Varicose veins during pregnancy—how to prevent them, how to treat them

In honor of Mothers Day, we’re discussing the topic of varicose veins during pregnancy, but with a focus on the positive: prevention and treatment. (We explore the effect of pregnancy on veins in greater depth in a previous blog post. Click here to read more.)

During pregnancy, the two most important preventative things to consider with vein care are periodically elevating the legs and compression. 

Maternity compression stockings come in a variety of styles and strengths, from knee-highs and thigh-highs, to full-length stockings. Many panty hose styles have more room in the belly and are specially designed to expand during pregnancy without restricting the abdomen. Maternity graduated compression stockings are specially designed to fit more snugly at the ankles and calves and less so toward the top. The gradual change in compression helps the weak valves in the veins to circulate the blood more effectively. Many women who wear maternity graduated compression report that it makes their legs feel great!

Though pregnancy compression stockings (and body garments) are available with a doctor’s prescription, many maternity stores also offer them. Accurate sizing is critical, so it is best to check with a doctor prior to purchasing any type of compression while pregnant.

In most cases, women can be safely treated for varicose veins 6-8 weeks after delivery. Hormonal levels are usually back to normal within that time (if the patient is not breastfeeding), and water retention and any clotting risks have usually returned to baseline.

           

Depending on the type of treatment, breastfeeding may be an issue for some patients. Treatments that require a local anesthetic, such as endovenous laser ablation (ELVA) or microphlebectomy, have been proven safe. Sclerotherapy is not recommended if the patient is breastfeeding, as certain medications used during this procedure have not been proven safe and may be excreted in breast milk. However, if the patient is willing to forgo breastfeeding for 24 hours, sclerotherapy is possible.

Another important preventive measure is knowledge. If someone in your family has had a history of vein issues, chances are you might too. Some vein specialists recommend that women seek evaluation, and possibly treatment, for problematic veins before their first pregnancy, especially if there is a strong family history of vein issues. Evaluation and education can be very important for preventing or controlling issues before you need treatment.

What women can do about varicose veins (and free eArticle)

It is a common misconception that only women experience troublesome veins. In the U.S. one in three people— including men— has some form of venous disease. Still, gender does make a difference. Why?

A woman has three potential “high risk” times in her life that men do not. Significant hormonal fluctuations typically happen during menarche (menstruation), pregnancy, and menopause. Surges in the hormone progesterone, in particular, can cause veins to stretch, sometimes enough for vein valves to tear and fail to do their job. Women who have venous insufficiency may notice that their symptoms worsen during menstruation.

Even after menopause, when most hormone fluctuations have stopped, a woman’s risk of vein disease continues to increase with age. There is a higher incidence of varicose veins in older women, because as the body ages, it produces less collagen, which causes the veins (and vein valves) to become weaker.

With the right information, women have the ability to reduce their risk of developing venous disease and/or decrease its severity. Preventative measures include: wearing graduated compression stockings; living an active lifestyle; and maintaining a healthy weight.

There are also a number of effective, minimally invasive treatments available for varicose veins and other symptoms of vein disease. If you’d like to learn more about how women can improve their vein health, read our latest eArticle “Women and Vein Treatments.” Click here to download your free copy.

Keeping Legs Healthy “From Hips to Heels”

Maine Radio Show Addresses Leg Health 

Is it better to run barefoot?

Why are compression stockings a mainstay of care for pregnant women?

What is the source of plantar fasciitis? 

A recent episode of Maine Calling on MPBN focused on these and other questions about our lower half – from varicose veins to the causes of joint pain.

In our lifetime, it’s very likely we’ll be challenged by issues arising from our feet, legs, or hips. This month, Keith Shortall welcomed three physicians that specialize in these regions of the body. Join Keith, Dr. Cindy Asbjornsen, founder of the Vein Healthcare Center in South Portland, Dr. Brian McGrory of Maine Medical Partners Orthopedics, and Dr. Kenny Maisak of Portland Foot & Ankle to get some of the most common questions answered about the parts of the body charged with supporting us from below. Listen to the show.

Inside “Hips to Heels”: Expecting? Early intervention is the Key 

Dr. Cindy Asbjornsen

According to Dr. Cindy Asbjornsen, for women, it’s not the weight of late stage pregnancy that causes symptoms of venous disease – it’s the hormones of early pregnancy that cause damage to the vein walls and lead to venous insufficiency and varicose veins, something that can be treated with prescription compression stockings. Ironically, the first trimester is often when patients aren’t even being treated by a physician. “Prevention can start on day one,” said Dr. Asbjornsen. “Compression stockings are the mainstay of care for pregnant women.”

Dr. Asbjornsen also recommends persistence when it comes to treatment for leg and vein issues – sometimes primary care physicians are not as informed about the changes in the field of phlebology as they could be, nor are they knowledgeable about how straightforward and effective treatments can be. “This is an incredibly new field,” said Dr. Asbjornsen. “It has only come into existence in the last thirty years, and a lot of the modern treatments have only been around since the late 90s. For many physicians it’s hard to stay current.”

Learn more about Dr. Cindy Asbjornsen.

For Moms-to-Be, Varicose Veins Are Common – And Treatable

Mother’s Day is a time to celebrate being a mom whether you already have a family or yours is just beginning. It’s a perfect time to celebrate good health as well. If you are pregnant, being an expectant mom can be full of surprises. Some of them, like the appearance of varicose veins, just aren’t welcome.

About 40% of pregnant women will develop varicose veins.  Hormone surges are part of the biological process of pregnancy, and varicose veins are sometimes part of that process. Varicose veins tend to run in the family as well. Expectant mothers might ask their own moms or other women in their family if they had vein issues during or after their pregnancies

Pregnancy & Vein Health: What You Should Know

Varicose Veins

First Trimester: The first trimester is an especially important time to think about vein health. Women with known risk factors for venous disease should consider wearing compression stockings throughout the first three months of pregnancy and possibly longer. Specially designed maternity graduated compression stockings are available with a doctor’s prescription or at many maternity stores – check with your doctor before you purchase.

Second & Third Trimester: While the most damage seems to happen in the first trimester, the second and third trimester may also carry some risk of developing varicose veins. The volume of blood in a healthy woman increases to about 50% more than before the pregnancy, with the largest increase in the second trimester. With more volume to move, all of the blood vessels are under increased stress. In this final trimester, the uterus continues to expand and put pressure on the veins in the abdominal region.

Varicose Vein Prevention For Moms-to-Be 

Paying attention to vein health can go a long way toward treating, and even preventing varicose veins for mother-to-be. There are several ways to decrease or prevent varicose veins during pregnancy:

• Wear graduated compression stockings, especially in the first trimester.
• Exercise often—even a brisk walk will help circulation and reduce symptoms.
• Frequently pump the foot (heel to toe), even if on bed rest.
• Avoid tight clothes or high-heeled shoes.
• Gain only as much weight as recommended by the obstetrician.
• Take a pre-natal vitamin daily.

Many women find that their varicose veins go away a few months after labor, while
others continue to suffer with them. There are many options available to treat varicose veins. You can find out more about varicose veins and their treatment at the Vein Healthcare Center. Happy Mother’s Day & happy vein health!

What are Varicose Veins?

Varicose veins are visible veins in the leg that bulge, often protruding through the skin. They are the result of venous insufficiency: blood that pools in the vein because of a faulty valve and causes the protrusion.

Varicose veins are a symptom of early stage venous disease. They affect approximately half of the U.S. population, and in addition to causing pain and discomfort, those with varicose veins struggle unnecessarily with their appearance.