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What causes varicose veins in women's legs?

According to statistics, up to 20% of the population suffers from varicose veins in the lower extremities, while in women the disease occurs 2 times more often. It has been proven that women have additional predisposing factors that contribute to a decrease in vascular tone (pregnancy, taking estrogen-progestin contraceptives, imbalance of sex hormones).Types of treatment for leg veins do not differ between men and women, however, the frequency of postoperative relapses in women is higher due to the additional influence of hormones (estrogenic and progesterone influence).

varicose veins on women's legs

What causes varicose veins in women's legs?

Venous diseases of the legs should be treated by a phlebologist who specifically deals with this pathology. Various methods of treating varicose veins are not radical, since they are not aimed at eliminating the main pathogenic cause - the failure of the valvular apparatus of the vein. Surgical and conservative treatment delays the progression of the disease for long periods. The recurrence rate is high and reaches 10 to 50% 5 years after surgery.

The treatment of varicose veins must be comprehensive. There are three groups of methods to eliminate varicose veins:

  • phlebosclerosant,
  • surgical,
  • conservative.

Each type of treatment has its own advantages and disadvantages and a certain relapse rate. The choice of method is conditional, since the phlebologist often has to combine all three methods to achieve the most favorable result.

Characteristic symptoms of varicose veins in women.

The symptoms of varicose veins begin with the appearance of functional disorders such as a feeling of heaviness in the legs and swelling of the ankle joints at the end of the workday. Spider veins form first in the skin of the legs.

Spider veins are one of the first symptoms of developing varicose veins in the legs. The main signs of the disease (associations of saphenous varicose veins) appear several years after the onset of the disease. If not treated at this stage, symptoms such as cramps in the calf muscles and itchy skin on the legs occur.

Signs of trophic disorders: pigmentation of the skin in the lower third of the leg, cyanosis, sclerotic changes in the subcutaneous tissue, eczema, against which a trophic ulcer is formed.

Characteristic symptoms of varicose veins in women.

  • Painful symptoms appear cyclically and intensify before menstruation, which is associated with changes in the level of sex hormones;
  • During pregnancy, signs of varicose veins may disappear after childbirth;
  • in the second half of the menstrual cycle, due to the action of progesterone, the diameter of the varicose veins increases, so the symptoms of swelling and heaviness in the legs are more pronounced;
  • Signs of varicose veins worsen during hormone therapy.

Now let's talk about therapy methods.

Radiofrequency ablation and intravenous laser coagulation.

Radiofrequency ablation of veins.

The method is based on the introduction, under ultrasound guidance, of a special disposable catheter into the lumen of the dilated vein. The catheter is equipped with a special electrode, the working part of which is heated to 120 degrees under the influence of radio frequency radiation. The advancement of the catheter along the vein leads to gluing or "welding" of the vascular wall. The obliterated veins are excluded from the circulatory system of the legs.

Intravenous laser coagulation

The surgical technique consists of puncture of the affected vein and insertion of a laser light guide into its lumen under ultrasound control. Under the influence of laser radiation, the proteins of the vascular wall coagulate, as a result of which the vein collapses and after some time becomes covered with connective tissue. Radiofrequency ablation (RFA) and endovenous laser obliteration (EVLO) are relatively new methods of treating varicose veins in the legs. Despite the differences in execution techniques, they have common characteristics.

Advantages and disadvantages of RFA and EVLA

Does not require hospitalization High price
Execution speed (from 30 minutes to 1 hour) Relapse rate up to 10%.
Without pain Impossibility of performing the procedure due to certain anatomical characteristics of the veins (severe tortuosity of the blood vessels)
Bloodless
Performed under local anesthesia.
Absence of postoperative scar (desirable cosmetic effect for women)
Short rehabilitation periods

RFA or EVLO is chosen by women who want to treat varicose veins on an outpatient basis with minimal restriction of physical activity in the postoperative period and maintaining the aesthetic appearance of their legs.

Phlebosclerotherapy

A special drug is injected into the lumen of the affected segment of the vein, which has a sclerosing ("gluing") effect on the vascular wall. The sclerosing agent can be used in liquid form or in foam form. Preference should be given to foam sclerotherapy due to the larger contact area of the substance with the vein wall.

Advantages and disadvantages of phlebosclerotherapy:

No postoperative scar Possible long-term pigmentation of the skin at the puncture site (up to 2 years)
Performed on an outpatient basis In rare cases, postoperative inflammation of the vein (phlebitis)
The operation is performed without anesthesia. Swelling and redness of the tissues for 2 days after the procedure.
The manipulation is practically painless (a slight burning at the puncture site) Allergic reaction due to individual intolerance to the drug.
In 20% of cases, spider veins appear on the legs (telangiectasias).
Relapse rate of up to 50%.

The recurrence of varicose veins after sclerotherapy depends on the lumen of the affected vessel: the wider the lumen, the greater the risk of recanalization in it. Sclerosing therapy is chosen in the treatment of recurrent varicose veins after surgical phlebectomy.

surgical phlebectomy

Surgery is a more radical way to eliminate varicose veins. The principles of surgical treatment are to eliminate the pathological discharge of blood from the deep to the superficial veins of the legs and to eliminate the dilated vessels themselves. Stages of combined phlebectomy:

  • Cross and ligate the mouth of the great saphenous vein (incision in the groin area) or the small saphenous vein (incision in the popliteal fossa);
  • Removal of trunks of varicose veins. It is performed using a special metal probe that inserts the vein into the skin incision.
Radicality Hospitalization for 5 to 7 days.
Possibility of performing surgery at any stage of the disease. Scar on legs
Spinal or general anesthesia.
Injury to surrounding tissues when a vein is removed
Possible complications: bleeding, wound infection.
Relapse rate of up to 20%.

It is preferable to treat trunk-type lesions surgically, when varicose deformation of the large or small saphenous veins occurs to a significant extent. And also when there are signs of trophic disorders of soft tissues and symptoms of decompensation of venous insufficiency.

Miniphlebectomy

Miniphlebectomy is a stand-alone surgical option that can treat varicose veins in the legs in the early stages. It is most often used in the presence of single varicose veins in the legs. A puncture is made in the skin over the pathological formation and the vein is removed and crossed with a hook. The operation does not require general anesthesia or skin sutures.

Conservative therapy

It is necessary to start the treatment of varicose veins in the legs with the use of medications and compression therapy.The prescription of medications that improve blood circulation and the use of medical compression stockings are the main conditions that determine the result of any surgical intervention on the veins in the legs.

Compression therapy

Elastic compression of the legs is the main method of treatment in cases where surgery is contraindicated. Elastic bandages and special medical knitwear can be used as compression products: stockings, knee-high socks, stockings. Medical products are very durable, maintain the original level of compression for a long time, and are comfortable to wear, which is important for women.

There are 4 types of elastic knitwear according to the degree of compression. Treatment of varicose veins with class 2 products is recommended in the absence of disease progression for a maximum of 6 months and with their additional use during physical activity or during a prolonged stay. If there are signs of damage to the deep vein valves or severe symptoms of poor lymphatic drainage, class 3 tees are prescribed until the progression of varicose veins stops.

The therapeutic effect of compression stockings is due to:

  • a decrease in the volume of the vein, which leads to less blood discharge into the varicose vessels;
  • increased absorption of tissue fluid into the bloodstream, due to which signs of swelling and symptoms of heaviness in the legs disappear;
  • improve blood flow, which prevents the formation of blood clots.

Varicose veins are one of the oldest diseases known to humanity. Mentions of it are found in the works of Avicenna, Hippocrates, Paracelsus and other legendary healers, and the Italian scientist Marcello Malpighi dedicated many years to the study of it. The pathology can affect any organ where there are large veins (stomach, esophagus, male testicles), but varicose veins of the lower extremities are the most common. Let's talk about the causes of varicose veins in the legs, methods for diagnosing and eliminating them.

About varicose veins of the lower extremities.

Varicose veins are an irreversible dilation of the veins due to the alteration of the valves involved in the circulatory mechanism of the veins of the lower extremities. With normal muscle contraction and relaxation, it moves vigorously upward from valve to valve, but when the vein dilatesvalves stop closing and blood flow slows, leading to a variety of clinical symptoms.

According to statistics, today people suffer from the symptoms of varicose veins in the legs: one in ten men and one in three women between 30 and 40 years old. Among the leading countries in terms of prevalence of pathology are the developed countries of Europe, where between 30 and 40% of the population are diagnosed; Varicose veins are less common in Africa and Asia (about 0. 1%).

Why it appears, risk factors.

The exact causes of the disease are unknown, but most expertsIt leans towards the hereditary theory.: People who have had cases of varicose veins in their family are at risk. Factors provoking the development of pathology also include:

  • gender. Women are more susceptible to varicose veins than men; This is due to the increased venous load during pregnancy and childbirth, as well as taking hormonal medications;
  • Bad habits and excess weight.. Smoking, abuse of fatty foods and alcohol have a negative impact on blood circulation in the body, increase the load on the veins and can cause corresponding disorders;
  • working conditions. People who, due to the nature of their profession, are forced to stand or sit motionless for a long time (hairdressers, salespeople, waiters, office workers) suffer from this disease more often than others;
  • excessive physical activity. Another category of people who are at risk of developing varicose veins are those who do heavy physical work or certain strength sports (for example, weight lifting);
  • uncomfortable clothes or shoes. Tight, restrictive clothing and high-heeled shoes also contribute to the deterioration of venous blood flow.

Classification

Most often (in 75-80% of cases), the disease affects the trunk and branches of the great saphenous vein, in 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 extremities, experts distinguish two forms and four groups.

Shapes:

  • descending– the process extends from top to bottom along the large femoral vein, starting from its mouth;
  • ascending– the disease begins in the foot and is caused by a malfunction of the valvular apparatus of the deep veins.

Groups:

  • subcutaneous or intradermal pathology not burdened by venous secretion;
  • segmental with reflux through the perforating and superficial veins;
  • generalized with venous reflux (through superficial and perforating veins);
  • Dilation with reflux through the deep veins.

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

  • – symptoms of the disease may be present, but are not determined by diagnostic methods;
  • I - this stage is characterized by transient swelling, "heavy legs" syndrome and the appearance of "spider veins";
  • II - appearance of persistent swelling that appears at night, skin discoloration, eczema;
  • III - the presence of trophic ulcers, including non-healing ones.

Danger and complications.

The risk to the patient's health and life is not posed by the disease itself, but by the complications it causes. These include poor nutrition of the skin, which causesTrophic ulcers and erysipelas can form., as well as the most dangerous complication - thrombophlebitis. It leads to increased thrombus formation, as a result of which blood clots, breaking off from the venous walls, can disrupt the functioning of internal organs and, in the most difficult cases, lead to the death of the patient.

Additionally, dilated vessels with thinner walls are at risk of mechanical damage that can lead to serious bleeding.

Symptoms

The first symptoms of the disease are heaviness and fatigue in the legs, which usually appear at night and decrease when lying down.Veins acquire a bluish tint and stand out on the surface of the skin, "spider veins" appear(a network of dilated capillaries visible through the skin), and a characteristic sign is that the venous pattern disappears if the extremities are elevated higher (for example, if placed in a chair).

Over time, varicose veins become more pronounced and appearappearance of small nodules or large conglomerates.

Unpleasant symptoms intensify and bother patients even at night, appearsoft tissue swellingmost frequently in the area of the feet, legs and ankles, as well as a feeling of fullness in the legs and cramps in the calf muscles.

In the absence of adequate treatment, varicose veins progress.the skin becomes dry, lumps and dark spots appearand later trophic ulcers. With the development of thrombophlebitis, the veins become bright red, cord-shaped and painfully compacted on palpation.

When should you see a doctor?

Many people ignore the first signs of varicose veins and attribute them to habitual fatigue. This greatly complicates the treatment of the disease and can lead to the most serious consequences, soYou should contact a phlebologist immediately after the symptoms of the disease appear.Constant feeling of fatigue and heaviness in the legs, changes in the color of veins and skin, swelling, spider veins, etc.

Diagnosis

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

  • general blood tests– by the number of red blood cells, platelets, leukocytes and hemoglobin level, blood coagulation disorders and the presence of inflammation can be judged;
  • ultrasonographyrepresents the most effective method to identify affected vessels and vein sections;
  • rheovasographycarried out to determine the lack of nutrition of tissues with blood (the so-called rheographic index), from which the stage of the disease can be determined;
  • phlebography, during which a contrast agent is injected into the veins, after which the state of the venous system is assessed using an X-ray machine;
  • physiological tests(Trojanov-Trendelenburg test, Hackenbruch test) allow judging the functioning of the valvular apparatus of the superficial veins.

Treatment

In the initial stages of varicose veins, it can be combated with conservative methods: taking medications, using ointments and gels, using compressive clothing and moderate physical activity. To correct cosmetic defects, patients may be recommended minimally invasive surgery or laser treatment. In more advanced cases, varicose veins can be removed only by surgery, and their type is selected individually for each specific case.

Varicose veins in the legs are a disease whose appearance is better to prevent, because it is quite difficult to cure. Therefore, every woman needs to know the causes and signs of such a problem.

What are the dangers of varicose veins in the legs?

With the early development of the disease, many believe that its worst manifestation is the appearance of a swollen limb. Unfortunately, it is not. The worst case scenario for the development of varicose veins in the legs in women is death. In addition, the complications of the disease can be very different.

The most common are:

  • trophic ulcers;
  • thrombosis;
  • phlebitis and thrombophlebitis.

Phlebitis is the process of damage to the inner walls of a vein. In this case, the leg swells more and the protruding vessels become hard on palpation. With further development of phlebitis, the patient's body temperature rises, and each movement of the leg causes severe pain. And then the phlebitis stops turning into thrombophlebitis. In this case, blood clots appear on the walls of the veins, small clots of stagnant blood.

Thrombosis is the formation of blood clots in the absence of phlebitis. This problem is scary because it is almost impossible to diagnose.

Attention! A thrombus detached from the vessel wall is the cause of death in most clinical cases. Furthermore, this process occurs instantly (sometimes within minutes) and it is almost impossible to recognize a dislodged blood clot before it stops blood circulation.

Now you know what the causes of varicose veins in women's legs are. To prevent varicose veins it is necessary to constantly take preventive measures. This is especially true for those women who have a hereditary predisposition to the disease. To reduce the risk of suffering from the disease, it is necessary to carry out moderate physical activity, wear comfortable shoes and avoid hypotension.

Consequences and complications.

There is no single course of varicose veins. Different groups of patients have individual characteristics of the course of the disease associated with the pathogenesis of varicose veins. Varicose veins can be primary, that is, associated with congenital insufficiency of the venous valve and weakness of the vascular wall, which is almost always accompanied by reverse blood flow (reflux). And secondary (acquired), when reflux develops several years after the onset of the disease.

What are the dangers of varicose veins in the legs of women? Varicose veins have a tendency to progress, as they develop and in the absence of conservative treatment, the symptoms of the disease worsen. Heaviness in the legs is replaced by persistent persistent swelling, against the background of which tissue damage develops, open trophic ulcers appear, as a result of which the person completely loses his ability to work and requires constant maintenance therapy.

Home treatment

Many women are interested in how to treat varicose veins on women's legs at home. Therapeutic exercises, herbal medicine and some recommendations for a healthy lifestyle for patients with varicose veins will help relieve the symptoms of the disease and prevent its further development.

Therapeutic exercises

Every day, in the morning and in the evening, it is necessary to perform simple exercises for varicose veins:

  • Lying on your back, raise your legs vertically, resting them against the wall at a 90° angle. Hold them in this position for 3 minutes, breathing slowly through the chest, not the stomach.
  • While lying on your back, perform a bicycle exercise for 3 to 5 minutes.
  • While standing, lift both feet on the balls of your feet 1 cm off the ground and lower them down. Perform 30 times in two approaches.
  • While standing, alternately lift one heel off the ground and then the other, at an angle no greater than 45°. Start with 15 minutes daily and expand to 30 minutes.

You should set aside time to walk every day, at least 30 minutes. It is useful to go to the pool to swim once a week.

Home remedies

Take the herbal mixture internally: mix 1 tablespoon of birch buds, motherwort, thread, calamus roots, coltsfoot leaves and thyme.

Pour boiling water over half a glass of the mixture and heat in a water bath for 40 minutes. Let it rest, strain. Drink 0. 5 cups before each meal for a month.

Make compresses with homemade ointments:

  • Mix half a glass of curdled milk with fresh chopped wormwood leaves. Apply to diseased veins, secure with gauze on top and cover with film. Maintain for 30 minutes daily.
  • 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, first pricking them with a fork until juice appears. Secure it with a bandage.

Forecasts and preventive measures

From varicose veinsIt is an irreversible process, in this case it is not necessary to talk about complete recovery. But with timely diagnosis, proper treatment and prevention, patients can completely get rid of unpleasant symptoms and lead a full life.

Preventive measures for varicose veins includehealthy lifestyle, proper nutrition and abandonment of bad habits.. People who, due to their professional activity, are forced to remain in the same position for a long time are recommended to avoid crossing their limbs, perform simple exercises from time to time, bend and straighten their legs, and perform a light massage to improve circulation. blood.

In your free time, you should walk outdoors as often as possible and do moderate physical activity.

Women who follow fashion or the work dress code and constantly go tohigh heels, you should change them from time to time for more comfortable shoes.

The same goes foruncomfortable clothes, because even tight underwear can cause poor circulation and the appearance of varicose veins in women's legs.

Varicose veins of the lower extremities are today considered a very widespread disease, which is often not given much importance.

It is very important to remember that thisLack of attention to the health of your feet can cost a person not only their ability to work, but also their life., while in the initial stages, varicose veins can be corrected quite successfully using the simplest methods.