As you know, pregnancy is not a disease, but a physiological state that leads to certain physical, functional and psychological changes to adapt to the new situation, which, although normal, exert an overload that will be perceived differently by each woman pregnant.
Some changes are global and others more local, that is to say, affect specific bodies. One of the leading organs of pregnancy is the uterus, therefore it is one of the most changes experienced.
Occasionally, diseases that exist before pregnancy can be aggravated and exceptionally may appear pathologies specific to pregnancy.
What changes occur during pregnancy in the genital organs?
We will refer to the external genitalia, vagina and cervix or cervix. From the first weeks of pregnancy, the genital area will undergo a series of changes. In these modifications, hormonal changes play a fundamental role:
The cervix softens, changes color and produces a viscous secretion known as a mucous plug that protects the fetus very effectively from possible germs that populate the vagina.
The vagina increases its size in width and length. It becomes more elastic and distensible because the muscle cells in its walls increase in size and the collagen fibers they contain also lengthen and separate from each other.
The blood vessels of the vagina, as in the cervix, dilate while new ones are formed. This vasodilatation together with the increase in blood flow causes superficial varicose dilatations in the vagina and vulva to occur frequently. There is also a change of coloration of the mucous membranes of the vagina and the vulva, its pink color will become red-purple.
The increase in blood flow causes the walls of the vagina as well as those of the cervix to produce greater secretion, which determines the gestational leucorrhoea, which can be milky and fluid or thicker, is secreted or flow, although physiological, is capable of altering the comfort of the pregnant woman requiring more hygienic care.
How does my intimate hygiene have to be?
Make proper hygiene in your daily shower: with a mild liquid soap, you will clean the genital area from front to back so that any microorganism deposited in the anal area does not move to the vagina. Proper hygiene does not mean doing a vaginal wash; on the contrary, there are women who introduce products into the vagina (antiseptics, soaps ...) with the risk of altering the vaginal flora that protects against infections. Washing once or twice a day is enough, discarding douching: the vagina cleans itself.
To avoid fungal infections, it is advisable to use cotton underwear and limit the use of protectors (protects pants and/or compresses), it is also not advisable to use thong-type underwear. In general, avoid tight clothes. If symptoms such as itching, burning or irritation are present, you should consult your doctor or midwife.
If the vaginal infection is detected, the doctor will prescribe a treatment and will recommend a specific product for intimate hygiene (cleansing solution without detergent, maybe thyme, burdock, tea tree) and insist on the proper hygienic habits.
What are vulvar varicose veins?
Vulvar varicose or perineal vulva varicose veins are varicose veins of the superficial veins of the vulva and perineum that appear as a result of changes that occur in pregnancy, more specifically around 20 weeks of gestation. They are observed as bluish protuberances that as the pregnancy progresses they become congested and increase in size. They can occur only on the vulva and often on only one side of the vulva, but occasionally they are also found on the rectum (hemorrhoids) of the vagina and the lower limbs.
Do they produce any discomfort?
Vulvar varicose veins are often accompanied by discomfort, a feeling of heaviness in the genital area, sometimes itching and even pain. Complications are not usually produced and much less frequent is even traumatic compression breakage.
Are they presented by all pregnant women?
No, they are very rare, they present between 4 and 7 percent of pregnant women, according to different authors consulted.
What is the treatment of vulvar varicose veins?
The most recommended treatment during pregnancy is conservative, aimed at relieving discomfort, pain, and discomfort. The hygienic measures indicated in this situation are to avoid prolonged periods of standing, heat and excessive weight gain.
It is recommended moderate exercises such as short walks or swimming, and interspersed in the day periods of rest, with legs a little high or lying on its side. In some cases, the symptomatology is alleviated by applying pressure in the vulvar area. It may be helpful to apply calendula cream in the area. It is also possible to use homeopathic remedies.
In other cases, the doctor recommends pharmacological measures such as phlebotonic from the second trimester of pregnancy, to relieve symptoms. In any case, let yourself be advised by your obstetrician or midwife.
Are vulvar varicose veins an inconvenience for vaginal delivery?
No clinical studies comparing vaginal delivery with cesarean section have been found in patients with varicose veins. But vaginal delivery is usually done without major complications in most cases. If possible, episiotomy should be avoided: the midwife or the obstetrician will always decide what is most appropriate in each case.
Preparation of the perineum, through the practice of perineal massage during pregnancy, is useful to reduce perineal trauma at birth (such as spontaneous tears or the need to perform episiotomy). Symptoms usually improve or disappear after delivery.
And the varicose veins in the legs?
Varicose veins of the lower limbs are a more frequent complication in pregnancy than the vulvar: they occur in 30 or 40 percent of pregnancies, according to several authors consulted. From this, we can deduce that, although frequent, varicose veins are not produced by pregnancy, but rather that it acts as a triggering factor in women with a predisposition to present them.
What mechanisms are involved in the appearance of varicose veins during pregnancy?
Already in the first trimester of pregnancy, there is a relaxation of the venous walls. These changes are mediated by a hormone called progesterone, which is responsible for ensuring the implantation of the fertilized egg in the uterus and its evolution.
Varicose legs
From the second trimester there is an increase in venous flow to the vena cava, which is a large caliber vein where, in addition to the blood coming from the lower limbs, the one coming from the pregnant uterus through the uterine veins This causes the circulation of return to the heart to be slower.
As the pregnancy progresses and especially in the third trimester, due to the increase of the uterus, compression of the inferior vena cava occurs, making it even more difficult for the blood to return to the heart. For all this and especially in the third trimester of pregnancy, the symptoms of heaviness and fatigue are accentuated, often adding swelling and leg pain especially in women who already had varicose veins before pregnancy.
Are there factors that predispose to varicose veins?
Yes, there is a genetic predisposition or family factor. Thus, women with a history of varicose veins have a 50 percent greater chance of developing them. Other factors that may favor its appearance are: having had more pregnancies (multiparity), obesity, jobs that require prolonged standing or exposure to heat sources. If varicose veins exist before pregnancy, pregnancy tends to make them worse.
What preventive and self-care measures can I use against varicose veins?
What you should avoid :
- Standing for long periods, for example, ironing.
- Sedentary lifestyle, sun exposure, and local heat.
- The excessive gain of weight.
- Wear tight clothing on the groin, like tight pants.
Highly recommended measures in prevention and self-care:
- Perform moderate physical exercises such as short walks, bending, extension, and rotation of ankles or swimming.
- Wear comfortable shoes with medium heels, which are the most recommended to achieve calf contraction and stimulate venous return.
- Apply cold water showers alternating with warm.
- Rest with elevated legs two or three times a day to facilitate venous return.
- Sleeping on the side, especially the left, to reduce the compression of the gravid uterus on the vena cava.
- Massages ascending from the feet to the hips.
- The use of elastic compression stockings (panty type) is very effective in prevention.
- Homeopathic remedies can be prescribed. If there are a lot of discomforts, the doctor can prescribe phlebotonics, but we must remember that only the symptoms improve, not the evolution of the process. Usually, varicose veins improve after delivery.
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