Varicose Veins When Pregnant With Twins: How to Manage and When to Worry

Twin pregnancy is known to heighten all sorts of pesky pregnancy symptoms! So if you find yourself developing varicose veins while expecting, here’s what to know about dealing with the discomfort and knowing when to worry.

If you’ve found yourself here, chances are you’re one of the unlucky expecting twin mamas dealing with varicose veins. I feel your pain, literally. For me, this was hands down one of the most frustrating symptoms I struggled with when pregnant with twins. Ugh!

So in case you’ve been dealing with this pregnancy symptom too, keep reading for a brief rundown of what causes varicose veins, how to find relief, and whether or not you can make them go away. 

What are varicose veins?

Varicose veins appear as bulgy, twisted veins in your lower body parts like your legs and pelvic area. 

Why do you get varicose veins when pregnant with twins?

Some estimates show that nearly 4 in 10 women develop varicose veins while pregnant. Most often, they begin to appear in the first trimester, but they can worsen or develop later on in pregnancy too. 

Pregnancy is actually one of the risk factors that can lead to varicose veins because of the stress that the additional blood flow can put on your veins, especially when you have a twin or multiple gestation. 

Another risk factor is your genetics. So if your mom, sister, or grandmother had varicose veins, you are at a higher risk for developing them during pregnancy too. 

Basically, the extra blood flow from pregnancy causes the small valves inside of your veins to become overworn, and eventually they stop functioning properly. This then leads to the swelling and bulging that you may notice on the surface of your skin. 

This is heightened during a twin pregnancy because the blood plasma volume increase experienced in a twin pregnancy is 43% higher than that of a singleton pregnancy. All this extra blood flow puts additional strain on your veins as does your expanding uterus and belly. 

To make matters worse, your hormones are much higher in a multiple gestation. Progesterone, in particular, that hormone that rises and causes all sorts of PMS symptoms, is much higher in twin pregnancies. This hormone causes your ligaments and blood vessels to relax which can interfere with those tiny valves inside of your veins. 

How to tell if you have varicose veins?

Here are some of the most common symptoms you are likely to experience if you develop varicose veins when pregnant with twins: 

• Tenderness or pain in your lower legs (or wherever the varicose veins are located)
• Noticeable changes to your skin (the veins may appear dark purple, blue, or even green)
• Cramping in your leg muscles (especially at night)
• A sensation of heaviness in your legs or other lower extremities
• Itching, throbbing, or swelling (especially after sitting or standing for extended periods)

Varicose veins in pregnancy: when to worry?

While the symptoms listed above can obviously be very bothersome, most of the time they’re nothing to worry about. 

That said, in some cases, varicose veins can lead to complications like deep vein thrombosis (DVT), aka a blood clot. This is considered a medical emergency and should spur you to see medical attention right away. Some signs to look for with DVT include: heightened pain or tenderness, cramping, increased warmth, and skin that is discolored or red. 

Yes, you are right in noticing that some of these overlap with regular symptoms of varicose veins. 

So if at any point during your twin pregnancy, you feel concerned about your varicose veins, it’s best to check in with your healthcare provider sooner than later. 

It never hurts to be overly cautious!

During my twin pregnancy, on top of having very painful varicose veins in my upper thighs and one side of my vulva, I also developed a blood clot in my leg just behind my knee.

Thankfully, it ended up being a superficial clot and not DVT, but I had much more peace of mind after having my care team run some additional tests to make sure.

How to treat varicose veins when pregnant with twins?

I hate to be the bearer of bad news here, but during pregnancy, there’s no way to avoid or get rid of varicose veins. That said, you can take measures to prevent them from worsening and causing extra discomfort. 

If you’re suffering from varicose veins, first and foremost, check in with your doctor so they can inspect them and give you interventions based on your unique medical history and pregnancy status. 

In the meantime, here are some recommendations that may support:

• Keeping your legs elevated when possible
• Wearing compression stockings (often, your insurance will cover these!)
• Keep from standing for too long or crossing your legs
• Engaged in pregnancy-safe gentle exercises (think: swimming and walking)
• Maintain a healthy pregnancy weight as best as you can (we know there’s only so much you can do in this department when you’re nourishing your body for 3 humans)
• Stay hydrated

While these measures may not totally take away the discomfort of your varicose veins, they can support your overall vascular function and limit some of the pressure and aching.

Once you deliver the babies, you may notice that your varicose veins get smaller over time, even if they don’t totally disappear. If after pregnancy, they continue to cause you discomfort or you just don’t like how they look, there may be additional measures you can take (like surgery) to address your varicose veins. This is something you can ask your doctor about!

Vulvar varicose veins while pregnant?

Yes, you can get varicose veins around your vulva. For me, it made this whole area look completely lopsided, and I felt extra sensation around my vaginal area from them. The good news is that in the months after giving birth, they became much less noticeable and mostly non-existent now (four years later). 

Nowadays, I mainly feel the after-effects of varicose veins when I’m on my period as the extra blood flow of menstruation makes those veins feel extra pressure.

Final reminders about varicose veins in twin pregnancy

If you’re worried about developing varicose veins or already have them while pregnant with twins, keep these important notes in mind:

• You didn’t do anything wrong that caused the varicose veins 
• Keep an eye on your varicose veins and be knowledgeable about sights of deep vein thrombosis
• Talk to your doctor about safe ways to manage your discomfort and share any concerns you have about your varicose vein symptoms
• You’re not alone in experiencing this pesky symptom. In fact, twin pregnancies come with all sorts of unwanted and weird symptoms. 

Want to read about more topics related to twin pregnancy and twin pregnancy symptoms? Check out these articles too!

• What Are the Weirdest Symptoms of Twin Pregnancy?
• What Are Common Complications of Twin Pregnancy?
• What to Know About Swelling in Twin Pregnancy

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