Varicose veins during pregnancy: Symptoms and treatment

During my two pregnancies, I managed to sidestep many not-so-great side effects that many expectant moms face. Varicose veins during pregnancy, however, turned out to be inescapable—and I was filled with dread when I first noticed those blue and purple bulges on my calves.

Varicose veins are swollen veins near the surface of the skin. They can be sore to the touch, itchy and make your legs feel tired and achy: symptoms that can get worse if you’ve been on your feet for a long time. Some women don’t experience the symptoms at all, but they still have to deal with those less-than-lovely lines on their legs.

While they’re common in the calves, they can travel up the leg and even beyond (yep—much higher than most women realize). Halifax obstetrician Jillian Coolen explains that they can even appear in the vulvovaginal area. “Some women experience pressure or a bulge in their vulva and don’t know what it is. The answer is varicose veins.” They don’t impact vaginal births, but can cause the same soreness women experience in their legs.

Even before pregnancy, the veins in our lower bodies are working against gravity to return blood to the heart, and once you’re pregnant, the hormone progesterone causes blood to pool down there. As your baby grows, your uterus compresses some of the blood flow returning to the heart, leading to an increased risk of varicose veins. Each pregnancy puts you at greater risk, and older moms are more prone. You’re also more susceptible if a family member is a varicose-veins sufferer. About 28 percent of women without a prior issue with varicose veins will develop them in pregnancy.

Coolen suggests that pregnant women try to cut back on the amount of time they spend standing. “If you have to be on your feet for your job, wear compression stockings. They won’t prevent varicose veins from developing, but they’ll help with the symptoms.” While many women experience relief with knee-highs, full-length pregnancy versions are on the market, which look like nylons and are especially helpful in the vulvar region. But they can be pricey. “Tight-fitting bike shorts help with compression in that area and are more affordable,” says Coolen, who has also prescribed a product called the V2 Supporter by Prenatal Cradle, which can be purchased over the counter and may be covered by insurance plans if prescribed. Other tips for easing symptoms include lying on your left side, keeping your legs elevated, not crossing them, and light exercise, which all relieve pressure and improve blood flow.

“The good news is that the appearance and symptoms are usually greatly improved within six weeks of delivery, though there are always exceptions,” says Coolen. They’re less likely to disappear completely if you had them before pregnancy, have a family history of varicose veins, are overweight, or stand for long periods of time.

Some over-the-counter products promise to improve the appearance. While the common main ingredient, witch hazel, has anti-inflammatory properties that might ease the ache, there are no studies to prove it’s safe during pregnancy or for breastfeeding moms, so save them for later.

Since varicose veins commonly return with each pregnancy, permanent treatments should wait until your baby-making days are over. Every summer I mull over the options, which include sclerotherapy or ablative therapies to seal the veins, or vein stripping, where veins are tied off and removed, but I’ve never taken the leap. When the time arrives, you can weigh the level of discomfort you live with and your cosmetic concerns to decide if treatment is right for you, or if you’re content to hold on to yet another badge of pregnancy.

A version of this article appeared in our July 2014 issue with the headline, “Varicose veins,” p. 49.

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