Vulvar varicosities – Say whaaaaaat? I have veins, where???

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Yep, you can get varicose veins on your vulva. I have seen a few women with vulval varicosities and they usually report ‘swollen labia’, feeling of their vulva ‘about to burst’ and pain or discomfort in the area. Inconveniently, it’s difficult for a pregnant woman to bend over and inspect the area! Conveniently, my dad is a Vascular Surgeon who (funnily enough) specialises in treating varicose and spider veins non-surgically. So, I asked him a few questions on vulvar varicosities, and he very kindly omitted any ‘dad jokes’ for you.

What are vulvar varicosities and what are the symptoms?

Simply put, varicose veins in and around the vulva. Although they usually come in with pregnancy (due to increased pressure in the pelvis causing back pressure in the veins feeding into the pelvis) they can occur without pregnancy, but commonly resolve after delivery. Persistent vulvar varicosities can be very uncomfortable, especially pre-menses, with a dull heavy aching and may be uncomfortable with intercourse. All of these can be treated with sclerotherapy (injection treatment).

How likely am I to get them?

They are not that common, so most people are very unlikely to develop them. About 4% of women have them and they are rare in non-pregnant women.

If I had them in my first pregnancy, how likely am I to get them again?

Unfortunately, very likely. They can be injected in the latter part of pregnancy if they are extremely uncomfortable.

What are my treatment options?

A Duplex ultrasound is required to see where they originate, and to ensure there is no intrapelvic cause (apart from a developing foetus). Sclerotherapy (injections) is the only treatment available. Sclerotherapy has a success rate of complete ablation of about 65% but nearly all patients get symptomatic improvement.

Are vulvar varicosities permanent?

Yes, if they don’t settle after pregnancy. We advise waiting for a few months after delivery before treating. It is quite safe to leave them if there are no bothersome symptoms.

Thanks Dad!

So you’re pregnant, you’ve seen your doctor and you’ve been told that you have vulvar varicosities but there’s no need for treatment. But you’re still bloody uncomfortable and want to know what to do?

  1. Get a support garment. Much like veins on your legs, a compression garment can help relieve discomfort. So, walk around all day clutching your crotch and pushing on your vulva. Just kidding. These things can help:
    • 2 large menstrual pads in some large, fitted underwear.
    • SRC pregnancy shorts.
    • the Baby Belly Groin Support Belt
  2. Prop your pelvis up when lying down. Let gravity put the blood back where it should be, by placing a rolled up towel or pillow under your hips when lying
  3. Avoid prolonged standing. Lie down often.
  4. Swimming is a great form of exercise. The water takes the pressure of the baby off your pelvic veins.
  5. Avoid lifting anything more than 5kg
  6. Icing the area may help with pain relief

Oh, and no, vulvar varicosities won’t affect your mode of delivery of your baby.

So, there you have it; another fun pregnancy detail that not many peeps talk about. However, if you do have vulvar varicosities, know that they are treatable and most likely aren’t medically serious.

Rob Fris is a vascular surgeon at www.theveincentre.co.nz in Auckland, NZ.  A graduate of the Otago Medical School, his surgical training and experiences include New Zealand, Australia, Canada, USA, Scotland, India, and Brasil. His background treating problem veins stretches back to 1978, while training in Canada, and to date has seen an estimated 4000 patients. Rob is married with three children. His youngest daughter, Caitlin, is clearly the most awesome person in the world 😉

– the vagina physio

Image credit: Instagram @poezieplaatjes

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