Vaginal Varicose Veins: What to Know About Vulvar Varicosities

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If you are pregnant, you have likely experienced a lot of changes happening to your body. Some people even experience pelvic area discomfort (like itching, swelling, irritation, and pain) well before they actually give birth.

This discomfort may be due to a condition known as vulvar varicosities, or varicose veins on or around the vulva. While this condition may catch you by surprise, it is normal and usually does not cause complications.

If you have vulvar varicosities, there are several things you can do to ease your discomfort through your pregnancy. Here is what you need to know.

Understanding Varicose Veins

Even if you’ve never heard of vulvar varicosities, you’re probably familiar with varicose veins—the term for any superficial vein that’s become enlarged, twisted, or swollen. 

Varicose veins can happen anywhere on the body, though the legs are the most common spot. Milder cases are often referred to as spider veins thanks to their cobweb-like appearance; severe cases can cause the veins to bulge and look dark blue or purple in color.

Varicose veins occur when the valves in your veins become weak or damaged. As your body pumps and circulates blood through your veins, these valves are designed to keep the blood flowing forward; however, the blood flow can be disrupted if the valves malfunction, causing pooling, bulging, and a misshapen appearance in the veins.

There are several risk factors for varicose veins, including advanced age, weight, pregnancy, family history, and anything that puts extra pressure on your veins, like working a job that requires you to stand for long periods of time.

Most of the time, varicose veins are a cosmetic issue meaning they don't typically pose any risk to your physical health. There are treatments available to reduce or minimize the appearance of varicose veins. Though most varicose veins aren't of concern medically, there can be medical problems associated with varicose veins like skin ulcers and a serious type of blood clot called deep vein thrombosis.

What Causes Vulvar Varicosities?

Vulvar varicosities are common during pregnancy and do not carry the same risks or complications as varicose veins elsewhere on the body.

While some people refer to these as "vaginal varicose veins," it's something of a misnomer. This condition doesn’t actually affect the vaginal canal, only the exterior genital area, which is known as the vulva.

Vulvar varicosities happen partially because there is increased blood flow in your body during pregnancy. In fact, the amount of blood your heart pumps during pregnancy can increase 30% to 50%. Where’s all that blood going? A lot of it goes to your uterus, but the vulvar region is also impacted by this increase in blood flow as your body prepares itself for birth.

During pregnancy, there’s also an increase in sex hormones like progesterone, which can cause more pooling of blood, as well as added pressure and compression of blood vessels in your pelvic region as your baby grows. All of these factors combined can cause the development of varicose veins on and around the vulva.

Symptoms

Some people with vulvar varicosities don't even realize they have them. For others, the issue is strictly cosmetic—you may notice the telltale bluish-purple veins protruding, but not feel pain or discomfort. For many people, though, the condition comes with a variety of uncomfortable symptoms including:

  • A sensation of fullness or pressure 
  • Discomfort while walking or exercising
  • Itching
  • Painful sex
  • Swelling

Most cases of vulvar varicosities resolve shortly after giving birth—anywhere from 4 to 6 weeks. Having them also won’t affect your labor and delivery (even if you’re planning a vaginal birth).

Prevention

Since increased blood flow, pressure, and hormones during pregnancy are unavoidable, there may not be much you can do to avoid varicose veins, especially if you have a family history or are genetically predisposed to them.

Still, there are a few ways to improve your chances of avoiding vulvar varicosities or making them more manageable if you do develop them. Getting regular exercise helps your circulation and encourages healthy blood flow, for example.

Eating a balanced diet may help, too. Most people gain weight during a healthy pregnancy, but obesity is a risk factor for varicose veins. So, try to stay within the recommended range of pregnancy weight gain by eating nutritious foods and staying active.

Additionally, take extra good care of your legs. Elevate your feet while sitting, avoid high heels or other ill-fitting footwear, and change positions frequently from sitting to standing to moving around. 

Pregnancy-Safe Treatments

If your best efforts haven’t prevented you from vulvar varicosities during pregnancy, there are safe ways you can treat them, or at least relieve any related discomfort. Here are some treatment options that may help.

Compression Garments

Compression stockings can increase the amount of blood flow in your legs, keeping the blood moving instead of pooling in your veins. Talk to a healthcare provider about choosing the right product for yourself during pregnancy.

There are also vulvar varicosity support garments meant to be worn over your underwear. These items can limit the uncomfortable sensation caused by varicose veins around your vulva or perineum.

Cold Compresses

Applying an ice pack to your vulva can minimize swelling and numb the pain, itching, and discomfort associated with vulvar varicosities.

Movement and Elevation

Keep moving during the day rather than remaining in the same position for an extended period of time. When you go to sleep at night, elevate your legs and/or your hips with a pillow to keep the blood flowing instead of pooling.

Corticosteroids

If you consult a healthcare provider who approves it, you can apply a small amount of an OTC corticosteroid cream to your vulva to relieve itching and irritation.

Blood Clot Medication

Sometimes, a blood clot actually forms within a varicose vein, which should be treated by a healthcare provider. They will prescribe a low dose of a blood thinner to clear the clot and prevent future ones.

Procedures

For people with severe cases of vulvar varicosities, there are a few surgical options if the condition hasn't improved after delivery. Most healthcare providers prefer to wait until after pregnancy to perform these procedures, as many cases get better on their own postpartum. These procedures include:

  • Phlebectomy, removal of the veins through small incisions in the skin
  • Sclerotherapy, an injection of a solution that causes the veins to scar over and close up
  • Transcatheter embolization, where medication is delivered to the veins via a catheter to eliminate blood flow to the area

A Word From Verywell

Vulvar varicosities are often uncomfortable, but in most cases they resolve post-delivery and don’t cause complications or require intense treatment during pregnancy. At-home prevention and treatment strategies can help you manage the condition during your pregnancy.

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