Vulvar varicosities are swollen, twisted veins that appear on the outer surface of the female genitals, known as the vulva. While they are a type of varicose vein, similar to those found in the legs, their location can lead to specific concerns for individuals. These veins are a relatively common occurrence, particularly during pregnancy.
What Are Vulvar Varicosities?
Vulvar varicosities are dilated veins that develop in the labia majora and minora, the folds of skin around the vaginal opening. These veins can appear as bluish, bulging, or worm-like structures on the skin’s surface. The underlying physiological process involves incompetent valves within the veins. When these valves weaken or fail, blood can pool and accumulate, causing the veins to enlarge, twist, and become visible. While similar to varicose veins in the legs, vulvar varicosities specifically affect the external genital area.
Why Do They Occur?
Pregnancy is the primary factor contributing to the development of vulvar varicosities, with an estimated 18% to 22% of pregnant individuals experiencing them. During pregnancy, increased blood volume to support the growing fetus and placenta places additional pressure on the venous system. Hormonal changes, particularly elevated levels of estrogen and progesterone, also cause vein walls to relax and become more susceptible to dilation. The expanding uterus further obstructs blood flow from pelvic veins, leading to pooling in the vulvar region.
Other factors can also contribute to the occurrence of vulvar varicosities. A genetic predisposition or family history of varicose veins can increase an individual’s risk. Multiple pregnancies may also heighten the chances of developing these varicosities, and they often appear earlier and more prominently in subsequent pregnancies. Additionally, prolonged standing or sitting, obesity, and chronic constipation can exacerbate pressure on the veins, potentially contributing to their formation or worsening.
Identifying the Symptoms
Symptoms of vulvar varicosities can vary widely; some individuals may not experience any noticeable signs. However, when symptoms are present, they commonly include a feeling of fullness, pressure, aching, or heaviness in the vulva. These sensations often worsen after prolonged standing, exercise, or sexual activity due to increased pressure on the veins.
In some instances, the labia themselves may appear swollen or enlarged. Discomfort can extend to itching or burning sensations in the genital region.
Managing and Treating Vulvar Varicosities
Conservative, at-home measures are frequently the first line of approach for managing vulvar varicosities, especially during pregnancy, as they often resolve spontaneously after delivery. Wearing specialized compression garments, such as supportive underwear or maternity compression shorts, can help improve blood circulation and reduce swelling in the affected area. Elevating the hips when resting, perhaps with a pillow, can help ease pressure on the pelvic veins and promote blood return.
Applying cold compresses or ice packs wrapped in a cloth to the vulva can help reduce inflammation and alleviate discomfort. Avoiding prolonged periods of standing or sitting is also beneficial, as these positions can worsen blood pooling in the veins. Regular, low-impact exercise, such as walking or swimming, can enhance overall blood flow.
When conservative measures are insufficient or if the varicosities persist after pregnancy, medical interventions may be considered. Sclerotherapy involves injecting a solution into the affected veins to cause them to scar and close, eventually leading to their disappearance. Phlebectomy is a procedure where the affected veins are surgically removed through small incisions. Transcatheter embolization is a less invasive option where synthetic materials or medications are infused into the veins via a catheter to block blood flow. These medical treatments are typically reserved for more severe cases or those causing significant, persistent discomfort.
When to Consult a Doctor
It is advisable to consult a healthcare provider for a proper diagnosis of vulvar varicosities. A medical professional can confirm the condition and rule out other potential causes of discomfort in the genital area. Seeking medical attention is particularly important if symptoms are severe, cause significant pain, or interfere with daily activities.
Additionally, individuals should consult a doctor if they notice any signs of complications, such as a vein becoming excessively painful, red, swollen, or hard to the touch, which could indicate a blood clot. Professional evaluation ensures appropriate management.