Vulvar Varicosities
Vulvar varicosities are swollen veins on your vulva that usually appear during pregnancy. These varicosities can be asymptomatic or may cause pain or a feeling of fullness in the vulva. They generally resolve after childbirth. In the meantime, lifestyle adjustments can help manage symptoms.
What are Vulvar Varicosities?
Vulvar varicosities are swollen, bluish or purplish veins on the vulva that often develop during pregnancy due to increased blood flow and pressure on the veins. They can also occur in non-pregnant individuals, typically in conjunction with pelvic congestion syndrome (PCS).
Who Experiences Vulvar Varicosities?
Primarily, vulvar varicosities occur during pregnancy, especially around the third or fourth month. In some cases, non-pregnant individuals may develop them, particularly those with pelvic congestion syndrome.
Prevalence
Approximately 4% of individuals with vulvas experience vulvar varicosities. Among pregnant individuals, the prevalence rises to about 20%. For those with varicose veins in the pelvis, roughly 20% to 35% also experience vulvar varicosities. However, the actual prevalence is challenging to determine as they may remain asymptomatic and undetected.
Symptoms and Causes
Indications
Vulvar varicosities can be asymptomatic or may present with visual and sensory changes in the vulva, including:
- Prominent, bluish or purplish veins visible beneath the skin
- Twisted, swollen, or clustered veins
- Veins localized on the vulva or extending to the upper thighs, buttocks, or calves
- Raised skin areas with swollen veins beneath
- Feelings of fullness, pressure, pain, itchiness, or discomfort in the vulva
- Discomfort in the upper thighs and lower back
- Increased discomfort during intercourse (dyspareunia) or prolonged standing
Causes
Vulvar varicosities occur when vulvar veins struggle to maintain proper blood circulation, primarily due to pregnancy-related changes such as:
- Increased blood flow to the pelvis, overburdening the veins
- Enlargement of the uterus, exerting pressure on pelvic veins
- Hormonal fluctuations leading to vein wall changes, dilation, and twisting
- Genetic predisposition influencing vein function
Diagnosis and Tests
Diagnosis typically involves a physical examination. Healthcare providers may assess the vulva when the patient is lying down and standing to observe changes in vein appearance under different conditions. Imaging tests may be ordered to evaluate vein size and blood circulation, guiding treatment recommendations.
Management and Treatment
Treatment Options
Treatment depends on pregnancy status and the presence of varicose veins in other pelvic regions. For pregnant individuals, vulvar varicosities often resolve postpartum. For non-pregnant individuals or those with persistent varicosities, treatment options may include:
- Sclerotherapy: Injection of a solution into the veins to induce scarring, closure, and eventual disappearance.
- Ligation: Small incisions to access and remove vein segments.
Symptom Management
Preventive measures and symptom management include:
- Avoiding prolonged sitting, squatting, or standing
- Limiting salt consumption
- Staying well-hydrated
- Elevating hips while sleeping
- Wearing supportive pelvic garments
Prevention
Vulvar varicosities cannot be entirely prevented, but measures to enhance overall circulation may help, such as:
- Regular exercise
- Healthy diet
- Comfortable footwear
- Avoiding prolonged seated positions
- Wearing loose-fitting clothing in the groin area
Outlook and Prognosis
Vulvar varicosities typically resolve about six weeks after childbirth. While symptoms can be bothersome, they do not pose pregnancy-related complications. For non-pregnant individuals, collaboration with healthcare providers for monitoring and treatment discussions is recommended.
Living With Vulvar Varicosities
When to Seek Medical Advice
Consult a healthcare provider when experiencing circulation issues or symptoms related to vulvar varicosities, and ensure regular check-ups for symptom monitoring. Be aware of signs of deep vein thrombosis (DVT), a rare but severe condition associated with vulvar varicosities, which include pain, redness, swelling, and hardness in the affected area.
Common Questions
Do Vulvar Varicosities Cause Pain?
Vulvar varicosities can vary in their effect on individuals. Some may experience mild discomfort, while others may have severe pain. It is crucial to communicate any symptoms to a healthcare provider.
Is Walking Beneficial for Vulvar Varicosities?
Moderate walking can promote overall blood circulation but should be balanced to avoid overexertion, which may worsen vein discomfort.
Can Vulvar Varicosities Be Treated?
Yes, treatment options are available. The choice of treatment depends on individual circumstances, and healthcare providers can guide patients through appropriate interventions.