Most people know that pregnancy aggravates or precipitates varicose veins with associated leg discomfort, swelling, and ugliness. What is not so well known is that the presence of varicose veins dramatically increases the risk of venous thromboembolism (blood clots), which is the second leading cause of maternal death during pregnancy. Now that I have your attention, let’s explore the true relationship of pregnancy to varicose veins and thrombosis.
Pregnancy most certainly exacerbates varicose veins and their complications, but it doesn’t cause them. A person either is destined to get varicose vein in their lifetime or not according to genetics; one is either born with this common predilection or not. If you are, then the hormone balance necessary during pregnancy to sustain the fetus operates on that genetic background. Although supportive of pregnancy, these hormones actually dilate veins causing increased blood flow, which in turn, cause predisposed veins to fail. This hormone balance is similar to menstruation, which explains why many women experience increased symptoms of venous insufficiency during menses. It also explains why women often suspect they are pregnant even before they miss their period by observing the appearance of new leg varicosities and associated symptoms.
Since you can’t choose different parents or alter your genetics, what can you do – especially during the hot summer months? First, wear properly fitted, graduated, therapeutic (20-30 mm) support hose – not OTC Leggs or Haines. Yes, it’s another layer to wear in the summer heat, but the alternative is unacceptable if you think about it! Second, elevate your legs when the opportunity arises, such as when watching TV or during a long car ride as a passenger. Third, if you have vaginal varicosities, ask your OB doctor about getting a “V2 pelvic supporter.” It is like a jock strap for women and provides tremendous temporary relief until the baby’s delivery provides more permanent relief. Although these items have been around for decades, I continue to be surprised how many women relate stories of months of pain without ever being offered stockings or pelvic supporters.
Should you survive a pregnancy complicated by varicose veins with or without blood clots, don’t become complacent and ignore what happened. Although the majority of varicose veins recede or resolve after delivery, they will return worse than before with the next pregnancy, or simply recur over time even without pregnancy. Contrary to the old adage to postpone treatment until after all pregnancies, it is highly preferable and much safer to have your varicose veins treated in between (or before) pregnancy whenever possible to prevent the pain and complications associated with varicose veins. This is especially true with modern endovenous non-surgical techniques that require only a brief 30-minute doctor’s office appointment with immediate return to normal activities. Be proactive so you can enjoy a longer life with loved ones!