What are the causes of vaginal and vulval varices (varicose veins)?
Almost all vaginal or vulval varices (varicose veins) come from varicose veins inside the pelvis. These deep pelvic varicose veins communicate through the veins of the vagina to the varicose veins on the outside.
There are 2 ovaries inside the pelvis. Each ovary has a very long vein called the ovarian vein - there is one on the right and one on the left. The ovarian vein should take blood from the ovary back to the major veins so it can be pumped back to the heart.
If the valves stop working in these veins, the veins around the ovaries get very swollen- a condition called 'ovarian varicocele' - or pelvic congestion syndrome.
There are two other veins in the pelvis that can go wrong as well - the right and left internal iliac veins. These are lower in the pelvis and can cause the same problems. However, if other branches (tributaries) of this vein are affected, it can cause piles (haemorrhoids) or varicose veins around the buttocks.
What symptoms can I get from vaginal or vulval varicose veins?
The symptoms associated with vaginal or vulval varices can be split into 2 main groups:
1) The symptoms associated with the veins themselves
2) The symptoms associated from the underlying pelvic vein reflux (pelvic venous congestion or pelvic congestion syndrome)
1) Symptoms from vaginal or vulval varicose veins
Varicose veins in the vagina or vulva can be very embarrassing. They can make someone very uncomfortable in intimate situations. If big enough, they can actually hang down making it embarrassing to wear bikini bottoms or panties - and if very large can make it difficult to pass urine without spraying and can inhibit sexual intercourse.
2) Symptoms from pelvic vein reflux and pelvic varicose veins (pelvic venous congestions / pelvic congestion syndrome)
Varicose veins in the female pelvis can push on any of the pelvic structures causing symptoms. Depending on how big the veins are, and where they are in the pelvis, women can have any combination of the following symptoms - or all of them:
- "Dragging sensation" - in the pelvis the weight of the blood in the pelvic varicose veins can lie on the muscles of the pelvic floor, giving a "heavy" or "dragging" feeling in the pelvis. This is usually worse during the period
- Irritable bowel - the rectum (lower bowel) is in the pelvis behind the ovaries. Pressure from the pelvic varicose veins onto this can give irritable bowel
- Irritable bladder - similarly if the pelvic varicose veins push forwards against the bladder, it too can become irritable
- Discomfort of sexual intercourse - "Deep dyspareunia" the presence of large varicose veins in the pelvis around the vagina internally can cause discomfort during sexual intercourse