What You Need To Know About Vulvar Varicosities

Vulvar varicosities, or varicose veins of the vulva, are a type of varicose vein that shows up on your labia majora and minora (the outer and inner lips of the vulva). These swollen veins usually form because of increased pressure in the veins of the vulva, most often during pregnancy, and are considered a symptom of chronic vein disease¹ or pelvic varicose veins².

Researchers don’t know exactly how common vulvar varicose veins are, but one study found they affect about 1 in 5 pregnant women and up to 1 in 3 women with varicose veins in the pelvis.² They may also cause pain during sex, ongoing vulvar pain, and emotional or relationship stress. While they’re not always a medical concern, vulvar varicose veins can be linked to blood clots, both during and outside of pregnancy.² 

Managing vulvar varicosities doesn’t have to mean toughing it out. There are simple ways to manage symptoms. Support garments, cold compresses, gentle movement, and compression therapy can help reduce swelling and discomfort. And if symptoms don’t improve, medical treatments like vein embolization or sclerotherapy may be helpful.

Causes and risk factors for varicosities on vulva

Vulvar varicosities and swollen veins in the pelvic area aren’t well studied, but we can learn a lot from what’s known about varicose veins in general.³

These veins enlarge when blood has trouble flowing back to the heart, often due to weakened vein walls or backward blood flow (reflux). In vulvar varicosities, this reflux can happen when there’s a problem where leg veins connect to deeper veins near the pelvis leading to increased pressure and swelling in the vulvar area.²

Pregnant women may be at an increased risk for developing vulvar varicosities. During pregnancy, it’s thought that changes in the body — like the growing uterus pressing on veins and shifting hormone levels — can make it easier for vulvar varicose veins to form, especially during the second trimester (around 12 to 24 weeks).^4,2 Each pregnancy can raise the chances of getting vulvar varicosities, and they often show up earlier and more clearly in later pregnancies.²

Other risk factors may include:³

• Being female
• Having multiple pregnancies
• A family history of varicose veins
• Higher body weight
• Constipation
• A history of blood clots
• Job duties that involve standing or walking for long periods
• Tall height (according to some genetic studies)⁵
• Genes linked to high blood pressure6
  

Although vulvar varicosities are most common during pregnancy, they can also be linked to pelvic congestion syndrome, a condition involving chronic pelvic pain and poor blood flow in the pelvic veins.⁷

Symptoms of vulvar varicosities

Symptoms of vulvar varicosities can vary from mild to severe and may include:^2,4

• Swollen veins on the labia majora or labia minora
• Vulvar pain, heaviness, or burning in the perineum
• Swelling of the labia, especially toward the end of the day
• Discomfort or pain during sexual or physical activity
• Vulvar itching (pruritus) or skin breakdown
• Visible or palpable swollen veins in the pelvic area
• Difficulty walking or standing for long periods

Not all vulvar varicosities cause discomfort. Interestingly, one study found that women with visible vulvar varicose veins may actually report less pelvic pain than those with internal pelvic varices.²

Can vulvar varicosities happen when you’re not pregnant?

Yes. Vulvar varicosities can happen in nonpregnant women, particularly in those pelvic varicose veins.

Do varicosities on vulva go away after pregnancy?

Most of the time, vulvar varicosities improve within a few weeks after giving birth. However, about 8% of women may experience persistent varicosities.² Medical treatment may be necessary if symptoms persist or worsen. 

Is a vaginal birth or cesarean delivery better if I have vulvar varicosities?

The research isn’t clear. One small review of 11 case studies found that vaginal delivery may be associated with fewer severe complications than cesarean section for women with vulvar varicosities, but much more research is needed to understand the best birthing option.⁴ Still, the decision should be made with your healthcare team, based on the severity of your varicosities, any other health concerns, and your personal preferences.

Vulvar varicose veins in pregnancy treatment: How to manage discomfort

If you’re dealing with swollen veins during pregnancy, there are simple, effective ways to ease the discomfort. Try these nine tips to help reduce pressure, improve circulation, and feel more supported every day.

1. Avoid prolonged standing or sitting

Reducing time spent standing or sitting helps decrease venous pressure in the pelvic and vulvar areas. If your job requires standing, try to shift positions frequently and take breaks.

2. Wear varicosities on vulva support garments

Compression therapy is highly effective. Use specially designed vulvar varicosities support garments to  support the pelvic area, reduce swelling, and improve blood circulation. Some great options are:

• Pelvic Pro
• Pelvic Floor Press
• Lovesteady Maternity & Postpartum Bloomers
• Knee high compression socks 

3. Elevate the pelvis and legs

At the end of each day, lie on your back with pillows or a pelvic wedge under your hips. Tilt slightly to your left by placing a pillow under your right hip. This position promotes circulation and helps reduce swelling. 

Perform Kegel exercises in this position to improve pelvic floor muscle strength and improve blood flow.

4. Use an ice pack or cold compresses

Apply an ice pack or cold compress to your vulva for a few minutes, several times a day. This helps reduce inflammation and pain. Support garments often have pockets for ice packs. You can also use a bag of frozen peas wrapped in a cloth.

5. Sleep on your left side

This position decreases pressure on the inferior vena cava, improving circulation to the pelvic area and lower extremities.

6. Limit heavy lifting

Reduce lifting to avoid increased abdominal pressure that stresses vulvar tissues. Modify workouts and ask for light duty at work if necessary.

7. Exhale on exertion

Practice good pressure management by exhaling slowly and steadily during lifting or straining. This technique reduces pressure in your abdominal cavity and protects the veins in your pelvic and vulvar regions.

8. Get a squatty potty

Correct posture during bowel movements helps relieve pressure on the pelvic floor and vulvar veins. A Squatty Potty supports your best posture. Use a slow, controlled exhale as you have a bowel movement, and you can apply pressure up on the perineum and vulva as you bear down.

9. Get pelvic floor training

Exercises, posture training, and breathing techniques can help ease your symptoms. Online pelvic floor workouts in the V-hive can help manage pelvic floor muscle tightness or weakness, both of which can make vulvar varicosities worse.

Medical treatment options for persistent varicosities on vulva

If vulvar varicosities stick around or get worse in the postpartum period, or if symptoms severely affect your quality of life, medical treatments like vein embolization, resection surgery, or sclerotherapy² may be helpful to redirect blood flow away from the affected veins. Medications to help manage underlying chronic vein disease may also be an option. Talk with your healthcare provider if you have concerns about vulvar varicosities to understand your treatment options. 

Finding relief from varicosities on vulva

Vulvar varicosities are more common than you may think, especially when you’re pregnant. While they usually get better after birth, they can stick around causing pain, discomfort during sex, and even emotional stress.

Join the V-Hive and start an expert-led pregnancy and pelvic floor programs to get simple, powerful tools to manage symptoms. Whether you’re dealing with vulvar varicose veins, pelvic congestion syndrome, or just trying to stay comfortable during pregnancy, we’ve got your back (and your pelvic veins). Get started with a free 7-day trial and take the first step toward feeling better today.

References

1. Hamdan, A. (2012). Management of varicose veins and venous insufficiency. JAMA, 308(24), 2612–2621. https://doi.org/10.1001/jama.2012.111352
2. 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
3. Antani, M. R., & Dattilo, J. B. (2023). Varicose veins. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470194/
4. 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), 03000605221097764. https://doi.org/10.1177/03000605221097764
5. Fukaya, E., Flores, A. M., Lindholm, D., Gustafsson, S., Zanetti, D., Ingelsson, E., & Leeper, N. J. (2018). Clinical and genetic determinants of varicose veins. Circulation, 138(25), 2869–2880. https://doi.org/10.1161/CIRCULATIONAHA.118.035584
6. Ahmed, W. U., Kleeman, S., Ng, M., Wang, W., Auton, A., Lee, R., Handa, A., Zondervan, K. T., Wiberg, A., Furniss, D., & 23andMe Research Team. (2022). Genome-wide association analysis and replication in 810,625 individuals with varicose veins. Nature Communications, 13, 3065. https://doi.org/10.1038/s41467-022-30765-y
7. Kim, A. S., Greyling, L. A., & Davis, L. S. (2017). Vulvar varicosities: A review. Dermatologic Surgery, 43(3), 351–356. https://doi.org/10.1097/DSS.0000000000001008