does the birth control pill favour varicose veins?

Varicose veins are superficial veins that have become enlarged and don’t fulfil their initial function of transporting the blood back into the heart anymore. Most of the time they appear in the legs and may be disturbing for cosmetic reasons or may cause symptoms such as pain and discomfort.

Risk factors for the development of varicose veins

So far it has been impossible to determine one specific cause for the development of varicose veins1. The formation and progression of varicose veins is multifactorial and many risk factors such as gender, increasing age, obesity, pregnancy as well as family history and lifestyle have been identified2. These various risk factors have been described in multiple research studies. Whether taking birth control pills may also cause the formation of varicose veins has also been largely discussed.

1Muzaffar A. Anwar et al, A Review of Familial, Genetic, and Congenital Aspects of Primary Varicose Vein Disease, 2012.
2Jari O. Laurikka et al, Risk indicators for varicose veins in forty- to sixty-year-olds in the tampere varicose vein study, 2002.

Will varicose veins form because of the birth control pill?

Birth control pills usually contain hormones such as estrogen and progestin. The hormones are stopping a woman’s body from ovulating during her cycle and are also increased during a pregnancy. Higher levels of estrogen have been shown to increase the risk of blood clot formation which subsequently can lead to deep vein thrombosis or – in the worst case – lead to pulmonary embolism3.
Another effect those hormones have is a reduction of the blood flow in the circulative system. During a pregnancy this hormonal effect proves very important as it helps prevention of excessive bleeding during delivery. However, when taking the birth control pill this effect can increase the risk for blood clot development and the formation of varicose veins. This is also because estrogen can have a relaxing effect on vein walls which can aggravate efficient pumping of the blood. In combination with water retention which can be a side effect of contraceptives, higher blood volume can increase the pressure on veins and facilitate varicose vein development4.

3The Relationship Between Birth Control and Varicose Veins, 2019.
4Journal of the Royal College of General Practitioners, Oral contraceptives, venous thrombosis, and varicose veins, 1978.

Risk remains small despite birth control pill

Nevertheless, physicians agree that whilst the risk for formation of blood clots and varicose veins can be increased through contraceptives, the overall risk is very low and usually remains below the risk women face during a pregnancy. This is because modern birth controls contain much lower dosages of estrogen than they used to in the past. As an example, it is suggested that annually approx. 1-5 women out of 10,000 develop blood clots when taking no birth control. Even with a 2-4 times higher risk only about 0,2% of women on birth control will be affected.

Why do varicose veins come with pregnancy?

When should I be careful with taking a birth control pill?

Birth control is not considered as a factor that alone is responsible for the formation of varicose veins, however, it can worsen existing conditions or predispositions5. For that matter, women which are already facing a higher risk for venous disease, should have an in-depth discussion with their physician prior to taking the birth control pill. Risk for venous disease may be higher in obese women as well as woman who are smoking or are having a family or personal history of varicose disease6.

5DR. Van Cheng, Birth Control and Varicose Veins, 2018.
6Ibid.

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