How to Treat Vaginal Varicose Veins

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Rahul Sood

Woman holding SOS sign in front of her pubic area

A varicose vein on the outermost layer of the female genitalia is known as vulvar varicosity (vulva). Vaginal varicose veins commonly occur during pregnancy. It is because of increased blood flow to the pelvic veins and slow blood circulation — with which blood flows from the pelvic floor to the heart. Blood pools in the leg varicose veins and also the vulvar area, resulting in vulval varices. Vulvar varicosities can develop naturally or with leg spider veins.

So how can you treat vaginal varicose veins? One thing you can try is wearing a supportive garment. Some clothing is tailor-made for vulvar varicosities. Compression clothing for the abdominal area and pelvic veins is also available in some styles. Avoiding prolonged periods of standing or sitting is highly advised. Raise the legs to promote better circulation of blood. Applying cold compresses to the vaginal veins could also alleviate stress.

Distinguishing Vaginal Varicose Veins From Vulvar Varicosities

Vaginal varicose veins, also known as vulvar varicosities, are bulging veins in the labia majora and minora. Labial varicose veins are believed to affect 22 percent to 34 percent of women with spider veins of the pelvis and 18 percent to 22 percent of pregnant women. 

Vaginal varices may remain and expand with time in 4%-8% of patients during the postnatal period. These vascular problems are linked to venous insufficiency that can affect both pregnant and non-pregnant women. They can also lead to superficial dyspareunia and vulvodynia.

Varicose veins in the vulvar develop in 2-4 percent of pregnancies. They’re more likely to be diagnosed at a frequent OB appointment if they’re enlarged or symptomatic. Others are likely to go unnoticed, as indicated by the fact that 20% of people with leg varicose veins also have pelvic veins, even if no vulvar, an internal iliac vein, or labial varicosities are visible.

Causes of Vaginal Varicose Veins

The main risk factor for vulvar varicosities is pregnancy. The constriction of the primary vein (internal iliac vein) that drains each leg is a less well-known cause of pelvic venous congestion. Varicosities in the vaginal and labia majora, as well as the groin and buttocks, are common. 

These veins result in abnormal veins in the pelvis near the uterus, bladder, rectum, inferior vena cava, and ovary. The pelvic vein may be the underlying issue because of the placement of these superficial varicose veins. 

Vulvar varicosities are caused by the common changes that take place during pregnancy. Weight gain can lead to increased strain on the pelvic floor, increased volume in blood vessels, and dilatation of the pelvic tendons and leg veins. With pregnancy, these changes cause venous blood to pool. With each pregnancy, the chances of getting vulvar varicose veins and more common leg varicose veins increase.

Varicose veins in the vulvar area can emerge as early as 12 to 26 weeks during pregnancy. They usually disappear six to twelve weeks after delivery on their own. Symptoms of a syndrome called pelvic congestion disorder (PCD) might influence a patient’s wellbeing when vulvar varicose veins are untreated. 

Menstruation, standing for long hours, and sexual intimacy are all known to worsen these symptoms. While pregnancy is more likely to develop vulvar varicose veins, non-pregnant women can still develop pelvic congestion syndrome or vaginal varicosities. 

The following are the major causes:

  • Portal hypertension: An increase in blood pressure in the vein wall that receives blood from the pancreas, spleen, stomach, and intestines. 
  • The internal iliac veins draining each leg become scarred.
  • Klippel-Trenaunay Syndrome (KTS): is a rare congenital (present at birth) illness with unclear causes.

How to Diagnose Vulval Varicose Veins

Vulvar varicosities are not always evident. Patients may be unaware that they have them. Some or all of the following signs may be present in vulvar varicose veins:

  • Vulvar fullness or pressure
  • Swelling of the vaginal/vulvar area
  • Pain or discomfort in the genitalia
  • Visible veins that are bluish, rough, or bulging
  • Urinary pain or urgency
  • Rectal discomfort and hemorrhoid

Bulging visible veins on or around the vaginal area are more severe occurrences. Varicose veins in the legs are somewhat common during pregnancy. According to some research, almost 20% of women with varicose veins in their legs also have vulvar and pelvic veins. After giving birth, these veins may disappear on their own for some women. 

If this is not the case, it could be a sign of Pelvic Congestion Disorder (PCD). Symptoms of Pelvic Congestion Disorder include:

  • Pelvic pain that feels like contractions or a heavy period
  • Painful intercourse
  • Chronic pelvic pain post intimacy
  • Painful or difficult urination

It is essential to have a professional team specializing in the examination; and treatment of vulvar varicosities and PCD. A thorough history and physical examination are used to make the diagnosis. A group of competent medical professionals such as an interventional radiologist uses advanced duplex ultrasound to diagnose vulvar varicose veins and leg veins when necessary. 

Doctors may propose additional research based on these results. A venogram would be used to photograph an affected vein that is most prone to cause pelvic vein reflux and vulvar varicose veins.

Available Therapies for Vulvar Veins

If the varicosities persist after delivery, treatment is symptomatic throughout pregnancy and curative afterward.

During pregnancy 

To alleviate the patient’s anxiety, it’s also helpful to refer them to a vascular specialist who is well-versed in the subject. Pruritus is relieved by bathing in a non-soap foamy solution and then using a water-based zinc oxide paste. High-dose phlebotomic medicines are used to relieve pain and heaviness.

In this case of varicose veins, lower compressive therapy is used consistently. Class 2 calf-high stockings are worn over which class 2 thigh-high stockings are worn. That is the same as a class 4 foot and calf compression and a class 2 thigh compression.

Post pregnancy

Vulvar varices usually dissolve within a month of delivery. After a year, small, asymptomatic remaining varices are discovered. Curative therapy treats large or symptomatic varices. 

Sclerotherapy is one of the preferred treatments for these thin-walled varices since it is exceedingly successful. It uses a fine gauge needle and a liquid sclerosing solution in a very superficial varicose vein blister under visual monitoring. 

Another treatment is ovarian vein embolization: it is a slightly invasive treatment for painful pelvic congestion syndrome. It works by employing imaging guidance and a catheter to close affected veins, preventing them from enlarging with blood. Embolization is a highly successful method of bleeding management that is far less intrusive than traditional surgery.

Read more: What Are the Options for Varicose Vein Surgery?

The Outlook

Vulval varicosities are a frequent venous condition that affects pregnant women or women with pelvic varicose veins and vulvar varices. Vulval varicosities can usually be diagnosed via a pathological evaluation and do not require any specialized testing. The diagnostics necessitate an examination of the pelvic varicose veins. 

That may also require postnatal monitoring and assessment in cases of pregnancy. Treatment ranges from strictly conservative methods during pregnancy to various vulvar and ovarian vein reflux surgical operations. 

Patients with pelvic congestion syndrome and venous reflux can significantly benefit from a personalized approach to diagnostic procedures and treatment for these disorders.

During the fifth month of a second pregnancy, vulvar varices appear. Their occurrence is underestimated. At the sixth month of pregnancy and one month after delivery, screening to identify them with the patient standing is recommended. 

Doppler sonography gives a unilateral presentation of vaginal varicosity as well as thrombosis at the beginning of a first pregnancy. The vascular expert usually recommends foam sclerotherapy when the varices continue after child delivery. 

Eliminate Vulvar Varicosities at Vein Center Center

If vulvar varicosities are bothering you, visit our website for more information on different vein therapy. The goal of Vein Center Doctor is to ensure that patients are as comfortable as possible during the procedure, from diagnosis to treatment.

Our therapy programs are designed to help patients recover mentally and physically. We work hard to guarantee that you can own your skin and be free of vulvar veins. From aesthetic operations to more functional therapy, we provide a broad array of services.

Schedule a consultation today to get rid of those vulvar veins.

Rahul Sood

DO, R.PH

About Rahul Sood

Dr. Rahul Sood is a triple board-certified physician who specializes in cosmetic vein treatment, namely spider veins and varicose veins, as well as any accompanying issues related to venous insufficiency such as leg pain. He has carried out over 10,000 leg procedures during 10-plus year career and is highly regarded throughout Westchester County and New Jersey.

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