Problems with veins are very common among the general population. About 55% of women and 40 to 45% of men in the U.S. have to deal with some type of vein problem in their lives. As this statistic suggests, women are more often treated for vein-related health issues. Also, it has been observed that hormonal fluctuations can often be linked to vein physiology. Alterations in the balance of the sex hormones, which naturally happen during pregnancy and pre-, post- and during menopause, play an important role in the development of varicose veins and their smaller versions, spider veins.
For some people, varicose veins and spider veins are a benign cosmetic concern, while others can experience discomfort and pain. Furthermore, varicose veins can sometimes lead to more serious problems and can be connected with heart and circulation issues. That is why it is essential to maintain your vein health. In menopause, it can be particularly important to have your legs and circulation medically evaluated. If you have already developed varicose veins, you should also consider investigating the root of the problem. For a comprehensive assessment and the opportunity to receive best guidance, it might be advisable to visit a vein clinic NYC.
What are varicose veins?
Varicose veins are swollen and twisted or bulged veins. They are usually red, purple or blue, but can also be skin-colored. Although varicose veins are most commonly seen in the legs (thighs, back of the calves, insides of the legs, ankles), any vein in the body can be affected. Spider veins, for example, which resemble spider webs or branches of a tree and appear closer to the surface of the skin, can also develop on the face.
To send the blood upwards to the trunk and the heart, veins in the legs need to work against the force of gravity. This exposes them to high pressures and is the reason lower extremities are the usual site of varicose veins. The veins only have one-way valves, which prevent the blood from flowing back. However, if these valves become damaged or weakened, the blood starts collecting in the vein, causing the swelling, which can eventually make the vein varicose.
Some of the common symptoms of varicose veins include swelling, muscle cramping, throbbing, aching pain and heaviness in the legs, itchiness around the veins and restless legs.
Menopause and varicose veins
Etiology of varicose veins is still poorly understood. Studies do show, however, that the risk increases with age, pregnancy and in menopause, the latter two connected with the influences of hormonal fluctuations. In menopause, the production of hormones estrogen and progesterone is decreased, causing the familiar symptoms of menopause (hot flushes, loss of bone density, fatigue, depression). Estrogens are also vasoactive substances (causing constriction or dilation of blood vessels) and veins contain receptors for this hormone. Lower levels of sex hormones therefore affect the circulatory system and can contribute to the development of varicose veins.
There are other risk factors that can increase your chances of developing varicose veins. Some of these include:
- family predisposition,
- prolonged standing and sitting (sometimes connected with certain professions),
- being overweight or obese, and
- a history of blood clots or circulation problems.
Although both hormone replacement therapy (HRT) and oral contraceptives (OC) can increase the risk of thrombosis (clotting of the blood), research findings regarding their effect on varicose veins are not conclusive. While some studies showed that users and ex-users of the oral contraceptive pill might be at higher risk of varicose veins, other studies found no correlation. Similarly, the effect of HRT on varicose veins is not clear yet. Some studies showed that HRT users can have lower prevalence of varicose veins. However, this has not been confirmed by other studies that suggested either no correlation or even increased risk associated with HRT. One Finnish research group, for example, found a significant risk of varicose veins in women on HRT at the start of their study. But, at follow-up, women on HRT did not develop more new varicose veins, which would suggest that HRT might not increase the risk.
Things you can do by yourself to avoid varicose veins in menopause
Some of the causes and contributing factors of varicose veins can be managed by changing certain aspects of your lifestyle and daily routine. Here are some strategies you might want to consider, which are also being promoted by the Office on Women’s Health of the U.S. Department of Health and Human Services:
- Maintain a healthy body weight.
- Exercise regularly, which will boost your circulation and help you strengthen your legs and veins. Walking, running, biking and swimming are all types of exercises that will increase your leg health and circulation.
- Avoid sitting or standing for long periods of time. Also, avoid the habit of crossing your legs as this squeezes the veins at the knees and inhibits the blood flow.
- Elevate your feet when sitting or resting, which will increase the flow of blood into your legs. You can also elevate the foot of your bed to reduce pressure on the legs.
- If you are at risk, consider wearing compression stockings. Graduated elastic compression stockings can improve some symptoms of varicose veins, including swelling and leg tightness. You will need to get prescription-strength gradient compression hose and be fitted for them by a professional trained to do this.
- Wear appropriate sun protection to prevent spider veins on your face.
- Reduce your salt intake and eat a diet rich in fiber. This can help prevent constipation, which has also been linked to the development of varicose veins.
When should you see a doctor?
As mentioned earlier, cardiovascular health is an important aspect of a woman’s health and health prevention as she goes through her menopause. Furthermore, there are certain symptoms connected with your veins that should urge you to see a doctor. These symptoms include:
- The vein has become swollen, red and warm to the touch.
- The varicose vein is bleeding.
- You notice rash or sores.
- You develop ulcers near your ankle.
- You observe discoloration or color changes.
- All these symptoms suggest you have a serious vascular problem that requires medical attention.
Also, see a doctor regarding your varicose veins if you feel they are interfering with your daily activities or if their appearance is causing you distress.
Effective treatments for varicose veins
There are several treatment options available, both invasive and non-invasive. Some of the options include conservative approaches (leg elevation, compression stockings), sclerotherapy, surface laser treatments, endovenous techniques (radiofrequency and laser), ambulatory phlebectomy and surgical vein ligation, with or without stripping. Venotonic medications that improve venous tone have also been shown to provide some symptom relief.
For mid-sized veins and spider veins, sclerotherapy, laser ablation and endovenous techniques are usually considered to be the most effective approaches. Some medical literature also suggests that for very large varicose veins, long-term outcomes are superior with surgical treatment. However, more randomized controlled trials are needed to compare the effectiveness of different treatment approaches.
The most appropriate treatment option for each individual case should be determined by a specialist doctor following a thorough assessment and consultation.
Hagen, M. D., Johnson, E. D., & Adelman, A. (2003). What treatments are effective for varicose veins?. Journal of Family Practice, 52(4), 329-331.
Jukkola, T., Mäkivaara, L., Luukkaala, T., Hakama, M., & Laurikka, J. (2006). The effects of parity, oral contraceptive use and hormone replacement therapy on the incidence of varicose veins. Journal of Obstetrics and Gynaecology, 26(5), 448-451. doi:10.1080/01443610600747389
Lee, A., Evans, C., Hau, C., Allan, P., & Fowkes, F. (1999). Pregnancy, oral contraception, hormone replacement therapy and the occurrence of varicose veins: Edinburgh vein study. Phlebology, 14(3), 111-117.
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