General: About the Conditions:
I am on low dose compounded progesterone and triest estrogen creams. My leg veins seem more prominent. My mom had varicose veins due to 9 pregnancies. Am I at risk for varicose veins? Is it the estrogen or the progesterone causing this? Or the combination?
Family history and pregnancy are the most important predisposing factors for varicose veins. Hormone therapy, particularly progesterone is an additional causative factor.
Is all sclerotherapy the same?
No! Sclerotherapy is an art. The experience, skill and touch of the operator are paramount. There are many factors that contribute to a good result. These include the size and type of the needle used, the type and concentration of the solution, the pressure with which the solution is injected, the volume of solution used even the size of the syringe, to name just a few.
What are the symptoms of varicose veins?
While varicose veins don’t develop overnight, they sometimes take years to turn into a problem. Besides their unsightly appearance, symptoms may include burning, aching, fatigue, heaviness, swelling, and muscle cramping.
Sudden leg swelling that with or without pain and redness could mean a blood clot in the deep veins, and you should seek immediate medical attention. Skin ulcers near the ankle may indicate a severe form of vascular disease that requires immediate medical treatment.
Which veins are affected?
The larger, shallower veins are more affected by venous disease because they deeper ones are firmly supported by the muscle structure and therefore do no develop varicosities.
Valves that leak blood could happen at any location of the legs, mostly caused by faulty valves in the groin region or behind the knees; both are sites/junctions for major blood flow on the superficial level and into the deeper veins. The flow in this region is controlled by a one-way valve which is structured to direct blood to the inner regions and larger veins and to the upper level, to lead the blood back to the heart.
Since the Saphenous vein is one of the main superficial veins in the thighs, it is the central dock of several smaller veins flowing into it. Extra blood that is forced into it through the leaks of the valves at the junctions stretches the vein further and distorts its balance and pressure which leads to further leaks from the main valve itself. This leads the blood wrongly further down the legs and finally to pool in the further branches of the veins, causing them to fill up with blood and make them look bulges, darker in color, and protruding.
Few patients develop varicose veins because of faulty valves.
What helps prevent varicose veins?
There are no fool-proof preventive measures to avoid varicose veins, though several changes in one’s lifestyle help build a healthy structure that would slow down the development of such abnormalities. Improving one’s circulation and muscle tone can reduce the risk of getting varicose veins or getting additional ones. Exercise like walking is a great way to improve blood circulation in your legs. Your doctor can recommend an appropriate exercise level for you.
Other helpful recommendations include: - Minimize the use of high heels, shoes with lower heels work calf muscles more.
- Any tight garments at the groin or calf region could interfere with blood flow.
- Elevate your legs three or four times a day for several minutes to improve circulation.
- Encourage blood flow through avoiding long periods of sitting or standing and make a point of changing your position frequently.
Maintain a healthy weight to take unnecessary pressure off your veins.
What are the risks of varicose veins?
To some, varicose veins are painful, and sometimes have the potential to lead to worse medical cases. Symptoms of varicose veins worsen as the vein anomalies increase. With the enlargement of the veins, their insufficiency increases and therefore other complication arise, such as blood clots, leg ulcers (breaks in the skin), bleeding, infection, and skin changes in the legs. Varicose veins also may signal a higher risk of other disorders of the circulatory system.
Pooling in the veins is caused by stagnation of blood from the spider and varicose veins, therefore they appear when the legs are placed below the heart and disappear or become lighter when elevated above the heart. The inability to lead the blood flow correctly up to the heart is known as ‘venous insufficiency’.
The most dangerous of cases are the ones including blood clots formed in these veins that become mobile and may move up to the lungs, becoming ‘emboli’ and then becoming a great danger of blocking the lungs or heart, resulting in death at times. High pressure blood flow causes the dislocation of several cells to settle into the extra-venular structures such as tissue surrounding the capillaries. The following breakdown of the deposited blood leads to it turning dark and rusty which reduces the transfer of nutrients and oxygen.
Are varicose veins treated during pregnancy?
Unless the varicose veins have caused major problems (phlebitis, severe inflammation or blood clots), we recommend postponing treatment until after delivery. Several of the varicose veins that appear during pregnancy disappear or recede after delivery and may require no further treatment.
We recommend that all pregnant women wear knee high stockings during the first and second trimesters and pantyhose compression during the third trimester.
What are spider veins?
Spider veins are small clusters of red or blue veins that appear near the surface of the skin. Spider veins are the thread-like colored veins most often seen on the surface of the skin. Spider veins occur most commonly in the legs but are often seen on the face and elsewhere. These spider veins, medically referred to as Telengeictasia, are of cosmetic concern to many women. They may sometimes cause of pain or burning sensation.
What are unwanted veins?
Unwanted veins are dilated and enlarged veins that may occur anywhere in the body and are unsightly to patients. These veins become prominent and bulging due to a several reasons. Weakening of the vein wall is a contributing factor. Other factors include thinning of the overlying skin and loss of elasticity that makes veins unsightly. Common locations for these unwanted veins are the hands, temple areas of the face, around the eyes, the breasts and the chest.
What causes varicose and spider veins?
The most important contributing factors are:
- Heredity
- Hormonal effects of estrogen and progesterone
- Pregnancy
This explains why most patients with vein problems give a strong family history of varicose veins. Also women, being subjected to the effects of estrogen more than men have a higher incidence of vein problems. It is estimated that 6 in every 10 women have bothersome spider or varicose veins.
We encourage you to ask questions. Please contact us.
Questions that are pertinent to the public will be added to this FAQ.
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