Preventing Varicose Veins
Although it’s a common misconception that only women experience troublesome veins, the fact is, one in three people in the U.S. including men has some form of vein, or venous, disease. That breaks down to 55% of women and 40 to 45% of men; of these, 20 to 25% of women and 10 to 15% of men will have visible varicose veins. Still, gender does make a difference.
What is venous disease?
Venous disease is defined as the impairment of blood flow back towards the heart. This occurs when healthy vein valves become damaged and the backward flow of blood “pools” in the legs or feet. Symptoms may include discomfort, fatigue, or heaviness in the leg, causing varicose veins and other skin changes. Over time, the increased pressure can cause additional valves to fail. If left untreated, it can lead to extreme leg pain, swelling, ulcers, and other health problems.
Risk factors for developing venous disease, regardless of gender, include family history, age and inactivity. Another significant risk factor, fluctuations in hormones is related to gender. Women have three potential “high risk” times in life for vein issues: menarche, pregnancy, and menopause. Why? Because the hormone progesterone can act as a vasodilator, something that opens or relaxes blood vessels which causes the valves in the veins to stretch, sometimes to the point of damaging them. Women who have venous insufficiency will often notice that their symptoms worsen during menstruation, for example.
What to expect
About forty percent of pregnant women are likely to develop varicose veins. During pregnancy, a combination of hormonal changes (specifically, greater amounts of estrogen and progesterone) and increased pressure on the abdomen can cause varicose veins. The most damage seems to happen in the first trimester, so if you have risk factors for vein disease, consider wearing graduated compression stockings, especially in the first three months. Some women feel so much relief that they wear them throughout the entire pregnancy. (See “Preventing varicose veins during pregnancy” sidebar.)
Pregnancy is also a time when women are more prone to blood clots, so phlebitis (inflammation of the walls of a vein that can cause a clot to form) can also be a concern. Many women find that their varicose veins go away a few months after labor, while others continue to suffer with them.
Some vein specialists may recommend that women seek treatment for problematic veins before their first pregnancy, especially if there is a strong family history of vein issues. If a woman experienced vein discomfort during a pregnancy, she may want to consider treatment before her next pregnancy, as the problems may worsen.
The effects of aging
After menopause when most hormone fluctuations have stopped, a woman’s risk of venous disease continues to increase with age. As the body gets older, a decrease in the production of collagen causes the veins to become weaker and the valves more likely to fail. For this reason, there is a higher incidence of varicose veins in older populations.
Additionally, the incidence of deep vein thrombosis (DVT) is higher in older people. DVT occurs when a blood clot forms in one of the large veins, usually one of the lower limbs, such as the thigh or calf. Post-menopausal patients who are taking hormone supplements should also be aware of the increased risk of blood clots, which can damage veins or worse.
Older women may think varicose veins are a normal part of aging, that having legs that feel heavy or achy is “par for the course.” The truth is, this is not normal, and there are solutions for women with vein symptoms, no matter what their age.
Being proactive
With the right information, women have the ability to reduce their risk of developing venous disease and/or decreasing its severity. Preventative measures include: elevating
the affected leg above heart level; wearing graduated compression stockings; living an active lifestyle, maintaining a healthy weight; and avoiding tight-fitting clothing and high-heeled shoes.
Modern treatment of vein disorders is vastly different from traditional treatments of the past. Today’s treatments are minimally invasive, virtually pain-free and are overwhelmingly successful over the long term when performed by an experienced phlebologist (vein specialist).
Spider veins and varicose veins are health issues, but due to misinformation or dated attitudes, many women do not treat them as such. Most important is to know your family history. Just because your mother or grandmother suffered from painful or unsightly legs doesn’t mean it has to be your destiny.
Dr. Cindy Asbjornsen is the founder of the Vein Healthcare Center in South Portland, Maine. Certified by the American Board of Venous and Lymphatic Medicine, she cares for all levels of venous disease, including spider veins, varicose veins and venous ulcers. Dr. Asbjornsen is the only vein specialist in Maine to be named a Fellow by the American College of Phlebology. You can contact Dr. Asbjornsen at 207-221-7799 or [email protected].
Preventing varicose veins during pregnancy
A woman’s body goes through many changes during pregnancy, including an increase in blood volume and fluid. Fluid retention often causes swelling in the legs, ankles and feet. Graduated compression stockings promote good circulation. They help to reduce swelling and pain and, in many cases, can minimize or even prevent varicose veins.
Any woman with a family history of problem veins should wear full-length stockings (or at least knee-high stockings) throughout her entire first trimester. Stockings come in a variety of styles and strengths, from knee-highs and thigh-highs, to full-length stockings.
Pregnancy compression stockings (and body garments) are available with a doctor’s prescription, and many maternity stores also offer them. There are panty hose styles with more room in the belly, specially designed to expand during pregnancy without restricting the abdomen. Accurate sizing is critical, so it is best to check with a doctor prior to purchasing any type of compression while pregnant.
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