Vulval varicosities during pregnancy

31 Aug Vulval varicosities during pregnancy

During pregnancy, vulval varicosities are very common. They happen when the veins in the vulva become engorged and swell.

They may present as:

• Swelling, ache, heaviness or bump around the vagina and vulval region

They are often due to:

• the extra blood volume in your body
• hormonal changes causing the relaxing of large veins
• hormonal changes causing softening of the connective tissue
• ongoing growth and increased weight of your baby, placing pressure onto the perineum/pelvic floor
• constipation during pregnancy – straining

How can you manage or prevent this condition?

• Firstly – DO NOT PANIC – in most cases vulval varicosities will completely resolve and tissues will return to normal with the following management (and prevention!) strategies and with time
• Avoid prolonged ‘static’ standing – ‘static’ standing can cause blood flow/fluid in veins to slow, and can exacerbate the feeling of heaviness
  • Try to walk around, alternate sit and standing
• Adopt resting positions across the day – antigravity positions, where the perineum/pelvic floor (ie. floor of your core) is ‘offloaded’.
  • This can significantly reduce your symptoms, even if you adopt these positions for 5-10 minutes, a few times a day.
  • In these positions, you can complete a few gentle pelvic floor squeezes to help with blood flow

(only complete pelvic floor squeezes if you know you are activating correctly – see previous blogs re this!)

• Ice
  • Try wetting regular pads, then freezing them
  • Once frozen, place a tissue or wipe over the top and insert into your undies.
  • Ice for 15 every 2-3 hours (approximately) – even 1x a day may help eg in evening
  • Remember – ice when you have time to rest/stay relatively still, we do not want rubbing/irritation to the area
• Avoid deep squats, lifting heavy items, or any activity that causes you to tense your body/hold your breath – as these can cause further downward forces onto the perineum.
  • If you are able, ‘pre-squeeze’ your pelvic floor before doing any of the above activities. This can lessen the load onto the pelvic floor and perineum
• Avoid constipation and straining to empty your bowels
  • You can use hand pressure to support the vulva area and perineal area while emptying your bowels to help
  • Speak to a professional if straining to empty your bowels to put a plan in place to help manage and prevent constipation