Varicose veins? We agree, it's not a term that makes you want to know more. However, given that vulvar varicose veins (also known as pelvic, vaginal or perineal varicose veins) are quite common in pregnant women, we felt it was important to broach the subject! Diagnosis, symptoms, causes, treatment... Elia tells you all about it!
What are vulvar varicose veins?
Vulvar varicose veins are one of the discomforts that pregnant women may experience during their pregnancy. Although they generally disappear after childbirth or when breast-feeding ceases, it is sometimes necessary to undergo treatment to cure them! In concrete terms, these are varicose veins in the vulva, caused by venous insufficiency, as with "classic" varicose veins in the legs. The area may be painful and swollen, due to dilation of the blood vessels. However, only 10% of pregnant women suffer from varicose veins, and most of these are primiparous women in their first pregnancy.
How to recognize vulvar or perineal varicose veins?
Pelvic varicose veins are the term used to encompass varicose veins on the vulva and perineum.
Vulvar varicose ve ins are easier to detect: the labia are swollen, even painful, with bluish or purplish streaks, which disappear with finger pressure.
Varicose veins of the perineum, on the other hand, are more difficult to recognize, as they manifest themselves mainly as pain in the lower abdomen, and can be confused with other symptoms of pregnancy.
What are the symptoms of vulvar varicose veins during pregnancy?
Far from being disabling, vulvar varicose veins are, for the most part, asymptomatic. However, some women may experience swelling of the labia, or even pain, itching or discomfort when walking. Sexual intercourse may also be more painful.
In what month of pregnancy do vulvar varicose veins appear?
Women who already have a history of venous insufficiency could potentially be prone to these discomforts from the start of pregnancy, but in general, they tend to appear at the end of pregnancy or from the second trimester onwards.
What causes varicose veins?
Varicose veins, whether on the vulva or the legs, are caused by venous insufficiency. In the case of vulvar or vaginal varicose veins , this is due to hormonal fluctuations during pregnancy.
Hormones (estrogen and progesterone) tend to cause veins to dilate, slowing blood flow and leading to venous insufficiency. The veins on the pubic area are sensitive to hormonal changes. In addition, the increasing weight of the baby during pregnancy puts pressure on the pelvic area .
Making a diagnosis
Since varicose veins are a relatively benign and sometimes asymptomatic condition, their diagnosis depends first and foremost on clinical observation of the area by a healthcare professional (midwife or gynecologist). Varicose veins can be recognized by purplish or bluish dilations, which disappear under pressure.
A person with vulvar varicose veins is often also affected by varicose veins in the legs. The doctor performing the examination will therefore need to check whether the patient has varicose veins on her lower limbs, and whether she has a history of thrombosis or venous insufficiency.
If necessary, the opinion of a phlebologist can be sought to perform a Doppler ultrasound, and benefit from this double vision to confirm the diagnosis.
How are varicose veins treated during pregnancy?
Varicose veins often disappear spontaneously. If they don't, pelvic varicose veins may need to be treated by blocking them to prevent venous return to the vulvar veins. This is known as varicose vein embolization.
Should malformations appear post-partum, the doctor may consider vein surgery .
How can I prevent the appearance of vulvar varicose veins?
They can be avoided by following these tips:
- Don't hesitate to wear compression stockings, tights or socks, which can be prescribed and reimbursed by Social Security;
- Avoid crossing your legs or staying in the same position for too long (sitting for several hours, or standing in a static position);
- Wear loose-fitting clothing, especially around the crotch, pelvis and thighs;
- Drainage massages: starting at the feet and working up to the top of the legs (lymphatic massages are ideal in this case!);
- Continue to exercise (gentle sports such as yoga, daily walking, cycling, pilates, etc.);
- Place wedges under both feet at the end of the bed, to elevate the legs during sleep;
- Apply cold : for example, a cotton cloth placed in the freezer as a cold "patch" to relieve the burn and reduce the size of the vein;
- Avoid hot showers and baths.
Do varicose veins complicate childbirth?
Generally speaking, they do not complicate childbirth, and a woman can give birth vaginally without risk to her health. The only exception is if they are too painful or large, in which case the gynecologist may consider a cesarean section to avoid the risk of varicose hemorrhage.
Varicose veins FAQ
Do vulvar and pelvic varicose veins occur at the same time?
Pelvic varicose veins is the term for both vulvar and perineal varicose veins. In general, when varicose veins occur in the perineum, the risk of contracting vulvar varicose veins is high.
How do I remove vulvar varicose veins?
In most cases, they disappear spontaneously after pregnancy. Prevention remains the best way to avoid being affected by vulvar varicose veins during pregnancy! If, however, the varicose veins do not go away, you should consider embolization of the varicose veins near the pelvis, to prevent blood reflux to the veins of the vulva.
