Vaginal Varicose Veins: What to Know About Vulvar Varicosities

If you’re pregnant, you’ve likely gotten used to a lot of changes happening to your body. And some of them have even been affecting your most sensitive areas, like your breasts, groin or pelvis, and genitals. 

Yes, unfortunately some women do experience discomfort (like itching, swelling, irritation, and pain) well before they're actually giving birth due to a condition known as vulvar varicosities, or varicose veins on or around the vulva.

While it's quite unpleasant, it's also very normal, and there are several things you can do to ease your discomfort while you ride out the rest of your pregnancy.

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.

Most of the time, varicose veins are a cosmetic issue. There are treatments available to reduce or minimize the appearance of varicose veins. However, 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 thankfully don’t really carry the same risks or complications as varicose veins.

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 women with vulvar varicosities are lucky enough to not 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 women, though, the condition comes with a variety of uncomfortable symptoms including:

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

The good news is that most cases of vulvar varicosities resolve shortly after giving birth—anywhere from four to six weeks—and having them 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 during those nine months either, especially if you have a family history or are genetically predisposed to them. 

Still, there are a few ways to improve your chances of skipping over this unpleasant pregnancy symptom (or at least making it less painful).

• Get regular exercise. This helps your circulation and encourages healthy blood flow.
• Eat a balanced diet. Most women gain weight during a healthy pregnancy, but obesity is a risk factor for varicose veins—so try to stay within the recommended range of weight gain by eating nutritious foods.
• 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 your pain until after delivery.

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 your doctor about choosing the right product for yourself during pregnancy.

There are also vulvar varicosity support garments meant to be worn over your underwear, which 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 your doctor 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 your physician. They will prescribe a low dose of a blood thinner to clear the clot and prevent future ones. 

Procedures

For women with severe cases of vulvar varicosities, there are a few surgical options—though most doctors prefer to wait until after pregnancy to perform them (like if your condition still hasn’t improved postpartum). They include:

• Sclerotherapy, an injection of a solution that causes the veins to scar over and close up.
• Phlebectomy, removal of the veins through small incisions in the skin.
• Transcatheter embolization, where medication is delivered to the veins via 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 while you wait for your bundle of joy (and relief from your symptoms).