Varicose Veins and Pregnancy: What You Need to Know
Pregnancy is one of the most common times for women to develop varicose veins or notice that existing veins become more prominent. This is because pregnancy places additional demands on the venous system through a combination of hormonal and physical changes. The good news is that many pregnancy-related varicose veins improve during the months after childbirth.
Why Does Pregnancy Cause Varicose Veins?
Hormonal Changes
Pregnancy hormones, particularly progesterone, relax the walls of the veins. While this is a normal part of pregnancy, it also makes the vein walls more likely to stretch and the vein valves less efficient, increasing the risk of venous reflux.
Increased Blood Volume
During pregnancy, blood volume increases substantially to support the growing baby. This places additional pressure on the veins in the legs and increases the workload of the venous system.
Pressure from the Growing Uterus
As the uterus enlarges, it places pressure on the pelvic veins and the inferior vena cava, making it more difficult for blood to return from the legs to the heart. As a result, blood tends to pool in the lower limbs, increasing venous pressure.
Genetics
Women with a family history of varicose veins are more likely to develop them during pregnancy. Pregnancy often reveals an underlying inherited tendency rather than being the sole cause of the condition.
What Symptoms Can Occur?
Common symptoms include visible enlarged veins, aching or throbbing legs, a feeling of heaviness or fatigue, ankle swelling, itching around the veins, night cramps, and burning or discomfort after prolonged standing. Symptoms often become more noticeable as pregnancy progresses and are usually worse towards the end of the day.
Will My Varicose Veins Disappear After Pregnancy?
Many women notice a significant improvement during the first three to six months after delivery as hormone levels return to normal and pressure on the pelvic veins resolves. However, veins that remain enlarged six to twelve months after childbirth are less likely to disappear completely. The likelihood of persistent varicose veins increases with multiple pregnancies, a strong family history, more severe varicose veins during pregnancy, and previous venous disease.
Can Varicose Veins Be Treated During Pregnancy?
In most cases, definitive treatment is postponed until after pregnancy. Procedures such as Endovenous Laser Ablation (EVLA), Radiofrequency Ablation (RFA), Mechanochemical Ablation (MOCA) and VenaSeal™ are generally not performed during pregnancy because symptoms often improve after delivery and there is limited evidence supporting routine intervention during pregnancy. Treatment during pregnancy is usually conservative and focuses on relieving symptoms.
How Can I Relieve Symptoms?
The following measures are often helpful: walk regularly to activate the calf muscle pump; avoid prolonged standing or sitting; elevate your legs whenever possible; sleep on your left side, particularly in later pregnancy, to reduce pressure on the major veins in the abdomen; wear properly fitted graduated compression stockings if recommended by your doctor; maintain regular physical activity as advised by your obstetrician. These measures can reduce aching, heaviness and swelling, although they do not reverse venous reflux.
When Should I Seek Medical Attention?
While most pregnancy-related varicose veins are not dangerous, you should seek prompt medical assessment if you develop sudden swelling of one leg, severe calf pain or tenderness, a painful red hard vein, significant bleeding from a varicose vein, or shortness of breath or chest pain (seek emergency medical attention immediately). These symptoms may indicate a deep vein thrombosis (DVT), superficial vein thrombosis, or another condition requiring urgent treatment.
When Should I Consider Treatment After Pregnancy?
If your varicose veins remain symptomatic after childbirth, it is reasonable to arrange a consultation once your body has had time to recover. Many vascular specialists recommend waiting approximately six months after delivery, or longer if you are still breastfeeding and your symptoms are improving, before considering definitive treatment. This allows pregnancy-related hormonal and circulatory changes to stabilise and provides a clearer assessment of the underlying venous disease. A duplex ultrasound scan can then determine whether persistent venous reflux is present and whether treatment is likely to improve your symptoms.
The Bottom Line
Pregnancy commonly brings out varicose veins, but many improve naturally after childbirth. Conservative measures such as walking, leg elevation and compression stockings can help relieve symptoms during pregnancy. If troublesome varicose veins persist after your body has recovered, a vascular specialist can perform a duplex ultrasound assessment and discuss whether treatment is appropriate.