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Varicose veins are common during and after pregnancy and they are a great cause of concern for many women. On one hand, there is the cosmetic aspect. While stretch marks (another “annoyance” of pregnancy) can be easily hidden, your varicose veins will most likely show sooner or later. On the other hand, some women are concerned of venous rupture and bleeding. Let’s review why varicose veins develop and what you can do to prevent them or, if they already appear on your legs, what you can do to minimize them.
Why do varicose veins develop?
During pregnancy, you produce an extra volume of blood to support yourself and your growing baby. This extra amount of blood creates additional pressure on your blood vessels, especially on the veins in your legs, which have to work against gravity to push all that extra blood back up to your heart. The problem is that the rate at which blood flows from your legs to your pelvis decreases during pregnancy because of your growing uterus and the extra progesterone your body is producing.
When do varicose veins appear and how do they manifest?
Varicose veins can appear at any time of pregnancy but usually they become visible at around week 29. Because they have a hereditary component, if your mother had them during pregnancy, you are more likely to have them too. The good news is that, in most cases, they will not produce any problems to you or to your baby and often they diminish -or disappear altogether- within three months to a year after giving birth.
Varicose veins are usually blue or purple, sometimes squiggly, most likely in your legs, although you may also get them in your vulva or elsewhere (in fact, hemorrhoids are really just varicose veins of the rectal area.) You may have little or no discomfort from them, or they may make your legs feel heavy and achy. The skin around a varicose vein may also itch, throb, or feel like it’s burning. The symptoms tend to be worse at the end of the day, especially if you’ve been on your feet a lot.
What you can do
Following are some tips that may work:
- Avoid sitting or standing in the same position for long periods of time. Get off your feet whenever you can, and keep your legs elevated when sitting.
- Exercise is key in preventing varicose veins! Take walks as often as you can.
- Wear clothes — including underwear — that fit well and don’t bind, especially around the tops of your legs. Don’t wear tight belts or socks with tight elastic tops. Avoid wearing high heels. It is better to wear lower-heel or flat shoes.
- Wear special support hose. Graduated-compression stockings, which are twice as thick as normal pantyhose, work best. These stockings are available from medical supply stores and pharmacies.
- Watch your weight. Keep your weight gain during pregnancy down to what your practitioner recommends – usually 25 to 35 pounds. Extra poundage only increases the demands on your already overworked circulatory system.
- Avoid crossing your legs while sitting.
- Sleep on your left side. This will help relieve pressure on the inferior vena cava.
- Don’t strain. Heavy lifting or straining on the toilet can add to vein visibility.
- Reduce sodium intake to minimize swelling of the veins.
- Drink plenty of water and eat enough fiber to prevent constipation. If the veins don’t go away after the baby has arrived, you can think about having them medically treated or surgically removed then — but not during pregnancy.
- Do not treat your varicose veins with horse chestnut seed extract. The safety of this product for you and your baby is not known.
When you should be worried
There is some remote risk that a varicose vein could become inflamed, possibly indicating a blood clot. This is called “superficial venous thrombosis”, which is not the same as the serious deep venous thrombosis (DVT). Pregnancy makes you more susceptible to DVT, whether or not you have varicose veins, but it’s not common. Your chance of getting it either during pregnancy or in the weeks after you give birth is about 1 in 1,000. (Women with blood clotting disorders or on prolonged bedrest are at higher risk.)
Contact your health care provider if your veins become swollen, warm, tender, or red, if they bleed, if you have a rash on your leg or ankle, or if the skin on leg changes color or thickens. If a clot is suspected, you’ll have a special ultrasound evaluation of the affected area. If you do have one of these clots, you’ll need to be hospitalized and treated with a medication.