13 distinct subtypes, all linked by a common thread: abnormal production, structure, or processing of collagen.
Collagen is the body's most abundant protein and the structural backbone of skin, tendons, ligaments, blood vessel walls, and organ tissue. When collagen is defective or insufficient, these structures lose the tensile strength and flexibility they need to function properly. The result can be joints that bend too far, skin that bruises and tears easily, and blood vessels that are weak, stretchy, and prone to dysfunction.
In 2017,13 subtypes of EDS were formally classified using specific diagnostic criteria, according to the NIH. The most common is hypermobile EDS (hEDS), which accounts for the majority of diagnoses. The most medically serious is vascular EDS (vEDS), formerly known as Type IV, which carries significant risks for life-threatening arterial and organ complications.
Hypermobile EDS is characterized by generalized joint hypermobility, joint instability, pain, soft and hyperextensible skin with easy bruising and atrophic scars in some patients, and cardiovascular autonomic dysfunction, according to the National Center for Biotechnology Information (NCBI). EDS causes problems with connective tissue throughout the skin, joints, and blood vessel walls.
To understand why EDS raises your risk of venous insufficiency, it helps to understand how healthy veins work. Inside every vein, tiny one-way valves keep blood flowing upward toward the heart, against gravity. Those valves, and the vessel walls around them, depend on collagen for their structural integrity.
When collagen is defective, vein walls lose their elasticity and strength. The valves weaken. Blood flows backward and pools in the legs, a condition called venous reflux, which is the underlying mechanism of venous insufficiency and vein disease.
Research published in PubMed Central confirms that people with EDS are significantly more likely to develop varicose veins and other vein problems. That's because the same faulty genes that cause EDS also weaken the walls of veins, making it harder for them to hold their shape and keep blood flowing in the right direction.
This isn't just a cosmetic concern. When venous insufficiency goes untreated, it can progress from visible varicose veins and spider veins to chronic leg swelling, skin changes, and, in serious cases, venous ulcers that are slow and difficult to heal.
Of all 13 EDS subtypes, vascular EDS (vEDS) is the most serious for vein health. It's caused by a gene mutation that affects a protein called collagen III, which the body needs to keep tissues and blood vessels strong. When that gene doesn't function correctly, the body either produces too little collagen III or a faulty version that can't do its job properly, according to Cleveland Clinic.
Cleveland Clinic also notes that people with vEDS are more likely to develop varicose veins at a younger age and bruise more easily than the average person. A study published in the journal Phlebology found that nearly half of vEDS patients develop vein disease before the age of 20, far earlier than most people experience vein problems. The study's authors concluded that defective collagen III is a likely direct cause of the early, rapid development of varicose veins in these patients, according to PubMed.
For context, the general population develops venous insufficiency primarily as a result of family history, aging, prolonged standing, pregnancy, and obesity. In vEDS patients, it can appear in teenagers and young adults, well before those typical risk factors even come into play.
There is one important thing vEDS patients and their doctors need to know before pursuing any vein treatment: traditional vein stripping surgery is considered too risky for people with this condition. According to research published in the Wiley Online Library, the tissue fragility that comes with vEDS means that surgery can cause serious damage to nearby veins and arteries, which is why doctors strongly advise against it.
Fortunately, modern minimally invasive vein treatment techniques offered at Center for Vein Restoration are effective alternatives.
📞 Call Center for Vein Restoration at 240-249-8250
📅 Or book online HERE
For people with hypermobile EDS, venous insufficiency often shows up in a less visible but equally disruptive way: through a condition called postural orthostatic tachycardia syndrome, or POTS.
The Ehlers-Danlos Society confirms that venous insufficiency plays a critical role in the symptoms experienced by those with Ehlers-Danlos syndromes and hypermobility spectrum disorders, with weakened vein structure leading to blood pooling, dizziness, and brain fog.
When blood pools excessively in weakened leg veins upon standing, the heart has to work much harder to compensate, triggering the rapid heart rate and dizziness that characterize POTS. POTS is found in 15 to 41 percent of patients with EDS, with the theory that the connective tissue disorder affects blood vessel elasticity and interferes with blood circulation, per PubMed Central.
This overlap is significant because many hEDS patients spend years being evaluated for cardiac or neurological conditions before the venous component of their symptoms is ever properly assessed. A thorough vascular evaluation by a qualified vein specialist can be a critical piece of the diagnostic puzzle.
If you have hEDS and have been chasing answers for dizziness, fatigue, or racing heart without resolution, a painless duplex ultrasound at Center for Vein Restoration can assess your vein function and determine whether venous insufficiency is contributing to your symptoms.
Schedule a consultation at a CVR vein center near you and let a board-certified vein specialist help complete the picture.
📍Find a Center for Vein Restoration near you HERE
If you have EDS and are experiencing any of the following, it's worth having a formal vein evaluation with a board-certified vein doctor:
Leg symptoms:
Systemic symptoms that may have a venous cause:
These symptoms deserve more than a shrug. They are meaningful signals about what's happening inside your blood vessels.
Managing vein disease in the setting of EDS requires an experienced hand. A few important points for patients with this diagnosis:
Minimally invasive is the standard. Because EDS affects how fragile tissues are and how well they heal, minimally invasive vein treatments are strongly preferred over traditional surgery. Research published in the journal Phlebology found that minimally invasive procedures work well for vEDS patients, effectively relieving vein symptoms and offering a real alternative to long-term compression garment use, per PubMed.
Modern outpatient options at Center for Vein Restoration include:
Endovenous Laser Ablation (EVLA) and Radiofrequency Ablation (RFA): These procedures use thermal energy delivered through a thin fiber inside the affected vein to seal it shut, rerouting blood to healthy vessels. They are performed in-office, require only local anesthesia, and involve minimal recovery time.
Sclerotherapy: A specialized solution is injected directly into spider veins or small varicose veins, causing them to collapse and fade. This is one of the most widely used and well-tolerated vein treatments available.
VenaSeal Closure: A medical adhesive seals the affected vein without heat or injections, allowing patients to return to normal activity almost immediately.
Compression therapy: Graduated compression stockings are often one of the first tools recommended for EDS patients dealing with venous insufficiency. They work by gently squeezing the veins in the legs, which pushes blood back toward the heart and reduces pooling.
For people with EDS, compression garments offer a bonus benefit beyond circulation: they also improve body awareness and joint stability, giving patients two meaningful reasons to wear them.
It's also critical for EDS patients to disclose their diagnosis to their vein specialist before any procedure. The altered tissue fragility, bleeding tendency, and healing characteristics of EDS require a personalized approach to treatment planning.
Living with Ehlers-Danlos syndrome is already demanding. You shouldn't have to manage worsening vein problems on top of everything else, especially when effective, minimally invasive treatment options are available.
At Center for Vein Restoration, our board-certified vein specialists understand the complex relationship between connective tissue disorders and venous insufficiency. Your consultation begins with a duplex ultrasound, the gold standard for evaluating venous reflux, followed by a personalized treatment plan tailored to your EDS subtype, anatomy, and symptoms.
With 80+ vein doctors across 120+ locations nationwide, and a 98 percent patient satisfaction rate, CVR accepts most major insurance plans for medically necessary vein treatment, including Medicare and Medicaid. Contact us to confirm your coverage before your first visit.
📞 Call Center for Vein Restoration at 240-249-8250 📅 Or book online HERE
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