Pain During Pregnancy ... Varicose Veins Beyond Your Legs

Pregnancy itself is one of the major risk factors for varicose veins. A Hagerstown, Maryland woman was recently referred to me by her OBGYN after complaining of constant pubic pain when sitting or standing for long periods.  She had delivered her third child several months earlier and found that the varicose veins had not resolved themselves.

During pregnancy, your body increases blood volume, which adds to pressure in the venous system. Additionally, a higher level of the hormones estrogen and progesterone contribute to varicose veins by causing the veins to be more dilated or open. As gravity exerts a downward pressure on the legs, the veins can swell and bulge, leading to symptoms of pain, heaviness and even blood clots.

But varicose veins during pregnancy aren't limited to your legs. They can also occur in your vulva. They can be small and barely noticeable, or they can be quite large and somewhat disfiguring. Your vulva can feel sore and swollen, making it uncomfortable to sit. A V-2 supporter is beneficial during pregnancy to help compress the swollen veins. 

As part of the work up for labial varicose veins, we often will get a CT scan of the pelvis post partum to evaluate for venous insufficiency. When found, treatment is very effective with a variety of modalities.

Of course, most leg varicose veins arise from saphenous vein reflux in the inner thigh, which is best treated with the Venefit Procedure (formerly known as VNUS Closure). This office-based procedure is done under local anesthesia and allows immediate recovery. While we do not perform this procedure during pregnancy, you can be treated after the baby is born.  Your optimal management of varicose veins while pregnant is good quality support hose and leg elevation as much as possible. Many varicose veins will regress post partum, though underlying venous reflux often manifests later.  

Early evaluation and treatment are beneficial.  Be sure to seek an expert in varicose vein treatment by visiting a reputable medical society website like the American Venous Forum or the American College of Phlebology. 

Laser vs. Venefit ... Which Works Best for Varicose Vein Treatment?

Interestingly, patients tend to equate anything "laser" with being painless, effective and high quality. In the world of varicose veins, this is not so accurate. Patients with symptoms of aching and heaviness coupled with bulging leg veins have backflow in feeder veins that cause elevated pressure within the surface veins.  Treating this condition consists of heating the vein internally using a small wire, which leads to shrinkage and eventual absorption of the vein by your body. 

The best treatment available is the Venefit Procedure, formerly known as VNUS Closure, which was introduced in 1999. Advances in this technology have led to the least painful method of successful varicose vein treatment, in contrast to laser, which has been shown to cause more pain and bruising. In fact, I saw a Leesburg, Virginia patient who had his left leg treated with laser a few months ago. He came to CVL because he felt the laser procedure was too painful and wanted another option. I treated his right leg with Venefit two weeks ago and he is quite vocal that the Venefit treatment was much better and resulted in a quicker recovery.

When we see a patient for an initial consultation, we perform a full evaluation and often suggest patients try support hose to alleviate the symptoms. While we know these stocking are not curative, most health insurance companies will require patients to try them before it will authorize payment for a vein procedure.

A duplex scan will follow, giving us a roadmap of the entire venous system. Based on the scan, we can most accurately give advice about the best treatment option(s). Closure of the saphenous vein, the most common treatment for varicose veins, works best with the Venefit Procedure, which is done in the office under local anesthesia and allows immediate return to normal activity.

When seeking advice about your varicose veins, be sure to find an experienced physician who is a member of the American Venous Forum or a Diplomate of the American Board of Phlebology.  They will provide the best recommendations for treatment.

Your Best Choice For Varicose Vein Treatment

Varicose veins are quite common in both men and women, and are clearly influenced by your genetic makeup. Other factors such as multiple pregnancies, blood clot history, and obesity can play a role in weakening the legs veins. Fortunately, these bad veins are easily treated with office-based procedures like the Venefit Procedure.  Many vein centers offer treatment using lasers and, although it is a much more appealing option than the “old school” vein stripping treatments, lasers can still be painful.  

One of our Ashburn, Virginia patients received laser vein treatment from another doctor last year.  She came to CVL to see if there was another treatment option for the opposite leg because the laser was so painful. Unfortunately, I hear this repeatedly from patients. The laser basically "boils" the blood in the vein, attempting to seal it shut.

Venefit, previously known as VNUS Closure, uses thermal energy to cause the vein wall to shrink and obliterate. Your normal veins take over, bringing the blood up your leg against the constant downward force of gravity. As the circulation normalizes, symptoms like leg aching and heaviness vanish almost immediately.  We have found that the Venefit Procedure is less painful than laser treatment and has actually been shown to provide superior results when studied over many years.

Early evaluation and treatment of varicose veins gives you the best chance for a relatively simple fix to the problem.  To maintain excellent leg health and ensure you receive the most current information, seek advice from a physician with added qualifications from the American Board of Phlebology.