July 25, 2014

Vulvar varicose veins



Unfortunately for pregnant women vulvar varicose veins are quite often overlooked. Vulvar varicose veins are an embarrassing problem that most women don’t want to talk about but instead will suffer in silence hoping that they will simply go away after delivery. This post is designed to help pregnant understand vulvar varicose veins and what can be done about them.

First off, varicose veins in the groin are no different than varicose veins in legs. They are simply distended veins that have been under downward pressure and have lost their shape and ability to move blood upward toward the heart. The most common reason for vulvar vein distention is pregnancy. Pregnancy causes this vein distention through a number of ways which I cover well in another post titled “Pregnancy and Varicose Veins“. Here we are going to focus on the symptoms of vulvar vein problems and what can be done about them.

The symptoms of vulvar varicose veins are usually pain and swelling. The swelling can be profound and result in fullness and disfigurement of the vulva and groin. I have seen swelling so large that it affects sitting and urination. With this swelling comes pain and it is the pain that is so incapacitating for women. The constant ache and throb that occurs can simply be intolerable. When these develop early in pregnancy then women are looking forward to 5 or 6 months of continuous pain before they deliver and even then there is no guarantee that they will go away. Put simply, vulvar varicose veins are a major problem for pregnant women.

The good news: There is hope. First off, compression socks. In the case of vulvar varicosities you must use pantyhose style compression socks. This will compress not only leg veins but also the pelvic veins. by doing this you can overcome the swelling (and in turn much of the pain) that occurs while up and about during the day. It won’t be perfect, but should be a huge improvement. Most pregnant women find that they do not need these at night. When they are lying down, the blood flow up out of the pelvis is better, the swelling is less, and the pain subsides. So I typically recommend using the pantyhose compression socks during the day only.

Next, there are treatments that are OK to pursue during pregnancy. That’s right. You may not need to wait the whole 6 months to obtain pain relief. As vein specialists we now have a number of treatments that are safe to use during your pregnancy. For example, the new endoluminal catheter procedures can treat leg veins and procedures like phlebectomy and sclerotherapy can be used to treat the vulvar veins. I have done this in my own practice for many pregnant women and have great success in eliminating the pain and swelling. The best part is that these are office procedures with only some local anesthetic and no general anesthesia that would affect the fetus!

My advice on this matter is simple. Don’t be shy about discussing vulvar varicose veins with your Obstetrician and asking for a referral to a vein treatment specialist if you are really suffering with vulvar varicose veins. If you only have a few and they are not that uncomfortable then I would recommend waiting to see if they don’t just go away after delivery.
For more information on pregnancy, varicose veins, and vulvar varicose veins you really should consider obtaining a copy of my book “The Vein Game“.

Thanks for stopping by!