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Varicose veins during pregnancy: causes, prevention, treatments
Pregnancy is a common trigger for varicose veins. Here are the causes, how to prevent them, the treatments allowed while expecting, and the reassuring news for after delivery.
- Pregnancy hormones and the growing uterus dilate and compress leg veins.
- The risk rises with each pregnancy, from about 23% to 31% by the fourth.
- Prevention relies on movement, leg elevation, cool legs and compression.
- Surgery and sclerotherapy are contraindicated during pregnancy.
- Many pregnancy varicose veins fade on their own within months of delivery.
Have varicose veins appeared on your legs since you became pregnant? Here we answer the main questions: causes, prevention and the treatments available.
As a reminder, varicose veins are swollen, enlarged veins, medically the winding dilation of the superficial veins. Under gravity, and as the veins widen, blood that normally flows upward tends to stagnate or flow back, because the valves no longer close properly. Varicose veins are the most common sign of chronic venous insufficiency.
In 2020, France's High Authority of Health estimated that 20 to 30% of the population is affected by varicose veins, and they clearly affect women more often during pregnancy.
Why do varicose veins appear during pregnancy?
Varicose veins are one of the many complaints that can appear during pregnancy, for several reasons:
- Hormones: oestrogen promotes edema and progesterone dilates the veins, which favours varicose veins.
- Extra weight: the added weight and the compression of pelvic veins by the growing uterus both play a role.
- Heredity: most women who develop varicose veins during pregnancy have a family history.
- Repeat pregnancies: the risk rises with each one, from about 23% in the first to 31% by the fourth.
Want the detail? See our article on why varicose veins come with pregnancy.
How to prevent them during pregnancy
Doctors make several recommendations from early pregnancy:
- A healthy lifestyle: drink plenty of water and stay active, with your doctor's consent, through walking, swimming, yoga or cycling.
- Mind the position of your legs: raise them when lying down and avoid crossing them.
- Consider lymphatic drainage to lighten and decongest the legs.
- Avoid heat, which makes the legs swell.
How to treat them during pregnancy
Non-invasive advice aside, sclerotherapy and surgery are strictly contraindicated during pregnancy. Treatment relies on three pillars:
- Weight control, physical activity and compression stockings, which press on the veins and boost blood flow (learn more here).
- Osteopathy, which improves drainage of the legs.
- Cold water on the legs to reduce swelling and stimulate circulation.
After birth, it is best to wait 3 to 6 months before a new varicose vein check-up: many will fade on their own in the meantime, so there is no need to rush.
If varicose veins persist once your pregnancy is over, you can then discuss a definitive, non-invasive treatment. Focused ultrasound (echotherapy) closes the vein without any incision or injection.
When should you be concerned?
Varicose veins can be uncomfortable but usually pose little risk. Still, see your doctor if a vein becomes tender, red and warm, with fever, leg pain or a rapid pulse: the main complication is varicose thrombosis, a clot in a varicose vein, and, over the longer term, a varicose ulcer where fragile ankle skin breaks down.
The good news
Varicose veins are not inevitable in pregnancy: a woman with no family history, a healthy weight and regular activity has a low risk. And for many women, varicose veins improve or disappear after delivery, especially if they had none before.
Wondering whether echotherapy is available near you? A growing network of centres is already equipped with the SONOVEIN.
Questions fréquentes
Why do varicose veins appear during pregnancy?
Hormonal changes lower vein tone, the growing uterus compresses the pelvic veins, and blood volume rises, so blood pools more easily in the legs.
Can I treat varicose veins while pregnant?
Only conservative measures are used during pregnancy: weight control, physical activity, compression stockings and cold water. Sclerotherapy and surgery are contraindicated.
Do pregnancy varicose veins go away after birth?
Often, yes. Many fade within 3 to 6 months of delivery, especially if you had none before pregnancy, which is why treatment is usually postponed.
When should I worry about varicose veins in pregnancy?
See a doctor if a varicose vein becomes red, tender and warm, with fever, leg pain or a rapid pulse, as this may signal a clot (varicose thrombosis).
How can I prevent varicose veins during pregnancy?
Stay active with walking, swimming or yoga, elevate your legs, avoid crossing them and excess heat, and consider compression stockings.