Why do varicose veins come with pregnancy?

Varicose veins are veins which have reduced capability to transport blood back to the heart against gravity. They often appear twisted, swollen and enlarged. They are often only of cosmetic concern but can also be of medical concern if symptoms become more severe.

Are varicose veins more common during pregnancy?

Pregnancies and childbirths have been identified as one of several potential causes that increase the risk of developing varicose veins1. Whilst incidences for varicose veins are similar between boys and girls at young ages, varicose disease becomes more prevalent in women with increasing age2.
In about one-third of women having given birth to their first child signs of varicose veins can be observed. After multiple pregnancies this number raises to 50%.

1Anthony A. Bamingboye et al; Interventions for varicose veins and leg oedema in pregnancy, 2007.
2Eva Thaler et al; Compression stockings prophylaxis of emergent varicose veins in pregnancy: a prospective randomised controlled study.

What is causing varicose veins during pregnancy?

The causes and contributors to the formation of varicose veins are not fully understood yet. However, pregnancies have shown to be a major contributor. Changes occurring during pregnancy are assumed to be mainly responsible for the increased risk of developing venous reflux: Firstly, variations in the hormonal environment which are lowering venous tone in combination with uterine compression of venous return can lead to a strong distension of veins. Especially in the case of minor pre-existing venous insufficiency, these conditions can cause significant progression of the disease.
Another cause for varicose veins during pregnancy is that blood volume increases. In parallel the blood flow rate from the legs to the pelvis decrease, which puts additional pressure on the veins and thus may cause damage of vein valves.

How can varicose veins be prevented during pregnancy?

Unfortunately, some women are more prone to forming varicose veins during pregnancies, little that can be done to fully prevent it. However, to minimize formation of varicose veins elastic compression stockings are sometimes used in combination with simple leg exercises. Daily low-impact exercises (if approved by a physician), regular breaks from long sitting or standing activities and moving a lot may reduce the risk.

Does working in a standing position favour varicose veins?

Other preventive measures contain avoidance of crossing legs whilst sitting, wearing flat shoes rather than high heels, periodical elevation of the legs for better circulation and lowering of sodium intake to reduce swelling of veins.
Often, varicose veins will improve after delivery due to the reduction of pressure by the uterus on the large vein that carries blood from the legs and feet to the heart (also called inferior vena cava5). In many cases varicose veins vanish within 3 months to 1 year after delivery. For that reason, it is also uncommon to treat varicose veins during pregnancy.
There are also other factors that have been shown to increase risk4 of developing varicose veins, such as age, genetics, obesity or working in a standing position.

4Rupal Christine Gupta; Why Do Some Pregnant Women Get Varicose Veins?
5Ibid.

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