Varicose veins are swollen blood vessels that we see most often in the legs. They often twist, swell, and enlarge. Varicose veins tend to run in families and are more common in individuals who work on their feet for a living or are overweight. They can form for a number of reasons, especially from middle age onwards and if they run in your family. They are fairly common in pregnancy. We’ll talk you through what to expect if you do develop them.
Veins are essentially rubbery pipes with one-way valves that help keep blood flowing in the right direction, from organs and tissues back towards the heart. Pressure on these valves, such as in pregnancy, causes them to swell up and become prominent. It also leads to some of the water content in blood leaking from the veins into surrounding tissues – this most often happens in the lower legs due to gravity, causing swollen sore ankles. Pregnancy causes increased pressure, both from the growing foetus on the blood vessels in the pelvis and from the increased blood volume. Hormones in pregnancy also causes the veins to swell. Standing for a prolonged period of time can also exacerbate these problems, as gravity causes fluid to pool in the lower legs.
Varicose veins are positioned anywhere along the legs and look like enlarge twisted bluish-purple veins. They may have no symptoms at all but some people feel self-conscious about how they look. They may sometimes cause discomfort and itching, and in extreme cases can cause pain and ulcers. They can also sometimes cause leg cramps and swelling in the lower legs. Varicose veins occur in superficial veins, close to the surface of the skin. You may have heard of blood clots in the lower legs called deep vein thrombosis (DVT), requiring urgent diagnosis and treatment, but these occur in deeper veins. Pregnancy puts you at a higher risk of these and blood clots in the lungs (pulmonary embolus), but varicose veins are not related to these conditions.
Avoid prolonged sitting and standing and ensure that you do some exercise such as walking or swimming. Regular foot stretching and moving can improve your circulation. When you do get a chance to sit or lay down, position your legs on a stool or pillow to raise them above the pelvis, so fluid can easily drain back to the heart. Try to keep weight gain under check in pregnancy, as that causes excess pressure on your legs. If your veins are causing symptoms, graduated compression stockings can help to relieve the symptoms of varicose veins and reduce the swelling. Your doctor or nurse will need to measure these so you get the correct size, and they may prescribe them or you may need to purchase them - your pharmacy can order in the right size. Varicose veins can be surgically removed or ablated, but they are rarely treated on the NHS no unless they cause severe symptoms, such as ulcers. They are seen as a cosmetic procedure and therefore require privately-funded treatment.
Thankfully, the majority of varicose veins that develop during pregnancy do improve within the first year of delivery. To help this process, make sure you continue exercising, avoid prolonged sitting and standing and maintain a healthy weight.