Vulvar varices are characterized by the dilation of the diameter of the veins located at the level of the vulva. Various factors favor the appearance of this vascular disease.
Vulvar varices are characterized by the dilation of the diameter of the veins located at the level of the vulva. Various factors favor the appearance of this vascular disease, such as hormonal changes (pregnancy, menopause), venous insufficiency chronic or pelvic congestion syndrome. Of the effective and natural solutions exist to relieve pain and discomfort caused by varicose veins, such as veinotonics, wearing compression pants or applying cold.
What are vulvar varices?
Vulvar varices are dilated veins that appear at the level of the vulva (labia majora external). Vulvar varices are not not always visible to the naked eye. When visible, the vein may be swollen, bluish, blistered or tortuous.
What does it look like ?
Vulvar varices can take several forms:
- The dilation is bluish, the venous wall is soft and depressible;
- The vein is swollen unilaterally (on a single outer lip);
- The vein is abnormally dilated, causing the lip to protrude.
“It’s a taboo subject and difficult to discuss”
Symptoms of vulvar varices
Vulvar varices are uncomfortable or really disabling on a daily basis. The main symptoms are:
- A feeling of heaviness in the pelvis and vulva;
- Of the itching sometimes strong;
- A swollen vulva feeling ;
- Pain that may be unbearable when standing;
- Of the difficulty walking or to raise the legs;
- Exacerbated pain during sexual intercourse or during menstruation.
Some women have no symptoms, vulvar varices may be asymptomatic. “It’s a taboo subject and difficult to talk about. In addition, a vulvar varices is not always visible when lying down, hence the importance of auscultation while standing during the gynecological consultation or with the midwife”, says Emmanuelle Santos, founder of Herapreg, a company whose vocation is to provide concrete solutions to these pains.
What are the causes of vulvar varices?
The main causes of vulvar varices are venous reflux, THE obstacles to pelvic venous drainage and hormonal variations; that’s why they mainly appear during pregnancy. When they occur at the time of menopausethey are caused by hormonal disruption, but also by a loss of tone in the vein walls.
During pregnancy: why, what to do?
THE vulvar varices affect between 7 and 10% of pregnant women while pelvic congestion syndrome (chronic pelvic varices) affects ⅓ of multiparas (women who have already had one or more children) with chronic pelvic pain. This phenomenon is explained by hormonal upheaval, associated with an increase in blood volume during pregnancy. They occur most often around the 3rd month of pregnancy, to disappear after delivery in 3 to 5 weeks, in 90% of cases. Vaginal delivery remains possible in case of vulvar varices, complications remaining rare. There compression pants relieves pain and feelings of heaviness of vulvar and pelvic varicose veins, thanks to the compression of blood flow. She has one mechanical action by lightly compressing the labia majora and the lower abdomen. Compression panties allow affected women to stand longer without discomfort. The natural gestures listed below are also effective in quickly relieving varicose veins during pregnancy. In the case of pregnancy, multiparity or an already existing venous insufficiency promotes the appearance of vulvar varices. They usually disappear after childbirth and therefore do not require any exploration. If not, you should talk to your doctor. If vulvar varices persist after childbirth, it is necessary to check for the presence and extent of pelvic varices (dilated veins in the pelvis, i.e. the small pelvis), via a medical imaging examination. “Women affected by persistent vulvar varices probably have pelvic varices”, says Emmanuelle Santos.
pelvic congestion syndrome
Pelvic congestion syndrome is characterized by presence of veins located in the small pelvis which become encumbered with blood, expand and twist, they do not systematically cause varicose veins in the vulva. The symptoms are different depending on the location of the varicose veins:
- Ovaries: pain and heaviness;
- Rectum: hemorrhoids and digestive disorders;
- Bladder: symptoms similar to those of cystitis;
- Vagina: pain during sexual intercourse.
Since the symptoms of pelvic congestion are very similar to those of endometriosis, many women undergo a medical wandering that is sometimes very long and very difficult to live with. “Fortunately, the SCP France patient association and many health professionals aspire to make this syndrome better known in order to improve the care and care pathway for the women concerned”, confesses Emmanuelle Santos. To make the diagnosis of pelvic congestion syndrome and the distinguish from endometriosis, the medical examination is essential. In a second step, a pelvic Doppler ultrasound will take place to visualize and note the presence of varicose veins in the pelvis.
► Venotonics: A venotonic treatment, also called phlebotropic drugs, is indicated to strengthen the venous wall. These medications can be effective in relieving pain associated with chronic venous insufficiency.
► Tights and compression stockings: In the case of vulvar varices, tights or compression stockings are ineffective in compressing the vulvar area. Nevertheless, they help to improve venous return: they are therefore highly recommended.
► Physical activity: When possible, regular physical activity is the best remedy, as it improves venous return and increases the threshold of resistance to pain. Walking is one of the best activities to do when you start to be bothered by vulvar varices.
► Physiotherapy: It helps to improve venous return and reduce pain in the perineum.
Embolization treatment when varicose veins persist
When the vulvar varices persist, they may be an indication for treatment by embolization, except during pregnancy. “Embolization is a minimally invasive technique : thanks to a puncture at the fold of the groin, we explore the venous network. The objective is to block specific communications with the veins of the labia majora so that the varicose veins are no longer symptomatic and, at the very least, to limit the pain and the impact on the lives of patients”. says Doctor Quentin Sénéchal, interventional radiologist. “The treatment by embolization offers two different techniques. In case of isolated vulvar varices, we inject a sclerosing agent in order to destroy the venous wall (Sclerotherapy). If it is pelvic congestion syndrome, venous reflux or varicose veins inside the pelvis, around the genitals, we perform an embolization. We remove all communication with the vulvar veins and varices to reduce the swelling and ensure that they are no longer symptomatic.” THE type of anesthesia depends on the technique embolization used. “The objective is to succeed in getting patients out of the circle of chronic pain, which is taken into account when choosing the type of anesthesia and post-embolization management, explains Doctor Sénéchal. The treatment lasts between 30 to 60 minutes, depending on the technique used. There post-operative pain is very variable from one patient to another. Taking analgesics is part of the treatment, as is home nursing care. “After embolization treatment, it is essential to hydrate properly and to walk, says the medical specialist. This syndrome is not so rare: in our office (Saint-Denis), we have about 1,000 patients per year and about 300 embolizations each year.” Embolization is part of a comprehensive care, with physiotherapy of the pelvispsychological treatment if the repercussions are strong, EMDR sessions (eye movement therapy) or even sophrology. “We also use compression panties. Support is also nutritional: patients may encounter digestive problems, such as diarrhea or constipation. Nutritional advice, including an anti-inflammatory diet with sometimes a vitamin supplementation necessary in some cases, is therefore part of the treatment.”
What to do in case of painful vulvar varices?
The compression panties are a revolutionary accessory for women suffering from this venous condition. “I started from a simple observation: a gesture effectively and immediately relieves all women with pelvic or vulvar varicose veins: compression. We then designed compression panties (Pelvinity) to eliminate the sensations of heaviness at the level of the vulva and lower abdomen. These panties are adjustable thanks to elastic straps and can be worn discreetly over everyday underwear. explains Emmanuelle Santos. In addition, these compression panties not only relieve women with vulvar or pelvic varicose veins, they also works in case of genitourinary prolapsecommonly called “organ descent“. By providing comfortable support to the pelvic floor, it provides relief from uncomfortable feelings of heaviness,” says the founder of Herapreg.
- Application of cold;
- Raising the feet of the bed and the legs at rest;
- Massages from bottom to top (except on varicose veins);
- walking;
- Avoid tight clothing, sun exposure, crossing your legs or cross-legged.
Thanks to Emmanuelle Santos, founder of Herapreg and creator of the Pelvinity compression pants and to doctor Quentin Sénéchal, interventional radiologist.