Can varicose veins affect women during menopause?


Menopause is the natural fall in the reproductive hormones in a woman when she reaches her 40s or 50s. As such, in the years leading up to menopause, like pregnancy, women experience a lot of hormonal imbalances or fluctuations which, in turn, can lead to multiple symptoms or disorders, said Dr Nanda Rajaneesh, General and Laproscopic Surgeon, Apollo Spectra Hospital, Bangalore. “One such common problem many women suffer from at this stage in their lives is varicose veins,” the expert told indianexpress.com.

What are varicose veins?

A varicose vein is a symptom that commonly occurs during menopause and usually fades away without any pain. In simple words, varicose veins are twisted and enlarged veins — purple in colour — that appear primarily on the legs. “As the symptoms of menopause sustain over years, women become more susceptible to varicose veins,” said Dr Nagarathna, DS, MBBS, DGO, consultant obstetrics and Gynecology, Apollo Cradle and Children’s Hospital – Koramangala.

“Apart from their primary reproductive functions, the hormones estrogen and progesterone help with the functioning of the blood valves, the flexibility of the valves, and enhance blood flow. Thus, a sharp decrease in the hormone levels thickens the blood wall, reducing flexibility. In the absence of these hormones, the veins become more brittle and dry, which leads to the pooling of blood in the valves, and hence, varicose veins,” Dr Nagarathna explained.

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Risk factors

Age, gender, pregnancy, family history, obesity, and standing or sitting for long periods are some common risk factors. “Research suggests that the reproductive hormones — estrogen and progesterone — have beneficial effects on vein wall support. Hormonal imbalances in the years leading to menopause cause an increased risk to develop varicose veins. During menopause, there is a rise in the levels of estrogen and progesterone followed by a subsequent drop. The increased levels of estrogen and progesterone have a thinning effect on the vein walls, which increases their elasticity. But when the level drops sharply, it has the opposite effect which is excessive thickening and constricting of vein walls. Due to this thickening, the valves in the vein stop working effectively, causing the blood to pool in the veins, contributing to their swollen and engorged appearance. The thickened vein walls may also create a narrowed pathway for the returning blood causing congestion and swelling of the leg,” elucidated Dr Nanda.

What to keep in mind

Whether a woman is menopausal or nearing it, there are certain important things they need to know about managing and preventing varicose veins.

“Varicose veins experienced when the woman attains menopause commonly fade and most of the time they are not painful. Unfortunately, however, a few women tend to develop pain, heaviness of the leg, skin problems like itching, ulcers over the leg, sudden bleeding from these varicose veins, and blood clots. Such symptoms require the expert help of a general surgeon or a vascular surgeon,” said Dr Nanda.

He said that the doctor will examine the leg and also do an ultrasound to check blood flow in the leg to have a better idea of the extent of the disease. Generally, surgeons advise lifestyle modifications that include adopting low impact exercises, which uses the leg muscles to improve circulation and also to avoid standing for long hours, using compression socks, and elevating the legs whenever resting or sleeping to tackle varicose veins, if the disease is mild or asymptomatic.

Menopause is not to be feared (Source: Getty images/Thinkstock)

If these lifestyle changes do not benefit or if the varicose veins are too severe, surgery like vein ligation and stripping is advised. However, since it requires anesthesia and is invasive, the medical fraternity has come up with a wide variety of minimally invasive options like sclerotherapy, laser surgery, endogenous ablation therapy and endoscopic venous surgery.

“Varicose veins tend to get worse over time if left untreated. So women of menopausal age should take care of their vein health and consult a doctor at the earliest sign of varicosities,” Dr Nanda noted.

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