Vulvar Varicosities — Causes, Symptoms & Relief

Most women know about varicose veins on the legs. Far fewer have heard of the ones that can turn up on the vulva during pregnancy, even though between 4% and 22% of pregnant women experience vulvar varicosities. They can appear anywhere on the outside of the vagina, most often on the outer labia, and sometimes on the upper thighs. The discomfort usually builds as the day goes on, after long stretches of standing or sitting, and often around a bowel motion.

Finding them for the first time can be a shock, especially if no one in your antenatal care has mentioned them. Here is the reassuring part. Vulvar varicosities are common in pregnancy, they are usually harmless, and they almost always settle after birth. This article walks through what they are, why they happen, what genuinely helps, and when to get them checked.

What are vulvar varicosities?

Vulvar varicosities are varicose veins that develop on the vulva, the external genital area that includes the labia. The veins stretch, enlarge, and often become visible under the skin. In pregnancy they are a common and usually harmless result of the circulatory changes your body is going through. Outside of pregnancy they are less common, and sometimes they point to an underlying vascular issue worth looking into.

You may also see them called vulvar varicose veins, vaginal varicose veins, or vulvovaginal varicosities. They are all the same thing.

What does a vulvar varicosity look like?

They look different from one woman to the next. The common features are:

A bluish or purplish tinge - where the veins have become more prominent under the skin.
Raised, rope-like or lumpy veins - on the outer labia, the perineum, or the upper inner thighs.
Swelling or puffiness - across the vulvar area.
One side more affected than the other - it is often not symmetrical.

If you are not sure what you are looking at, your GP, midwife, or a pelvic health physiotherapist can confirm it. This is something clinicians who work in pregnancy see regularly, so there is no need to feel awkward about raising it.

Why vulvar varicosities happen in pregnancy

A few things happen at once. Blood flow to your pelvis increases. Blood travelling from your legs back to your heart slows down. Pregnancy hormones soften the walls of your blood vessels. Put together, the veins in your vulva end up carrying more pressure than they are built for, so they stretch, swell, and become visible.

It is not a sign that anything has gone wrong. It is a predictable response to the circulatory changes of pregnancy.

What vulvar varicosities feel like

Symptoms vary, but the ones women describe most often are:

Heaviness or a dragging, full feeling - around the vaginal area.
Swelling that worsens - after long periods of standing, sitting, or walking.
Discomfort that builds through the day - and tends to peak in the evening.
A flare on the toilet - particularly when straining to pass a bowel motion.
A lumpy feeling - when you touch the area.
Visible veins with a bluish tinge - that were not there before.

Vulvar varicose veins can absolutely be painful. Many women describe a constant, low-level awareness of the area. It is rarely a sharp pain. It is more a heaviness that makes sitting, walking, and sleeping harder than they should be.

How do you treat vulvar varicosities during pregnancy?

The goal is simple: take pressure off the veins in your vulva. Here is what that looks like day to day.

Everyday habits that make a real difference

Listen to your body - if it is asking you to rest, rest.
Change position regularly - rather than standing for long stretches, put your feet up when you can.
Keep constipation in check - straining on the toilet adds pressure exactly where you do not want it. Fibre, water, and a toilet foot stool that lifts your knees into a squat all help.
Avoid heavy lifting, pushing and pulling - wherever you reasonably can.
Modify your exercise - swap high-impact movement for swimming or Pilates, which keep you moving without loading the pelvic floor.
Support yourself when you cough, sneeze or laugh - press one hand gently against your vulva. That bit of counter-pressure really does take the edge off.
Do your pelvic floor exercises - they support the whole area.
Use ice - 15 to 20 minutes, every couple of hours. A dedicated perineum ice and heat pack is shaped for this area and far easier to use than a bag of frozen peas.

Compression for the vulvar area

This is the step most women skip, and it is often the one that makes the biggest difference. Firm-fitting underwear with a pad, or pregnancy compression shorts and leggings made for this, apply gentle, targeted pressure that takes the strain off the stretched veins. A lot of women say a properly fitted garment lifts the heaviness almost straight away.

Our pick is SRC pregnancy compression shorts and leggings. They are built for exactly this kind of support and comfortable enough to wear all day. Compression socks can also help by supporting circulation through the lower legs.

One important note. Do not wear compression socks over the top of leggings that are already compressive. Stacking the two puts too much pressure on the same area. Worn separately, without overlap, compression shorts and compression socks are fine together.

Some of this overlaps with the heaviness of pelvic girdle pain and SPD in pregnancy, so if you are managing both, the same rest-and-support principles carry across.

When should you be concerned about vulvar varicosities?

For the most part, vulvar varicosities are uncomfortable rather than dangerous, and they settle on their own. It is worth checking in with your GP, midwife, or pelvic health physiotherapist if:

The pain is severe - or is stopping you sleeping, walking, or getting through your day.
A vein feels hard, hot, tender, or looks red - this can point to a clot in the vein and should be reviewed promptly.
There is bleeding from the area - outside of what your birth team is already aware of.
The veins appear when you are not pregnant - or do not settle after birth (more on the timeline below).

None of this is meant to alarm you. These situations are uncommon. But you know your body, and if something feels off, getting it looked at early is always the right call.

Getting a diagnosis

In most cases a clinical examination is all that is needed. Your GP, midwife, or a pelvic health physiotherapist can identify vulvar varicosities on sight. If anything is unclear, an ultrasound may be ordered, and that is usually as far as it goes.

How long do vulvar varicosities take to go away after pregnancy?

For most women, symptoms fully settle within 6 to 8 weeks of birth, and often sooner, as the pressure and hormones of pregnancy ease off. If they are still hanging around beyond 8 weeks postpartum, or if you develop them when you are not pregnant at all, it is worth a follow-up with your GP. In rare cases outside of pregnancy, vulvar varicose veins can signal an underlying vascular issue that benefits from specialist review.

Can you have a natural birth with vulvar varicosities?

Yes, almost always. As labour progresses, the pressure in the veins drops, and vulvar varicosities usually do not get in the way of a vaginal birth. The worry we hear most is whether a vein could bleed heavily or burst during delivery. In reality, if they bleed at all, it is usually minimal and easily managed by your birth team. Ask your midwife or obstetrician to note them in your file so everyone is aware and prepared. They very rarely change the plan.

Can you prevent vulvar varicose veins in pregnancy?

Not entirely. The causes are hormonal and circulatory, and some bodies are simply more prone to varicose veins than others. What you can do is meaningfully reduce your risk of severe symptoms: start the everyday habits above early, bring in compression support from the second trimester if you are prone to varicose veins, stay well hydrated, and keep as active as your pregnancy allows.

Where to start

If this is new for you, three things:

Get an accurate diagnosis - book in with your GP, midwife, or a pelvic health physiotherapist. The earlier this happens, the sooner your management plan can start.
Sort out compression - a firm-compression pregnancy garment made for vulvar and pelvic support is the single most useful thing you can buy. The vulvar varicosities support garments we stock, including the SRC shorts and leggings, are chosen for exactly this.
Be patient with yourself - pregnancy is demanding enough without expecting yourself to simply push through discomfort.

You do not have to quietly put up with this. Every recommendation here is grounded in current clinical practice, and most are backed by the published research. If you would like the plan tailored to your body and your pregnancy, a pelvic health physiotherapist can do exactly that. And if you are preparing for the fourth trimester too, our guide to using a peri bottle for postpartum recovery covers the toileting comfort side of things.