What causes varicose veins in women's legs?

According to statistics, up to 20% of the population suffers from varicose veins of the lower limbs, and the incidence rate in women is twice that of women. It has been shown that women have other predisposing factors for decreased vascular tone (pregnancy, use of estrogen-progestin contraceptives, sex hormone imbalance).There is no difference in the type of treatment for varicose veins in the legs between men and women, but women have a higher frequency of postoperative recurrence due to the additional influence of hormones (the effects of estrogen and progesterone).

What causes varicose veins in women's legs?

Leg vein disease must be treated by a phlebologist who specializes in this pathology. Various methods of treating varicose veins are not curative because they do not aim to eliminate the primary cause of the disease - failure of the venous valve apparatus. Surgery and conservative treatment can slow the progression of the disease for a long time. The recurrence rate is as high as 10% to 50% 5 years after surgery.Treatment of varicose veins should be comprehensive. Methods of getting rid of varicose veins are divided into three groups:

• venous sclerosis,
• surgical,
• Conservative.

Each treatment method has its own advantages and disadvantages and a certain recurrence rate. The choice of method is conditional, as the phlebologist usually must combine all three methods to obtain the most favorable results.

Characteristic symptoms of varicose veins in women

Symptoms of varicose veins begin with the appearance of functional impairments such as a feeling of heaviness in the legs, swelling of the ankle joints at the end of the workday. Spider veins first form on the skin of the legs.Spider veins are one of the first symptoms of varicose veins in the legs. The main symptom of the disease - saphenous varicose veins - appears several years after the onset of the disease. If left untreated at this stage, symptoms such as calf muscle spasms and itchy skin on the legs may occur.Signs of nutritional diseases: hyperpigmentation of the skin in the lower third of the legs, cyanosis, sclerotic changes in the subcutaneous tissue, eczema, and the formation of nutritional ulcers.

Characteristic symptoms of varicose veins in women

• Pain symptoms appear periodically and worsen before menstruation, which is related to changes in sex hormone levels;
• During pregnancy, signs of varicose veins may disappear after delivery;
• In the second half of the menstrual cycle, due to the effect of progesterone, the diameter of varicose veins increases, so the symptoms of leg swelling and heaviness become more obvious.
• Symptoms of varicose veins may worsen during hormone therapy.

Now let’s talk about treatments.

Radiofrequency ablation and intravenous laser coagulation

intravenous radiofrequency ablation

The method is based on the introduction of a special disposable catheter into the lumen of the dilated vein under ultrasound guidance. The catheter is equipped with special electrodes, the working part of which is heated to 120 degrees under the influence of radiofrequency radiation. Advancing the catheter along the vein causes the vessel walls to stick, or "weld, " together. Occluded veins are excluded from the leg's circulatory system.

intravenous laser coagulation

The surgical technique involves puncturing the affected vein and inserting a laser light guide into its lumen under ultrasound control. Under the influence of laser radiation, the proteins in the walls of blood vessels coagulate, as a result of which the veins collapse and, after a period of time, connective tissue overgrows. Radiofrequency ablation (RFA) and endovenous laser ablation (EVLO) are relatively new methods of treating varicose veins in the legs. Despite the differences in execution techniques, they share common characteristics.

Advantages and Disadvantages of RFA and EVLA

No hospitalization required	high price
Execution speed (from 30 minutes to 1 hour)	The recurrence rate is as high as 10%
painless	Surgery is not possible due to certain anatomical features of the vein (severe tortuosity of the vessel)
No bleeding
Performed under local anesthesia
No scars after surgery (ideal cosmetic result for women)
Short recovery period

RFA or EVLO is suitable for women who want to treat varicose veins on an outpatient basis with minimal restrictions on physical activity after surgery while maintaining the appearance of their legs.

venous sclerotherapy

A special drug is injected into the lumen of the affected vein segment, causing a stiffening ("gluing") effect on the vessel wall. Hardeners can be used in liquid or foam form. Foam sclerotherapy should be given priority because of the larger contact area of this substance with the vein wall.Advantages and Disadvantages of Venous Sclerotherapy:

No scars after surgery	Long-term pigmentation of the skin at the puncture site may occur (up to 2 years)
Conducted in outpatient setting	In rare cases, inflammation of the veins (phlebitis) after surgery
Surgery is performed without anesthesia	Tissue swelling and redness 2 days after surgery
The operation is almost painless (there is a slight burning sensation at the puncture site)	Allergic reactions due to individual intolerance to a drug
	Spider veins (telangiectasia) develop in the legs in 20% of cases
	The recurrence rate is as high as 50%

Recurrence of varicose veins after sclerotherapy depends on the lumen of the affected vessel—the wider the lumen, the higher the risk of recanalization. Sclerotherapy is the treatment of choice for recurrent varicose veins after surgical phlebectomy.

surgical phlebectomy

Surgery is a more radical way to eliminate varicose veins. The principle of surgical treatment is to eliminate the pathological drainage from the deep to superficial veins of the leg and to remove the dilated blood vessels themselves. Stages of combined phlebectomy:

• Pass through and ligate the opening of the great saphenous vein (groin area incision) or the small saphenous vein opening (popliteal fossa incision);
• Removal of varicose venous trunks. It is performed using a special metal probe to pull the vein into an incision in the skin.

Radicality	Hospital stay 5 to 7 days
Possibility of surgery at any stage of the disease	There are scars on the legs
	spinal or general anesthesia
	Pulling on a vein can damage surrounding tissue
	Possible complications: bleeding, wound infection
	The recurrence rate is as high as 20%

When the great saphenous vein or the small saphenous vein has a large degree of varicose deformation, truncal lesions should be treated surgically. When signs of soft tissue dystrophy and symptoms of decompensated venous insufficiency appear.

venous resection

Phlebectomy is a separate surgical option that can treat varicose veins in the legs in the initial stages. It is most commonly used when there is a single varicose vein in the leg. A puncture is made in the skin of the lesion, the vein is pulled out and crossed with a hook. The surgery does not require general anesthesia or skin suturing.

Conservative treatment

It is necessary to start treating varicose veins in the legs with medications and pressure therapy.Prescribing drugs to improve blood circulation and wearing medical compression stockings are the main conditions that determine the outcome of surgical intervention on the veins of the leg.

Compression therapy

In cases where surgery is contraindicated, elastic compression of the legs is the mainstay of treatment. Elastic bandages and special medical knitwear are used as compression products: stockings, knee socks, tights. Medical products are highly durable, maintain their original level of compression for long periods of time, and are comfortable to wear, which is important for women.Stretch knitwear can be divided into 4 categories based on the degree of compression. Class 2 products are recommended for the treatment of varicose veins in the absence of disease progression for up to 6 months, with further use during physical activity or prolonged standing. If there are signs of deep vein valve damage or severe symptoms of compromised lymphatic drainage, a Level 3 jersey should be used until progression of varicose veins has ceased. The therapeutic effect of compression stockings is attributed to:

• Decreased venous capacity, resulting in less blood flowing into varicose veins;
• The absorption of tissue fluid into the blood increases, so signs of leg swelling and heaviness disappear;
• Improves blood flow and prevents blood clots from forming.

Varicose veins are one of the oldest diseases known to man. It is mentioned in the writings of Avicenna, Hippocrates, Paracelsus and other legendary healers, and Italian scientist Marcello Malpighi also devoted many years to research. The lesions can affect any organ with large veins (stomach, esophagus, testicles in men), but varicose veins in the lower limbs are most common. Let’s talk about the causes, diagnosis, and elimination of varicose veins in the legs.

About varicose veins of lower limbs

Varicose veins are irreversible dilation of veins due to damage to the valves involved in the venous circulation mechanism of the lower extremities. Under normal muscle contraction and relaxation, it moves vigorously upward from valve to valve, but when the vein dilatesThe valves stop closing and blood flow slows, which can lead to a range of clinical symptoms.According to statistics, people today suffer from symptoms of varicose veins in the legs:1 in 10 men and women aged 30 to 40. In terms of prevalence of the pathology, the leading countries are developed countries in Europe, where 30-40% of the population is diagnosed with the disease; varicose veins are least common in Africa and Asia (approximately 0. 1%).

Why it happens, risk factors

The exact cause of the disease is unknown, but most expertsleaning towards genetic theory: People who have varicose veins in their family are at risk. Factors that trigger the development of pathology also include:

• gender. Women are more likely to develop varicose veins than men - this is due to increased load on the veins during pregnancy and childbirth and the use of hormonal medications;
• Bad habits and being overweight. Smoking, abusing greasy food and drinking alcohol will have a negative impact on the blood circulation in the body, increase the load on the veins, and can cause corresponding disorders;
• working environment. People who by the nature of their occupation are forced to stand or sit still for long periods of time (barbers, salesmen, waiters, office workers) are more susceptible to this disease than others;
• excessive physical activity. Another group of people who are at risk for developing varicose veins are those who engage in strenuous labor or certain strenuous activities, such as weightlifting;
• Uncomfortable clothes or shoes. Tight, restrictive clothing and high heels can also worsen venous blood flow.

Classification

Most often (75-80% of cases) the disease affects the main trunk and branches of the great saphenous vein, 5-10% the small saphenous vein, and in 7-10% of patients both veins are involved in the process. In the clinical course of varicose veins of the lower limbs, experts distinguish two forms and four types.shape:

• decline– The process starts from its mouth and spreads from top to bottom along the great femoral vein;
• rise– The disease begins in the feet and is caused by a malfunction of the deep vein valve device.

group:

• Subcutaneous or intradermal pathology not affected by venous discharge;
• Segmental reflux via perforating and superficial veins;
• Extensive venous return (via superficial and perforating veins) is present;
• Dilation by deep venous return.

Depending on the degree of venous insufficiency, varicose veins are divided into four main stages:

• – Symptoms of disease may be present but cannot be determined by diagnostic methods;
• I - This stage is characterized by transient swelling, "heavy legs" syndrome and the appearance of "spider veins";
• II - persistent swelling, skin discoloration, eczema at night;
• III - Presence of trophic ulcers, including non-healing ulcers.

Dangers and complications

The risk to the patient's health and life is not caused by the disease itself, but by the complications it causes. These include compromised skin nutrition, which can lead toMay form trophic ulcers and erysipelas, and the most dangerous complication - thrombophlebitis. It leads to increased thrombosis, which causes blood clots to break away from vein walls, disrupting the function of internal organs and, in the most difficult cases, leading to death of the patient.Additionally, dilated vessels with thinner walls are at risk for mechanical damage, which may lead to severe bleeding.

symptom

The first symptoms of the disease are heaviness and fatigue in the legs, usually at night and relieved by lying down.Veins appear blue and protrude on the surface of the skin, giving rise to "spider veins"(a network of dilated capillaries visible through the skin), a characteristic sign is the disappearance of the vein pattern if the limb is raised higher (for example, on a chair).Over time, varicose veins become more visible and appearSmall nodules or large conglomerates appear.Even at night, unpleasant symptoms intensify and disturb the patient, appearingSoft tissue swellingThe most common are in the feet, legs and ankle areas, as well as a feeling of fullness in the legs and cramping in the calf muscles.Without proper treatment, varicose veins can get worseSkin becomes dry, bumps and dark spots appear, and subsequent trophic ulcer. As thrombophlebitis progresses, the veins become bright red, cord-like, and feel pinched and painful when palpated.

When should you see a doctor?

Many people ignore the first signs of varicose veins, attributing them to ordinary fatigue. This makes the treatment of the disease very complicated and can lead to the most serious consequences, soYou should contact a phlebologist as soon as symptoms of the disease appear.Persistent leg fatigue and heaviness, vein and skin color changes, swelling, spider veins, etc.

diagnosis

The diagnosis of "varicose veins of the lower extremities" is made after a comprehensive examination, including:

• General blood analysis– Coagulation disorders and the presence of inflammation can be judged by the number of red blood cells, platelets, white blood cells and hemoglobin levels;
• UltrasonographyRepresents the most effective method of identifying affected parts of blood vessels and veins;
• rheology angiographyIt is carried out to determine the deficiency of tissue nutrients in the blood (the so-called rheological index), on the basis of which the stage of the disease can be determined;
• venography, during which contrast material is injected into a vein and an X-ray machine is used to evaluate the condition of the venous system;
• Physiological tests(Troyanov-Trendelenburg test, Hackenbruch test) can determine the function of the superficial venous valve apparatus.

treat

In the initial stages of varicose veins, varicose veins can be treated with conservative methods: taking medications, using ointments and gels, wearing compression garments, and moderate physical activity. To correct cosmetic imperfections, patients may be advised to undergo minimally invasive surgery or laser treatment. In more advanced cases, varicose veins can be eliminated by surgery alone, and their type is chosen individually for each specific case.Varicose veins in the legs are a condition best prevented because they are difficult to cure. Therefore, every woman needs to know the causes and signs of such problems.

What are the dangers of varicose veins in the legs?

As the disease progresses early, many consider its worst sign to be swelling of the limbs. Unfortunately, this is not the case. The worst thing that can happen to a woman with varicose veins in her legs is death. In addition, the complications of the disease can be very different. The most common are:

• trophic ulcer;
• thrombosis;
• Phlebitis and thrombophlebitis.

Phlebitis is the process of damage to the lining of the veins. In this case, the leg swells more and the prominent blood vessels become hard on palpation. As phlebitis progresses, the patient's body temperature rises and every movement of the leg brings severe pain. Then phlebitis no longer turns into thrombophlebitis. In this condition, blood clots - small clots of stagnant blood - develop in the walls of the veins.Thrombosis is the formation of a blood clot in the absence of phlebitis. This problem is scary because it's nearly impossible to diagnose.attention! In most clinical cases, thrombus detached from the vessel wall is the cause of death. What's more, the process happens instantaneously (sometimes in just a few minutes), making it nearly impossible to identify a dislodged clot before circulation has stopped.Now you know what causes varicose veins in women’s legs. To prevent varicose veins, preventive measures need to be taken continuously. This is especially true for women who are genetically predisposed to the disease. To reduce your risk, you must engage in moderate physical activity, wear comfortable shoes, and avoid low blood pressure.

consequences and complications

There is no single course of varicose veins. The pathogenesis of varicose veins in different groups of people has individual characteristics. Varicose veins may be primary, that is, associated with congenital venous valve insufficiency and vessel wall weakness, which is almost always accompanied by reverse flow (regurgitation) of blood flow. Secondary (acquired), reflux occurs several years after the onset of the disease.What are the dangers of varicose veins in women’s legs? Varicose veins have a tendency to develop; as varicose veins develop, the symptoms of the disease will worsen if conservative treatment is not taken. The feeling of heaviness in the legs is replaced by persistent swelling, in which case tissue damage occurs and open trophic ulcers develop, with the result that the person is completely incapacitated and requires ongoing maintenance treatment.

treatment at home

Many women wonder how to treat varicose veins in female legs at home? Therapeutic exercise, herbal medicine and some healthy lifestyle advice for people with varicose veins will help relieve the symptoms of the disease and prevent its further progression.

therapeutic exercises

Simple varicose vein exercises need to be performed every morning and evening:

• Lie on your back with your legs raised vertically, leaning against a wall at a 90° angle. Stay in this pose for 3 minutes, breathing slowly through your chest, not your belly.
• Lie on your back and perform cycling exercises for 3 to 5 minutes.
• While standing, lift your feet with your toes, 1 cm above the ground, and then lower them. Do this 30 times both ways.
• While standing, alternately lift one heel off the ground and then the other heel to an angle of no more than 45 degrees. Start with 15 minutes a day and increase to 30 minutes.

You should make time for a walk every day, at least 30 minutes. Going to the pool once a week can be helpful.

folk remedies

Herbal mixture for internal use: Mix 1 tablespoon each of birch buds, motherwort, thread, calamus root, coltsfoot, and thyme.Pour boiling water into half a cup of the mixture and heat in a water bath for 40 minutes. Let it brew and filter. Drink 0. 5 cups before each meal for a month.Make a compress with homemade ointment:

• Mix half cup of curd with freshly chopped mugwort leaves. Apply to the diseased vein, secure it with gauze and cover it with a film. Keep it up for 30 minutes every day.
• Grate the beets on a fine grater, add 2 tablespoons of melted honey, stir, cool and apply to sore feet.

To eliminate swelling at night, apply fresh cabbage leaves to your ankles, piercing them with a fork until the juice appears. Secure with a bandage.

Anticipation and preventive measures

Ever since I had varicose veinsis an irreversible process, in this case there is no need to talk about complete recovery. But with prompt diagnosis, adequate treatment and prevention, patients can be completely free of unpleasant symptoms and live a fulfilling life.Preventive measures for varicose veins includeHealthy lifestyle, proper nutrition and elimination of bad habits. People who are forced to maintain the same posture for a long time due to professional activities should avoid crossing their limbs and perform simple exercises from time to time, bending and straightening their legs, and performing light massage to improve blood circulation.In your free time, walk in the fresh air as much as possible and engage in moderate physical activity.A woman who follows fashion or work dress codes and frequently goes toHigh heel, you should change your shoes from time to time to get more comfortable shoes.Also applies touncomfortable clothesBecause even tight underwear can cause poor blood circulation in women's legs and cause varicose veins.Nowadays, varicose veins of the lower extremities are considered a common disease, but often do not receive enough attention.It's very important to remember thisNot paying attention to foot health can damage not only a person's ability to work, but also his life, and in the initial stages, varicose veins can be corrected very successfully using the simplest methods.