Why Do My Leg Veins Bulge and Hurt During PMS?

You see them on lots of people’s thighs and lower legs — colored, ropy protrusions that snake just beneath the skin. These are varicose veins. For many people, they’re merely an eyesore; for some, they indicate compromised vein health. Fortunately, treatments can help.

At Advanced Surgical Associates of Northern Minnesota, board-certified general surgeon Dr. John Bollins and our team diagnose and treat varicose veins at our three locations. 

Many women wonder why their varicose veins are worse just before or during their period. We address that here.

What’s chronic venous insufficiency (CVI)?

Your circulatory system is a closed loop. The heart pumps out oxygen-rich blood through the arteries to the body’s tissues. Once the cells take in the oxygen, the deoxygenated blood makes its way back to the heart through the veins.

The veins, though, are at a disadvantage; they must pump the blood upward toward the heart against the downward pull of gravity. 

The body helps the process in two ways: The calf and thigh muscles contract, forcing the blood forward. And the veins contain one-way valves that snap shut once the blood passes by, preventing backflow. Unfortunately, veins are delicate and easily damaged.

A blow to the leg or the force of high blood pressure can prevent veins from closing firmly, allowing blood to backtrack. It pools around the damaged valve and pushes out against the vein walls. If that happens in superficial veins, you see them as varicose veins.

CVI is a condition that occurs when blood flow in the veins stagnates. The flow is insufficient to meet the body’s oxygen and other nutrient needs.

Every year, about 1 in 50 adults with varicose veins develops CVI. Left untreated, that can progress to later stages of vein disease, such as edema (swelling in the tissues), deep vein thrombosis (blood clots in deep veins that can be life-threatening), and slow-healing leg ulcers.

Why do leg veins bulge during PMS?

Varicose veins are more common in women than men, in part due to the predominant female sex hormones estrogen and progesterone. These hormones regulate your menstrual cycle and support vein health — they help the vein walls relax to accommodate increased blood flow.

As the hormone levels rise before and during your period, their effect becomes more pronounced. The pressure inside the veins increases, worsening varicose vein symptoms like bulging, itching, pain, and heavy legs.

Bloating is another relatively common side effect of getting your period — your body retains more fluid than normal. This fluid puts additional pressure on the veins, making them more visible and painful.

Women’s hormones are intricately entwined with vein health, and not just during periods. Pregnant women, those taking oral contraceptives, and those going through menopause have a higher risk of developing varicose veins or having existing ones become more problematic.

Treating varicose veins

As we mentioned, varicose vein treatments can help solve the underlying problem and relieve symptoms. They include:

Sclerotherapy

The doctor injects an irritating solution into the vein, causing the vein walls to collapse. Your body breaks down and excretes the tissue, rerouting the blood through a healthy vein.

Venous ablation

Ablation uses heat from either a laser or radiofrequency energy to heat up and destroy the vein. As with sclerotherapy, your body breaks down and excretes the tissue.

VenaSeal®

VenaSeal is an injectable medical-grade adhesive that makes the vein walls stick together. The adhesive remains in the vein, so your vein isn’t removed, but your varicose veins disappear.

If you struggle with uncomfortable varicose veins before and during your period, Advanced Surgical Associates of Northern Minnesota can help. Call us in Hibbing, Duluth, or Hermantown, Minnesota, or schedule your appointment online today.

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