I get lots of feedback from patients regarding their varicose veins and pregnancy. Most commonly, they say that their vein problem started with one of their pregnancies. The other statement that I hear is that their doctor told them not to do anything about their varicose veins until after they are done having children.
It’s time we shed some light on this situation, clear up some misconceptions and myths, and get to the bottom of the relationship between varicose veins and pregnancy.
The first thing to understand is that all veins are not created equal. If you have a family history of varicose veins, you may develop the pain and suffering associated with this condition whether you become pregnant or not. The fact that approximately 40+% of males in their 60’s have varicose veins speaks to this fact.
Veins are thin-walled pliable structures which are profoundly influenced by the action of female hormones. The levels of these hormones go up dramatically during pregnancy. This is normal for maintenance and proper growth of the baby. These hormones cause the veins to dilate and become more pliable. When the veins dilate, at some point the small valves in the vein will fail to close adequately, allowing blood in the legs to flow backward under the influence of gravity. This adds further pressure to the leg veins, resulting in even greater dilation and pressure on the vein segments further down. So, you can see a vicious circle developing which results in increasing dilation of the veins and further leakage of the valves as the pregnancy continues.
When the baby is born, the hormonal levels return to normal. The veins then try to revert back to normal. However, often times the damage is done. The veins have been stretched beyond their ability to return to normal, much like a spring that has been over stretched. The now not pregnant woman is left with veins that leak backward and cause symptoms.
Adding to the hormonal factor is the steadily increasing size and weight of the fetus during pregnancy. As the baby grows the increased size and weight puts steadily increasing pressure on the large pelvic veins that are trying to return blood to the heart. This pressure is transferred down to the leg veins as there is a partial blockage in the pelvic veins, much like there would be a back up of water if you created a partial dam in a stream.
Further adding to the problem is the fact that a woman’s circulating blood volume increases during pregnancy. This adds increased pressure to the lower extremity veins as the blood is under the influence of gravity for most of the day.
Because of the changes in the veins as described above many women suffer from pain, aching, heaviness, swelling of their legs both during and sometimes after pregnancy. They are more prone to blood clot formation as well as the development of phlebitis [inflammation of the veins].
Next time we will discuss what women can do if they find themselves suffering from varicose veins both during and after pregnancy.