Varicose Veins – Reducing the discomfort ——————————————————————————– Written by Jill Dunn – MHSc Complementary Medicine, Registered Naturopath, Registered Medical Herbalist, Registered Nurse (Non-practising) What are varicose veins and what causes them? Varicose veins are dilated, tortuous veins that may have their origin in the deep saphenous veins that run up the back and front of the legs.
The saphenous veins carry approximately 80 to 90% of the venous blood from the legs back towards the heart. When the varicosity originates in these deep veins the condition is termed “primary” varicose veins and “secondary” when they occur as a result of impaired blood flow in these veins. Varicose veins occur as a result of genetic weakness of the veins or their valves, or when there is pressure on the pelvic veins caused by pregnancy or excessive abdominal weight. During pregnancy, there is an increase in blood volume and hormonal changes that relax the walls of blood vessels and can result in varicose veins in the legs, vulva or rectum in those who are susceptible. Prolonged standing, or increased intra-abdominal pressure caused by repeated heavy lifting and straining associated with constipation, are believed to be important contributing factors.
Constant increased intra-abdominal pressure accompanied by weakness in the walls of the veins, causes veins to dilate and hinders the flow of venous blood. Within the veins are valves which assist in the return of blood (against gravity) towards the heart and when damaged, blood tends to pool and causes the veins to bulge and become varicosed. If the veins involved are near the skin surface, they pose little harm to health although the legs may feel heavy, tight and tired. Obstruction and valve defects in the deeper veins are more serious and can be diagnosed by ultrasound. This type can lead to problems such as deep vein thrombosis (associated with long flights).
What can you do to reduce the likelihood of varicose veins? Varicose veins are uncommon in parts of the world where the diet is unrefined and high in fibre. Low fibre diets result in smaller, harder bowel motions that are difficult to pass. Straining increases intra-abdominal pressure, which obstructs the flow of blood back up the legs, and overtime are believed to weaken the vein wall causing varicose veins and hemorrhoids, as well as diverticula (outpouchings) in the wall of the large intestine. A diet rich in flavonoids, particularly proanthocyanidin-containing foods such as blue berries, black berries, boysenberries and cherries helps strengthen blood vessel walls. Grapeseed extract, bilberry, hawthorn and rutin are prescribed by naturopaths and medical herbalists to help build vein strength and to relieve discomfort, although during pregnancy these should not be taken without professional advice.
A short-term study, used the bioflavonoid rutin (3g per day for 14 days) in a group of forty-two women with haemorrhoidal varicosities during the last trimester of pregnancy and immediately post partum, and found it to be efficacious in 95% of women, significantly reducing pain. In a European animal study, rutin taken during pregnancy was not found to cause teratogenic effects (birth defects)5 but because there is no safety data on use during pregnancy in humans, rutin should only be taken with the approval of your doctor, and then not during the first four months of pregnancy. Bilberry (Vaccinium myrtillus), which is available as a tincture from medical herbalists, has not shown an increase in frequency of malformation or other harmful effects on the foetus, despite consumption by a large number of women, and is considered compatible with breast feeding.
A sedentary lifestyle contributes to varicose veins and haemorrhoids; regular exercise such as walking or swimming causes contraction of the leg muscles and assists venous circulation. To increase pelvic circulation, carry out pelvic floor exercises twice daily throughout pregnancy and postpartum. If haemorrhoids are present, tighten and release the muscles around the anal sphincter up to 50 times in quick succession, to help firm up the muscle tone of the anal blood vessels. Carry out this exercise morning and night, while lying on your side with your knees drawn up towards your chest. Elevating the end of the bed, three to four inches, can also assist venous return during sleep. Squatting, standing for long periods and crossing of legs, which hinder venous return, should be avoided.
During pregnancy it is particularly critical that the diet is high in fibre. Fresh fruit and vegetables, dried fruit, legumes and whole grains are good sources of fibre, but when consuming dry foods high in fibre, adequate fluids are required. Fibre is like a sponge in that it absorbs water and bulks out and softens the contents of the bowel. If insufficient fluid is taken, the bowel contents will remain dry and hard. Natural bulking agents such as psyllium hulls, are useful for chronic constipation and are considered safe in that they have not been associated with foetal malformation. However, psyllium hulls have the potential to reduce absorption of non-haem iron6 (from vegetables) and therefore should only be used in the short-term and not by those with anemia. When varicose veins are already present in a pregnant woman, support hosiery (tights) and elevation of the feet are recommended to assist venous return as well as regular exercise, particularly walking or swimming. Distilled Witch hazel (Hamamelis) can be applied externally as a compress to problem areas to help ease discomfort. Soak a flannel in distilled witch hazel and apply to the area while feet are raised. Hamamelis cream, or Witch Hazel extract with a blend of geranium, cypress, rosemary and lemon oils can be applied externally in gentle upward strokes, up the legs when they feel heavy and achy. Products containing cypress oil should not be used until after six months gestation.
The biochemic cell salt Calc fluor, is a homeopathically prepared micro-dose of calcium fluoride that helps support the contractile power of elastic tissue found in blood vessel walls. Taken regularly Calc fluor helps strengthen varicose veins. Increasing the intake of vitamin E containing foods such as sunflower seeds and wheat germ, vitamin C-rich fruit and berries is also recommended.
The approaches above will not stop or prevent varicose veins during pregnancy, but assist in symptomatic relief of discomfort associated with them. Frequently following child birth varicose veins and the associated heavy, aching and sometimes itchy legs, settle on their own accord. Like everything in pregnancy, discuss with your midwife or doctor before self treatment.
References Trowell, H. Burkitt, D. and Heaton, K. 1985, Dietary fibre, fibre-depleted foods and disease. Academic Press. London. Vahouny, G. & Kritchevsky, D. 1982, Dietary fibre in health and disease. Plenum Press. New York. Murray, M. & Pizzorno, J. 1998, Encyclopedia of natural medicine. Little Brown. London. Benzi, G. Vanzulli, A. Pozzi, E. & Acerboni, S. 1992, Clinical study for the evaluation of the tolerability of o-(beta-hydroxy-ethyl)-rutoside in the treatment of hemorrhoids during the 3d trimester of pregnancy and in the postpartum period. [Italian], Minerva Ginecologica, 44(11), pp. 591-597. Preuss-Ueberschar, C. Ueberschar, S. & Grote, W. 1984, Reproduction toxicologic studies on rats following oral administration of benzopyrone preparations. [German]. Arzneimittel-Forschung, 34(10), pp. 1305-1313. Mills, S. Bone, K. 2005, The Essential Guide to Herbal Safety. Churchill Livingstone, London. Conover, E.A. 2003, Herbal agents and over-the-counter medications in pregnancy. Best practice & research clinical endocrinology and metabolism, 17 (2), pp. 237-251.