Varicose Veins of the Vulva During Pregnancy
Varicose Veins of the Vulva During Pregnancy
Let’s talk about a common but rarely discussed complaint in pregnancy - varicose veins of the vulva. What a mouthful!
Varicose veins of the vulva, or vulvar varicosities, occur when veins in the labia majora and labia minora become dilated. This condition is estimated to affect around 20% of pregnant women, which is 5x the rate of women who are not pregnant. Vulvar varicosities are more common during pregnancy because:
high levels of oestrogen associated with pregnancy cause veins to dilate more easily
blood flow to the pelvic increases during pregnancy
They tend to appear earlier and be more severe in subsequent pregnancies, and often occur in conjunction with varicose veins in the legs.
https://helloclue.com/articles/cycle-a-z/vaginas-101
Typical Symptoms Include:
pain in the vulva area, especially at the end of the day or after prolonged standing/sitting
heaviness/burning in the perineum
swelling of the labia/perineum, particularly at the end of the day
visible varicose veins may or may not be present
Some of these symptoms overlap with other conditions commonly seen in pregnancy, such as pelvic organ prolapse and pelvic girdle pain, so it is important to see a pelvic health physiotherapist for assessment and individualised management. Vulvar varicosities are unlikely to cause any problems during birth, and are not a direct indication for Caesarean birth. Of course, talk to your care provider if you are concerned. They generally tend to disappear in the months following birth, and further improvement often occurs after finishing breastfeeding.
The following tips may relieve discomfort associated with vulvar varicosities:
Horizontal rest
Lying on your side for 10-15 minutes, 2-3 times per day, will help relieve some of the swelling and subsequent pressure around your pelvis
Break up periods of sitting or standing
Avoid constipation
Straining on the toilet may exacerbate symptoms
Ensure you are drinking enough fluid and eating enough fibre to keep your stools soft
See our blog on defaecation techniques for more tips
Ice to the perineum can help with swelling
TPS stock perineal icepacks which can be used in pregnancy, as well as postpartum.
Use for 20 minutes at a time, ideally when lying down
Make sure the ice is not directly against your skin
Compression
Support garments such as SRC shorts/tights or a belly band with vulva support may be used to provide firm compression