Veins and pregnancy
Pregnancy is the life event that has the most dramatic effect on the venous system of women.
Progesterone, the “hormone of pregnancy,” surges from the first day of pregnancy and continues to rise throughout the term. One of the effects of progesterone is to relax and stretch the veins in order for them to hold the approximately 50% increase in maternal blood volume of pregnancy. Ideally, the veins should return to their original pre-pregnancy size within a few months of delivery. Unfortunately, for many women the veins do not completely return to normal size and get progressively more dilated with each pregnancy.
In many women, the first time they notice that they have varicose veins is during pregnancy. In women with pre-existing varicose veins, their varicosities may get much worse during the course of the pregnancy and cause considerable discomfort.
Good advice for all pregnant patients is to wear compression hose as much as possible. Patients with no history of vein problems should consider over-the-counter 15-20 mmHg graduated thigh-high hose. Patients with mild vein problems may benefit from prescription 20-30 mmHg hose. Patients with significant vein disease during pregnancy may need 30-40 mmHg hose for maximum benefit. Your physician can write you a prescription or you may schedule an office visit with us to get the proper hose for your situation.
The old mantra of “wait until all of your pregnancies are over before getting your veins treated” is totally out of date. That made sense when the only treatment was invasive and incapacitating “vein stripping.” With today’s highly effective, office-based treatments the modern advice for young women is to get their veins treated "before the next pregnancy." This will make the future pregnancy much more comfortable and once treated, the same varicose veins don’t come back.
Some pregnant women develop large bulging vulvar varicose veins during pregnancy. The special V2 Supporter (shown below) is designed to hold pressure on these veins to improve patient comfort until delivery. Fortunately, most of these veins go away after delivery. If they do not completely disappear, they can be easily treated with sclerotherapy in the office.
No vein treatments, other than the wearing of compression hose, can be performed during pregnancy. After pregnancy, women with varicose veins should wait at least 60 days after delivery to schedule an evaluation. This time is necessary to allow the veins time to shrink down as much as they will after pregnancy. Before your next pregnancy, schedule a visit to keep your legs healthy.
Clovis E. Manley, MD
Evansville Regional Vein Center
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Model wearing the V2 Supporter to compress bulging vulvar varicose veins during pregnancy.