Most of us are familiar with varicose veins. But what we don't often talk about are varicose veins that pop up on your lady bits during pregnancy aka vulvar varicosities. Anywhere from 4-24% of us experience vulvar varicosities during pregnancy and they can affect any part of the outside bits of your vagina (commonly the outer lips) and upper thighs.
Cause
Pregnancy causes blood to pool in your vulva due to
- increased blood flow towards the pelvis
- slower movement of blood from your legs back to your heart
- hormones act on your blood vessel walls
If the increased pressure overwhelms your veins this will cause them to become stretched and enlarged, causing vulva varicosities.
Symptoms
Symptoms can vary, but you may experience
- heaviness or a feeling of fullness around the vaginal area
- swelling
- pain or discomfort, often worsened by prolonged standing or sitting
- feels lumpy to touch
- visible veins (often blueish) that aren't normally as prominent
Diagnosis
- Clinical examination
- In cases where the diagnosis is unclear, an ultrasound may be necessary
Treatment
Treatment focuses on managing your symptoms during pregnancy, and we do this by reducing the pressure in your vulvar
- Listen to your body - lie down and rest as needed
- Change positions - avoid prolonged standing or sitting
- Manage constipation - straining increases pressure on your veins
- Avoid activities such as heavy lifting, pushing and pulling
- Modify your exercise activities – swimming and Pilates can be great ways to keep active
- Apply gentle pressure with your hand to your vulva when coughing, sneezing, or laughing
- Do pelvic floor exercises
- Apply ice packs to your vulva (15-20 minutes, every two hours)
- Wear support garments that provide compression to your vulvar, such as firm-fitting underwear with a pad or SRC pregnancy shorts and leggings
- Wear compression socks to improve lower limb circulation
- Do not wear compression socks over the top of leggings that already provide compression ( e.g. SRC), as it can cause excessive compression
- Shorts and compression socks (that don’t overlap) can be worn at the same time
Prognosis
If a vaginal birth is in your birth plan, then the good news is that as labor progresses the pressure in your veins is reduced and vulvar varicosities typically do not affect your ability to have a vaginal birth. If they do bleed, they only have minimal blood and are usually easily managed.
Symptoms usually fully resolve within 6-8 weeks after giving birth.
Top Tips
- Schedule an appointment with your healthcare provider (GP, midwife, pelvic health Physio) for an accurate diagnosis
- Don't wait for your symptoms to worsen. Act now to make changes.
- Invest in medical-grade compression garments (with vulvar support) +/- compression stockings
- Be kind to yourself! Dealing with vaginal varicosities is tough, so now is the time to prioritize your health.
References
Gavrilov, S. G. (2017). Vulvar varicosities: diagnosis, treatment, and prevention. International Journal of Women's Health, 9, 463–475. https://doi.org/10.2147/IJWH.S126165
Giannella, L., Montanari, M., Delli Carpini, G., Di Giuseppe, J., & Ciavattini, A. (2022). Huge vulvar varicosities in pregnancy: case report and systematic review. Journal of International Medical Research, 50(5), 3000605221097764–3000605221097764. https://doi.org/10.1177/03000605221097764
Kim, Anna S. MD*; Greyling, Laura A. MD†; Davis, Loretta S. MD†. Vulvar Varicosities: A Review. Dermatologic Surgery 43(3):p 351-356, March 2017. | DOI: 10.1097/DSS.0000000000001008
Vulvar varicosities during pregnancy: What can you do? - Mayo Clinic
