Varicose veins can affect anyone, regardless of age or gender. However, women are more likely to develop varicose veins, which can lead to significant health risks without the right type of varicose vein treatment in Houston. This article will provide a closer look at some of the reasons why women are more susceptible to varicose veins and venous insufficiency.
Quick Answer: Women develop varicose veins more often than men mainly because of hormones and pregnancy. Estrogen and progesterone relax the walls of the veins, so the one-way valves inside them are more likely to stretch and leak. Pregnancy adds extra blood volume and pressure from the growing uterus on the pelvic veins. Family history, long hours on your feet, weight gain and, in some women, faulty pelvic veins add to the risk. A venous duplex ultrasound shows which veins are leaking, and most are treated with short, minimally invasive office procedures.
Meet your vein specialist
Dr. Syed Raza, MD
Vascular & Interventional Radiology · Founder, Premier Vein & Vascular Center
Fellowship-trained interventional radiologist certified by the American Board of Radiology and the Royal College of Radiologists (UK). Former Chief of Interventional Radiology at UTMB Galveston and Memorial Hermann Memorial City, with 15+ years treating varicose veins, venous reflux and peripheral arterial disease.
Hormones
For many years, the best explanation for the elevated risk of varicose veins in women was simply that women have weaker veins than men do. More recently, research has indicated that weakness in the veins of the legs is highly attributable to the hormone progesterone, which women have much more of than men. The risk of varicose veins is highest in women when progesterone levels in the blood are high, such as during pregnancy, menstruation, or puberty. Additionally, the use of some hormonal birth control pills can worsen varicose veins.
Pregnancy
In addition to the hormonal fluctuations of pregnancy, there are other physical changes in the body that can put pressure on the veins and lead to venous insufficiency. During pregnancy, women will gain a substantial amount of weight, and the growing uterus will put direct pressure on the veins. There is also an increase in the amount of blood in the body during gestation, so the veins will become enlarged, even during the earlier months of pregnancy.
Fashion
One of the preventable causes of varicose veins often seen in women is poor fashion choices. Wearing high-heeled shoes inactivates the calf muscle pumps causing the veins to work harder when pumping blood back to the heart. Opting for supportive footwear can help to prevent varicose veins in women. If you do notice that your clothing choices are causing discomfort or other early signs of poor circulation, try wearing compression stockings to restore healthy blood flow in the lower body.
Why Are Varicose Veins More Common in Women?
Varicose veins form when the small one-way valves inside the leg veins stop closing properly. Blood that should be moving up toward the heart falls back down, pools in the lower leg and stretches the vein until it bulges and twists. Doctors call this backward flow reflux, and the condition it creates is chronic venous insufficiency.
Men and women develop reflux in the same way. What differs is how often the vein wall is exposed to things that make it stretch. A woman’s veins go through repeated cycles of relaxation with each menstrual cycle, during each pregnancy and again around menopause. Each cycle puts a little more strain on the valves. The factors described above, hormones, pregnancy and footwear, are the biggest contributors, but they are not the only ones, and several of them tend to stack together over a lifetime.
Other Risk Factors for Varicose Veins in Women
Family history
Inherited weakness of the vein wall is one of the strongest predictors we see in clinic. If your mother or grandmother had varicose veins, your chance of developing them is higher, and they may appear earlier in life.
Menopause and hormone therapy
Hormonal shifts do not stop after childbearing years. Some women notice new veins or worsening heaviness around menopause. Hormone replacement therapy, like hormonal birth control, can influence the veins and also slightly raises the risk of blood clots, which is worth discussing with your doctor if you already have vein disease.
Standing and sitting jobs
Nursing, teaching, retail, hospitality, hairdressing and long desk days all keep the calf muscles still for hours. Without regular calf contractions, pressure in the leg veins stays high and the valves are under constant load.
Weight changes
Extra abdominal weight raises pressure in the pelvic and leg veins and slows blood returning from the legs. Weight gained during pregnancy that remains afterward continues that effect.
Pelvic vein reflux
In some women, especially after more than one pregnancy, the veins in the pelvis around the ovaries and uterus also develop leaking valves. These veins can feed varicose veins in the vulva, upper inner thigh and back of the leg. They can also cause a dull pelvic ache that worsens with standing, a condition known as pelvic congestion syndrome. Varicose veins in unusual places, or veins that keep coming back after treatment, are a reason to look higher up.
| Risk factor | Why it affects the veins | What you can do |
|---|---|---|
| Progesterone and estrogen | Relax the vein wall so valves stretch apart | Discuss hormone options with your doctor if you have vein disease |
| Pregnancy | More blood volume plus pressure on pelvic veins | Compression stockings, walking, leg elevation |
| Family history | Inherited weakness in the vein wall | Earlier screening if symptoms appear |
| Long hours standing or sitting | Calf pump inactive, pressure stays high | Movement breaks, ankle pumps, compression on long shifts |
| High heels | Limit ankle movement and the calf pump | Supportive, lower-heeled shoes for daily wear |
| Pelvic vein reflux | Leaking pelvic veins feed leg and vulvar veins | Specialist evaluation if veins are in unusual places |
Symptoms Women Commonly Notice
Varicose veins are not only a cosmetic issue. Many women tell us their symptoms follow a pattern: better in the morning, worse by evening, and often worse in the days before a period or during hot weather.
- Heavy, tired or aching legs, especially after standing
- Swelling around the ankles that leaves sock marks
- Throbbing, burning or itching over the veins
- Night cramps and restless legs
- Visible bulging veins, or clusters of fine spider veins
- Veins in the vulva, buttock or upper inner thigh, often after pregnancy
- Brown discoloration or dry, itchy skin around the ankles in longer-standing cases
Spider veins on their own are usually a cosmetic concern, but a large patch of them around the ankle or inner knee can be a sign of reflux in a deeper vein that is not visible from the surface.
Varicose Veins During and After Pregnancy
Pregnancy is often when women first notice varicose veins, and it is one of the most common reasons we see younger patients. Veins that appear during pregnancy frequently improve over the first few months after delivery as blood volume and hormone levels return to normal. Veins that are still present or symptomatic several months after delivery are less likely to go away on their own.
During pregnancy, we generally recommend conservative care rather than procedures:
- Wear properly fitted, pregnancy-appropriate compression stockings
- Walk daily and avoid standing still for long periods
- Lie on your left side when resting, which reduces pressure on the main vein in the abdomen
- Raise your legs when sitting
- Stay well hydrated, especially in the heat
Pregnancy and the weeks after delivery also carry a higher risk of blood clots. A painful, swollen leg during this time should always be checked promptly.
Call 911 or seek emergency care if you have:
- Sudden swelling, pain, warmth or redness in one leg, especially during pregnancy, after delivery or while taking hormones
- Sudden shortness of breath, chest pain or coughing up blood
- Bleeding from a varicose vein that does not stop with firm pressure and raising the leg
- A hard, red, painful cord along a vein together with fever
How We Evaluate Varicose Veins in Women
Looking at the leg tells us that a problem exists, but not where it starts. At Premier Vein & Vascular Center, the evaluation is designed to find the source:
- Focused history. We ask about your symptoms and when they are worst, pregnancies, hormone use, previous clots, family history and your work routine.
- Examination. We look at your legs standing, check for swelling and skin changes, and note veins in the groin, vulva or back of the thigh that may point to a pelvic source.
- Venous duplex ultrasound. In our IAC-accredited vascular lab, this painless scan maps the deep and superficial veins, measures reflux and rules out blood clots. You can read more on our venous ultrasound page.
- Pelvic imaging when needed. If the pattern suggests pelvic vein reflux, additional imaging such as an MRI or a pelvic ultrasound may be recommended.
- A clear plan. We explain which veins are leaking, what can wait, what should be treated and in what order, including whether you should finish having children first.
Treatment Options for Women With Varicose Veins
Treatment works by closing the leaking veins so that blood reroutes through the healthy deep veins. The procedures we use are done in the office under local anesthesia, and most patients walk out and return to normal daily activity the same or next day.
- Vein ablation. Endovenous thermal ablation or non-thermal ablation seals the main refluxing vein from the inside through a single needle puncture.
- Sclerotherapy. A medication injected into smaller varicose and spider veins makes them close and fade over the following weeks.
- Ambulatory phlebectomy. Larger bulging surface veins are removed through tiny nicks that usually heal without stitches.
- Pelvic vein treatment. When leaking pelvic veins feed leg or vulvar veins, they can be closed from the inside through a small catheter, a procedure performed by interventional radiologists.
For women planning another pregnancy, we talk openly about timing. Symptoms can usually be managed with compression until your family is complete, although severe symptoms may justify treatment sooner.
What recovery is like
Most women are surprised by how quickly they are back on their feet. After an ablation, you walk out of the office and are encouraged to walk several times a day from the start, because movement keeps blood flowing well through the deep veins. A pulling or bruised feeling along the inner thigh or calf is common for a week or two and usually eases with walking and simple pain relief if your doctor approves it. Compression stockings are often worn for a short period afterward.
Desk work can usually resume within a day or two, and jobs that involve long hours of standing often within a few days. Strenuous exercise, heavy lifting and hot tubs are usually avoided for a short time. A follow-up ultrasound confirms that the treated vein has closed and the deep veins are clear. Leg heaviness and swelling often improve within weeks, while the appearance of smaller surface veins keeps improving over the following months, sometimes with a touch-up session of sclerotherapy.
Preventing New Varicose Veins
You cannot change your genes or your hormones, but you can reduce the daily load on your veins:
- Walk for at least 30 minutes most days to keep the calf pump strong
- Break up long periods of standing or sitting with ankle pumps and short walks
- Save high heels for shorter occasions and choose supportive shoes for daily wear
- Wear compression stockings on long shifts, flights and during pregnancy
- Keep a healthy weight and avoid very tight waistbands
- Raise your legs in the evening after a long day
When to See a Vein Specialist in Houston
If your legs ache or swell by the end of the day, if veins from pregnancy have not settled after several months, or if you have veins in the vulva or upper thigh, an ultrasound can show what is driving them. Houston heat often makes vein symptoms worse in summer, and many women first come to us after a season of swollen ankles. Dr. Syed Raza is a fellowship-trained interventional radiologist with more than 15 years of experience treating varicose veins and venous reflux. If you are looking for a Houston vein specialist, same-week appointments are usually available, and most insurance plans, including Medicare, are accepted.
Talk With a Specialist at Premier Vein
Have questions about your symptoms or treatment options? Dr. Syed Raza and the team at Premier Vein & Vascular Center can evaluate your concerns and explain your options clearly. Same-week appointments are usually available, and most insurance plans are accepted.
Frequently Asked Questions
Why do women get varicose veins more than men?
Hormones such as progesterone and estrogen relax the walls of the veins, which makes the valves more likely to leak. Pregnancy adds extra blood volume and pressure on the pelvic veins. Over a lifetime, these repeated strains make varicose veins more common in women.
Do varicose veins from pregnancy go away?
Many improve in the first few months after delivery as blood volume and hormones return to normal. Veins that are still visible or causing symptoms several months later are unlikely to disappear on their own and can be evaluated with an ultrasound.
Can birth control pills cause varicose veins?
Hormonal birth control can make existing varicose veins worse in some women, and estrogen-containing pills raise the risk of blood clots. If you have vein disease, it is worth discussing your options with your doctor.
Should I wait until I am done having children to treat varicose veins?
Often, yes, because new pregnancies can create new varicose veins. However, if your symptoms are significant, treatment before or between pregnancies is reasonable, and a vein specialist can help you weigh the timing.
What causes varicose veins in the vulva?
Vulvar varicose veins usually come from leaking veins in the pelvis, often after pregnancy. They may come with pelvic aching and can feed varicose veins in the inner thigh, so evaluation may include pelvic imaging.
Are varicose veins in women dangerous?
Most are not dangerous, but they can cause aching, swelling and skin changes over time, and they slightly raise the risk of superficial clots. Sudden swelling and pain in one leg needs urgent assessment to rule out a deep vein thrombosis.
Trusted Health Resources
- Chronic Venous Insufficiency, Society for Vascular Surgery
- Venous Insufficiency, MedlinePlus Medical Encyclopedia (NIH)
- Varicose Veins and Spider Veins, MedlinePlus (NIH)