The Medicine Cabinet: Ask the Harvard Experts
By Jeffrey Ecker, M.D.
Q: Are there any risks for women with varicose veins during pregnancy?
A: Varicose veins — veins swollen with blood that appear beneath the skin as swollen purple vessels — are more common during pregnancy. That’s because blood volume increases during pregnancy and the growing uterus places extra pressure on the veins as they return blood from the lower parts of the body. This causes blood to back up and swell the veins.
Genetics and family history play a role, too. You are more likely to get varicose veins if multiple family members have varicose veins.
Varicose veins can occur anywhere from the waist down, including the labia, other tissues surrounding the vagina, and the legs.
Varicose veins can cramp, ache, itch or feel warm and uncomfortable. Symptoms from varicose veins generally worsen if you are on your feet a lot or as pregnancy advances.
Lying down (on your left side to promote venous blood flow from the legs), elevating your legs or wearing elastic support stockings can decrease your discomfort. Varicose veins should not interfere with plans for a vaginal delivery even if they involve the skin and tissues around the vagina.
In general, the presence of varicose veins does not increase the risk of deeper blood clots in the legs.
On rare occasions, a blood clot can form in a varicose vein. Because these veins are close to the skin, this superficial inflammation is not dangerous. But it may indicate that you have clots deeper inside the leg. A clotted varicose vein would likely be hard, warm, red and tender. If you become concerned about such symptoms let your doctor know.
Most often, varicose veins disappear after delivery — only to reappear with the next pregnancy. Because of this, most doctors suggest very conservative treatment during pregnancy. You can use elastic stockings and change body position frequently to move the uterus off the veins.
In terms of other treatments for varicose veins, I usually advise women to wait until their plans for childbearing are completed. If varicose veins cause problems and pregnancy is no longer planned, a variety of therapies are available for treatment.
(Jeffrey Ecker, M.D., is chief of the Department of Obstetrics and Gynecology at Massachusetts General Hospital and a professor at Harvard Medical School. For additional consumer health information, please visit www.health.harvard.edu.)