I love road trips. There’s just something fun about driving across state lines and taking in all the scenery. Although, of course, with a toddler and a baby on the way, I’m in the season of life when I just want the fastest route possible!

Whether on a road trip or just on your morning commute, chances are you’ve been driving down the interstate and seen a billboard for varicose vein treatment. On the billboard, you probably saw an image of a lady’s legs, right? While that’s certainly a common place for varicose veins, they can actually pop up just about anywhere on the body — and pregnancy can cause them to show up in a place you might never have expected: your vulva.

What are vulvar varicosities?

First things first, let’s define some terms. The term “varicose veins” simply refers to swollen veins anywhere in your body. The word “varicose” means abnormally swollen or dilated, and when this occurs in superficial veins on your body, they become visible (and sometimes uncomfortable). 

Vulvar varicosities refer to swelling of the vulvar veins, or in other words, varicose veins of the vulva. They can also cause vulvar swelling, labial swelling, and general discomfort, especially when sitting. This is a symptom of pregnancy that is rarely discussed, and I’m trying to change that. 

I believe that women should be empowered and equipped throughout their pregnancies, and that includes education about the less-than-fun bodily changes that may pop up! When you know what’s going on in your body, it reduces your anxiety and helps you make informed choices about treatment and care. So let’s get into it — why do varicose veins show up down there during pregnancy? 

Why do vulvar varicose veins occur?

Unfortunately, pregnancy provides the perfect combination of factors that can cause varicose veins, including: 

Increased blood volume

Did you know that blood volume increases anywhere from 30-50% during pregnancy? It’s incredible that your body can literally create more blood cells throughout your pregnancy, which are passed on to your baby as he or she grows. But even though it’s incredible, it’s a lot of stress on your circulatory system!

Increased weight gain

Obesity is a factor for varicose veins throughout your lifetime. The weight gain of pregnancy, which is completely normal and expected, puts a lot of additional pressure on your veins and pelvic floor. 

Increase tissue laxity due to hormonal changes

Progesterone increases during pregnancy, causing increased laxity in your body’s ligaments and tissues. This hormonal shift occurs so that your body can shift and stretch to accommodate your growing baby. But this process also dilates your blood vessels, which can cause damage to the valves of your veins. 

When vein valves are damaged, they can cause blood backflow. That means that the blood that should be pumped back to your heart travels backwards to your legs instead. Your calf muscles typically help return this blood to your heart, but when backflow occurs, they can’t combat the added pressure. Over time, this causes your veins to dilate, twist, and swell. 

Increased pressure on your pelvic floor due to a growing baby

Perhaps the most notable reason for vulvar varicosities is the sheer pressure added to your pelvic floor as baby grows. This pressure and weight can affect your circulatory system. 

Risk factors for varicose vein development

Not every woman experiences varicose veins during pregnancy – or ever! There’s no way to be certain if you’ll face this uncomfortable symptom at some point in your life, but going over additional risk factors (besides pregnancy) can provide some clues. These five things may put you at higher risk for varicosities:

• Family history
• Increased age
• History of varicosities with a previous pregnancy
• Low blood pressure
• Smoking 

7 ways prevent vulvar varicosities during pregnancy (and alleviate symptoms if they show up) 

If you notice varicose veins during your pregnancy, don’t panic. There are quite a few ways to alleviate uncomfortable symptoms — or even stop them before they show up in the first place! 

1. Invest in compression bloomers

Adding pelvic floor and core support garments into your regular rotation is a game changer during pregnancy. Go for an option that lifts from the pelvic floor up, like these from BaoBei! I swear by these compression bloomers, and so do thousands of women in this community. 

I bought 2 pairs during my first pregnancy, and I wore them pretty much daily — either over other underwear or with a panty liner. This saved me from needing to buy a ton of pairs, because they are pretty pricey. But the investment is so worth it! Use code drmaehughes for 15% off at checkout if you decide to join the club. 

2. Wear compression socks

Compression socks are a pregnancy favorite for me all the time — but especially when I’m traveling. I love these short pairs for minimal swelling of the feet, and I recommend them for all pregnant women. If you’re already struggling with severe varicose veins, try this higher length. The added coverage really helps with all lower body varicose veins, and medical grade compression 20-30mmHg ensures that you’ll get the support you need. 

3. Engage in regular exercise

If you’ve been around at all, you know I’m all about helping women exercise safely throughout their pregnancies. It’s a pretty self-explanatory solution for avoiding varicose veins: it gets your blood and your muscles pumping, which helps blood get back to your heart as needed. 

If you’re trying to find a pregnancy-safe workout routine, you’re in the right place. My Movement Through Pregnancy program was designed to help you work out through each trimester without anxiety about which moves are safe — and which moves are actually helpful as you prepare for labor and delivery. 

4. Avoid prolonged sitting or standing

Sitting and standing for long periods of time is honestly super uncomfortable when you’re pregnant, especially nearing your due date. But there’s another reason to mix things up and keep moving instead of staying stationary for long periods of time. Your muscles have a natural pump effect when they contract and relax in rhythm! Moving your body helps to return blood back to the heart, reducing the pressure on existing  varicose veins and preventing new ones from forming. 

5. Choose your clothing wisely

In general, tight clothing at the waist and lower body can disrupt your circulatory system. This is never truer than during pregnancy! We want to provide compression in all the right places and none of the wrong ones, so choose clothing that fits well and promotes healthy circulation. 

6. Elevate your legs

Not only is this a great practice for blood flow, it just feels GOOD during pregnancy! Try propping a pillow under your hips while laying on the ground with your legs up a wall. You can perform ankle pumps as well to really encourage proper circulation! Do this for 5-10 minutes at a time and you’ll see the difference. I personally elevate my legs like this every night as part of my toddler’s bedtime routine, and she loves joining me! 

7. Maintain proper hydration

It may seem counterintuitive to add more liquids when you’re swollen. But when you are dehydrated, your body hangs onto water and sodium, which further increases your swelling. Staying hydrated is essential for pregnancy and postpartum, especially when you incorporate movement! 

Make sure you are getting at least 64-96 ounces of water per day (a good rule of thumb for pregnancy and life in general).  You might need to up your intake further if you are working out or just moving around in a hot environment. 

Remember to add in electrolytes too — they’re just as important as water intake! I love these from Needed. They’re not too salty or too sweet, so they’re easy to incorporate into my daily routine. 

Stay Active and Reduce Pain Throughout Your Pregnancy

Every pregnant woman I know wants to stay strong and healthy throughout each trimester. But let’s face it: there’s a lot of misguided and conflicting advice out there about how to do it! That’s why I created Movement Through Pregnancy. 

In this program, you’ll find 37 progressive weeks of evidence-based, pregnancy-safe workouts. They were each developed by me, a pelvic floor physical therapist, and filmed during my pregnancies. No matter how many weeks pregnant you are, you can jump right in and follow along! You’ll also have access to educational modules that explain the physiological changes you’re experiencing and help you understand how to strengthen your body while pregnant. Knowledge is power, right? 

Purchase a single trimester or bundle them for a full pregnancy workout buddy and friendly expert! I can’t wait to see you there. Purchase Movement Through Pregnancy today!