Varicose Veins: Medical, Treatable

One of the most feared side effects of pregnancy is varicose veins, those bulging veins in the legs and elsewhere that can be both unsightly and painful. Gregory C. Zenni, MD of Vein Solutions, a division of Cardiac, Vascular & Thoracic Surgeons Inc. in Cincinnati, says varicose veins are caused by problems in the venous system, a condition called venous insufficiency or reflux. “The main veins don’t function normally, so blood backs up into the smaller side branches, which become dilated. Those are the bulging veins that you see,” he explains.    

The most common cause of varicose veins is heredity, but hormones also play a role. Roughly 40 percent of pregnant women will get them; the increased weight gain and blood volume associated with pregnancy can bring on the problem. “When a baby is sitting in the pelvis, it compresses the veins that run through the pelvis from the legs, causing those veins to dilate,” says Dr. Zenni, adding that the condition can worsen with subsequent pregnancies.    

Dr. Zenni offers several tips to help minimize the problem. The most effective treatment is to wear well-fitting compression stockings, which keep the leg veins from becoming congested with blood and dilating. Staying within normal weight-gain guidelines and exercising regularly can also help. “Try to avoid prolonged standing, and elevate your legs whenever you can to drain the venous system,” he recommends.    

If problems persist, Dr. Zenni recommends having a qualified vascular surgeon diagnose and treat the underlying cause. Several minimally invasive treatment options can offer relief, including small incisions to remove the veins, injection therapy, or ablation. Ablation is a common technique that employs radio frequency or a laser to heat the main vein from the inside, causing damage so it collapses and disappears. “It eliminates the feeding vein that causes those varicose veins,” he says.  

“There’s always an underlying cause for those dilated varicose veins,” says Dr. Zenni. “You need to have them evaluated and treated if you’re going to solve the problem for good.”