Pregnancy is the primary risk factor for developing vulvar varicosities. A less recognized condition that can cause pelvic veins is the narrowing of the major vein (iliac vein) that drains each leg.
Vulvar varicosities are seen in the vagina and labial area but can also be seen in the groin and buttocks. These veins are the visible manifestation of varicose veins in the pelvis near the ovary, uterus, bladder and rectum. The location of the superficial varicose veins indicates the pelvic vein that may be the underlying cause.
Natural changes of pregnancy contribute to vulvar varicosities. These include weight gain with increased pressure on the pelvic floor, increased venous blood volume, and the dilation of the pelvic ligaments and veins of the leg. These changes result in pooling of venous blood with pregnancy. The risks of developing vulvar varicose veins and more common leg varicose veins grow with each pregnancy.
Vulvar varicose veins can appear as early as 12-26 weeks into the pregnancy. In most cases, they go away on their own six to twelve weeks after delivery. In some, the vulvar varicose veins do not resolve and symptoms of a condition known as pelvic congestion disorder (PCD) can affect your quality of life. Symptoms often worsen with the menses, long periods of standing, or sexual intimacy.
While vulvar varicose veins affect more pregnant women, non-pregnant women can develop pelvic congestion and/or vulvar varicosities. The most common causes appear to be:
- Portal hypertension: increased blood pressure in the portal vein, which receives blood from the pancreas, spleen, stomach, and intestines
- Scarring of the iliac veins which drain each leg.
- Klippel-Trenaunay Syndrome (KTS): a rare congenital disorder (disorder from birth), with unknown causes