Based on recent comments on my most recent series on vulvar swelling/varicosities on social media, many had NEVER heard of vulvar varicosities UNTIL they were dealing with them themselves.
Even if they HAD dealt with them, they were never given an actual diagnosis, or strategies to help them manage their symptoms. They mostly were told, “it is just a nasty part of pregnancy and will go away after the baby comes”.
Well… you know how I feel about leaving people uninformed or embarrassed about normal things that can happen to their bodies without education or support. So, here we go with Part 1 of all things vein-y and vulvar-y.
So what exactly IS a vulvar /pelvic varicosity anyways?
A varicosity or varicose vein is an abnormally or markedly swollen or dilated vein. We tend to think of them in lower legs as those dark blue “buldgey” looking markings.
These dilated veins are more likely to occur in the lower body, but in pregnancy, with the changes in hormones (increased estrogen and progesterone), increased intra abdominal pressure, pelvic floor function, breathing mechanics, and posture we can also see them occur in the pelvis/suprapelvic region, groin, and into the vessels of the outer labia. Just lovely, right?
18-22% of pregnant people will experience some venous varicosities in the pelvis. (not just labial /vulvar but pelvis, and suprapubic/groin/ lower abdominal as well) So, if you thought you were the only one, think again. It is likely you are not the only person you know who has suffered with these! (1)
For many they do resolve post partum but for 4-8% they persist, and a vulva owners lifetime risk of a pelvic varicosity is 22-34%. (1)
Many symptoms of pelvic varicosities can mimic other pelvic conditions which is likely why they go undiagnosed and un treated so frequently. They can feel like heaviness, burning, pressure and swelling in the pelvis. They can cause vulvar hypersensitivity (vulvodynia) and painful penetration (dyspareunia) as well. Due to this, is not uncommon for a diagnosis of “pelvic pain” or “pelvic floor dysfunction” or even prolapse to proceed or prevent a proper diagnosis or treatment of pelvic/vulvar varicosities *.(1)
This is more common in cases that continue to be symptomatic post partum or later in life. When it progresses to this level it is sometimes referred to as “Pelvic Congestion Syndrome”
*Although pelvic floor dysfunction can be a major factor in the development and continuation of the condition*
If this is the case for you, finding a pelvic vein specialist may be a great option. There are many effective treatments for persistent pelvic vein issues and working with a team including a vein specialist and pelvic floor PT would be a great start.
Stay tuned for my next blog PART 2 all about how we can prevent and/or manage your vulvar /pelvic varicosities in pregnancy and beyond
(1) Sergey G Gavrilov, Vulvar Varicosities: Diagnosis, Treatment, and Prevention. International Journal of Womens Health. 28 June, 2017:9 463-475