Growing up in a medical family, I heard about many physical problems, but the one that always makes me grin when I think back is “varicose veins.” At the time, I listened as my mother’s friend discussed her varicose veins. She even pointed out the bulging blue, gnarly veins at the back of her leg. That’s when my child-sized brain put two and two together and determined that the illness was called “very close veins.” Clearly, those veins were “very close” to her skin surface, I thought. What I didn’t realize was how painful and even dangerous varicose veins can be.
The term “varicose” means abnormally swollen and knotty, which describes varicose veins perfectly. Veins are naturally closer to the skin than arteries, and they are not as strong as arteries. As veins weaken or become damaged, varicose veins can result.
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Veins, of course, are responsible for bringing oxygen-depleted blood back to the heart. (Arteries carry oxygenated blood from the heart to our organs.) However, it’s a long gravity-defying trip from the legs to the heart. As the veins weaken, the blood can flow backward and accumulate in the veins. This puts pressure on the walls of the vein, causing bulging and, eventually, ugly, knotty-looking varicose veins.
Note: A cousin to varicose veins is spider veins. Like varicose veins, spider veins are caused by improper blood flow. Spider veins tend to be more red than blue, are much smaller, and usually less gnarled and less painful. Spider veins can also be caused by sun exposure and hormonal changes. Otherwise, causes and treatments for spider veins are similar to those for varicose veins.
Varicose Veins Beyond the Legs
The New York-Presbyterian Hospital/Weill Cornell Medical Center recently released a report about male infertility and varicose veins in the scrotum, technically called varicoceles. Varicose veins in the scrotum are responsible for 35 percent of primary male infertility. However, surgically treating the varicoceles can restore fertility and testosterone levels.
“People often forget or often don’t realize that the testes have two purposes,” says Marc Goldstein, Professor of Urology and Reproductive Medicine at Weill Cornell Medical College. “One is the production of the sex cells (sperm) and the other is to produce testosterone.”
Testosterone production is lowered when varicoceles become enlarged and twist around the testes. The condition can be hereditary and is found in 15 percent of all males. Varicoceles begin forming at puberty, but most doctors don’t screen patients during routine check-ups.
In his research, Dr. Goldstein observed that following varicocele removal, testosterone levels greatly improve in more than two-thirds of the men studied.
Varicose Veins Risk Factors
According to WomensHealth.gov, 50 percent to 55 percent of women and 40 percent to 45 percent of men suffer from a vein problem. Varicose veins affect over half of people ages 50 and over.
Risk factors for varicose veins include:
- Family history for weak veins
- Female gender
- High-heeled shoes
- Hormone replacement therapy, including birth-control pills
- Increasing age
- Lack of exercise
- Prolonged periods of sitting or standing
- Sun exposure (more for spider veins)
Note, however, the belief that crossing your legs can cause varicose veins is largely a medical myth.
Problems with Varicose Veins
Varicose veins are unsightly, but they can also cause discomfort. If they become red, swollen, warm, or painful, it’s important to see your doctor. Sores or ulcers on the veins, bleeding, a rash on your leg, or other changes in the skin on your leg also should be evaluated. Another often-ignored red-flag symptom is leg fatigue.
Blood clots can occur due to varicose veins, including superficial thrombophlebitis and deep-vein thrombosis. Blood clots can be fatal, so you’re wise to report any varicose veins symptoms to your doctor immediately.
Varicose Veins Treatments
The American Academy of Dermatology suggests that self treatment can be your initial therapy and a strong preventative tact, providing you’re not having any of the symptoms listed above and the varicose veins are not bad.
They suggest that you:
- Avoid soaking in the tub
- Elevate your legs
- Exercise to better blood circulation
- Lose weight
- Take a break from sitting or standing every 30 minutes and go for a short walk
True medical options for varicose veins include:
- Compression stockings
- Endovenous laser therapy (EVLT)
- Radiofrequency ablation
- Surface laser treatments
Compression stockings help keep the blood moving in your legs. Compression stockings are those thick bandage-like socks frequently seen on elderly patients and used after major surgery. Support pantyhose will not offer the pressure you need. For best results, you should be properly fitted for compression stockings by your physician with information on how much support you need. And, if your physician orders the stockings for varicose veins, there is a chance your insurance may cover the cost.
Endovenous laser therapy involves a local anesthetic, but the procedure can usually be done in the doctor’s office with a quick return to normal life. Basically, the physician uses a laser to heat the varicose vein, which causes it to shut. The vein will then fade away, although it may take a year. A repeat treatment is possible.
Radiofrequency ablation is very similar to endovenous laser therapy, except a catheter is used instead of a laser.
Sclerotherapy is probably the most common treatment for varicose veins. The doctor injects a chemical into the vein that causes the vein walls to seal shut. This stops the blood flow and turns the vein into scar tissue. It can take three to four months for the varicose veins to disappear, and repeat procedures are sometimes necessary. Anesthetics are not required for this procedure.
Laser treatments can be used on smaller varicose veins, although it will take several therapy session to see results. Properly done, a laser-treatment session lasts around 15 minutes. The varicose veins disappear after the treatments within a few months. Due to the heat involved, laser therapies can be painful.
Surgery can be the only option for very large varicose veins. Although there are several possible surgical procedures, they all involve removing the vein from the leg. Some techniques can be done with local anesthetics, while others involve general anesthesia and a longer recovery.
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