Why Do I Have Blue Veins Around My Vagina?

Blue veins around the vagina or vulva are usually caused by increased pressure within the pelvic veins and changes in blood flow. These veins are known as vulvar varicosities or vaginal varicose veins and are often linked to pregnancy or underlying pelvic vein disease.

Although many women feel embarrassed discussing changes in the genital area, vulvar veins are relatively common and usually develop for the same reasons as varicose veins in the legs. In some women, they cause only mild swelling or visible blue veins. In others, they may lead to aching, heaviness, pelvic discomfort or pressure that affects day to day life.

Assessment includes a detailed vascular examination and, where appropriate, ultrasound imaging to determine whether the veins are isolated or related to a deeper pelvic vein condition.

Vulvar Varicose Veins?

Vulvar varicose veins are enlarged veins affecting the external genital area, particularly the vulva and labia. Vaginal varicose veins develop internally within the vaginal wall and are less commonly visible. Both conditions may occur together and are often linked to increased pressure within the pelvic veins.

Healthy veins contain valves that help blood return towards the heart. When these valves weaken, or pelvic vein pressure rises, blood can flow backwards and pool within the vein. Over time, the vein enlarges and becomes visible beneath the skin.

Some women notice only a few visible veins, while others develop widespread swelling extending into the groin, buttocks or upper thighs.

What Do Vulvar Varicose Veins Look Like?

Vulvar varicose veins may appear as:

Blue or purple veins beneath the skin
Bulging or twisted veins around the labia
Soft swollen areas in the vulva
Veins that become more obvious after standing
Swelling that worsens later in the day
Enlarged veins extending into the groin or upper thigh

Symptoms and appearance often fluctuate throughout the day and may worsen during pregnancy or menstruation.

Pregnancy and Vaginal Veins

Pregnancy is the most common reason for blue veins around the vagina. Around one in four pregnant women may develop vulvar varicosities during pregnancy.

Several factors contribute to this.

Increased Blood Volume

Blood volume rises significantly during pregnancy to support the developing baby. This places extra strain on the pelvic and leg veins.

Pressure From the Enlarging Uterus

As the uterus grows, it presses on the veins deep within the pelvis and slows the blood returning from the lower body. This encourages blood pooling within the veins around the vulva and vagina.

Hormonal Changes

Pregnancy hormones relax blood vessel walls and reduce vascular tone. Although this supports the pregnancy, it also makes veins more likely to dilate and become visible.

Previous Pregnancies

Vulvar veins often become more noticeable with each pregnancy. Women who have had several pregnancies are more likely to experience persistent vein problems later on.

Although vulvar veins can appear alarming, they rarely interfere with childbirth. Bleeding during delivery is uncommon and can usually be controlled without difficulty.

Pelvic Congestion Syndrome and Pelvic Vein Reflux

Blue veins around the vagina can sometimes indicate Pelvic Congestion Syndrome, a condition caused by enlarged and inefficient pelvic veins.

Pelvic Congestion Syndrome develops when blood pools within the ovarian and pelvic veins because the valves are no longer functioning properly. Increased pressure within these veins can then lead to vulvar varicosities and pelvic discomfort.

Women with pelvic vein reflux may experience:

A dull aching pain in the pelvis
Pelvic heaviness or pressure
Pain worsening after standing
Symptoms after intercourse
Lower back discomfort
Visible veins around the vulva or upper thigh
Symptoms worsening before menstruation

Pelvic vein conditions are frequently overlooked because symptoms may resemble gynaecological or hormonal problems. Specialist vascular assessment is often required to identify the underlying cause.

Other Causes of Blue Veins Around the Vagina

Although pregnancy is the leading cause, several other factors may contribute.

Family History

Varicose veins commonly run in families. Women with close relatives affected by vein disease are more likely to develop vulvar veins.

Ageing

Veins gradually lose elasticity with age. Valve function may weaken, allowing blood to pool more easily.

Standing for Long Periods

Occupations involving prolonged standing can increase pressure within pelvic and leg veins. Teachers, hairdressers, healthcare professionals and retail workers may therefore be more prone to venous problems.

Existing Varicose Veins

Women with varicose veins in the legs often have underlying venous weakness affecting multiple areas of the circulation, including the pelvis.

Excess Weight

Increased abdominal pressure may place additional strain on the pelvic veins and worsen symptoms.

Rare Pelvic Conditions

In uncommon cases, pelvic masses or other conditions affecting blood flow may contribute to enlarged veins around the vagina. Persistent or unusual symptoms should always be medically assessed.

Symptoms of Vaginal or Vulvar Veins

Some women experience only visible veins, while others develop symptoms that affect comfort and mobility.

Common symptoms include:

Visible blue or purple veins
Swelling around the vulva
Heaviness or pelvic pressure
Aching after standing
Burning or itching
Tenderness or throbbing
Discomfort during intercourse
Symptoms worsening during pregnancy or menstruation

Daily activities can sometimes become uncomfortable. Many women notice worsening symptoms after prolonged standing, exercise or sitting for long periods. Symptoms are often more noticeable towards the end of the day.

Can Vulvar Varicose Veins Be Dangerous?

Vulvar varicose veins are usually not dangerous, but they can become uncomfortable and occasionally painful.

Serious complications are uncommon. Bleeding from vulvar veins is rare, even during childbirth, and blood clots within these veins are unusual. However, persistent symptoms should not be ignored, particularly if pelvic pain, swelling, or varicose veins in the legs are also present.

In some women, visible vulvar veins may indicate underlying pelvic vein reflux or Pelvic Congestion Syndrome requiring treatment.

Diagnosis of Vaginal and Pelvic Veins

Assessment begins with a clinical examination and discussion of symptoms. Because vulvar veins can flatten when lying down, examination while standing may provide a clearer picture.

A duplex ultrasound scan is commonly used to assess blood flow within the veins and identify whether blood is flowing in the wrong direction. Ultrasound also helps determine whether the problem involves only superficial veins or deeper pelvic veins.

Some women require further pelvic imaging if symptoms suggest Pelvic Congestion Syndrome or ovarian vein reflux.

Proper vascular assessment is important because visible veins alone may not represent the underlying problem. Treating the source of venous reflux helps reduce the likelihood of recurrence.

Treatment for Blue Veins Around the Vagina

Treatment depends on symptom severity, pregnancy status and whether deeper pelvic veins are involved.

Conservative Management

During pregnancy, treatment usually focuses on symptom control because the veins often improve after childbirth.

Measures that may help include:

Avoiding prolonged standing
Gentle walking and regular movement
Elevating the legs when resting
Maintaining a healthy weight
Wearing supportive compression garments where appropriate
Sleeping on the left side during pregnancy
Avoiding tight clothing around the waist or groin

Sclerotherapy

Sclerotherapy is commonly used for smaller vulvar veins that persist after pregnancy. A specialised solution is injected into the vein, causing it to close and gradually fade.

Foam sclerotherapy may be suitable for larger veins.

Endovenous Laser Treatment

Endovenous Laser Treatment uses laser energy to seal faulty veins under ultrasound guidance. Blood then reroutes through healthier veins.

Radiofrequency Ablation

Radiofrequency Ablation uses controlled heat energy to close damaged veins and improve circulation.

Cyanoacrylate Glue Treatment

Medical adhesive closure uses a specially designed glue to seal the affected vein without heat treatment or multiple injections.

Pelvic Vein Embolisation

Women with Pelvic Congestion Syndrome may benefit from pelvic vein embolisation, a minimally invasive procedure used to close problematic pelvic veins and reduce pelvic pressure.

Choosing the Right Treatment

Not all visible vulvar veins should be treated directly. In some women, the visible veins are only a symptom of deeper pelvic vein reflux.

Treating superficial veins without identifying the underlying source may lead to symptoms returning. Specialist vascular imaging helps determine whether treatment should focus on vulvar veins, pelvic veins or both.

An individualised treatment plan is therefore important for achieving symptom improvement.

Recovery After Pregnancy

For many women, vulvar varicose veins improve naturally after childbirth as pelvic pressure reduces and hormone levels return to normal.

Improvement commonly occurs within the first six to twelve weeks postpartum, although some veins may take longer to settle completely.

In some women, symptoms persist beyond pregnancy, particularly if there is underlying pelvic vein reflux. Future pregnancies may also worsen existing vein problems.

A vascular specialist should assess persistent pelvic pain, pressure or visible veins after childbirth.

Emotional and Intimate Impact

Vulvar varicose veins can affect more than just physical comfort. Many women feel self-conscious about visible veins or swelling in such an intimate area.

Some experience discomfort during intercourse, anxiety during pregnancy or concern about how the veins may progress over time. These symptoms are common and should not be dismissed as simply part of pregnancy or ageing.

Professional assessment can provide reassurance and help determine whether treatment may improve symptoms and quality of life.

Symptoms That Should Not Be Ignored

Medical assessment is recommended if you experience:

Persistent pelvic pain
Sudden swelling or worsening veins
New veins developing rapidly
Symptoms continuing after pregnancy
Associated leg varicose veins
Pain affecting daily activities or sleep

Early assessment may help identify underlying pelvic vein disease before symptoms progress further.

Vein Solutions for Pelvic and Vulvar Veins

Vein Solutions patients undergo a detailed duplex ultrasound assessment to identify the source of venous disease and determine the most appropriate treatment approach.

Mr Sameh Dimitri and the team have extensive experience treating vulvar, pelvic and leg vein conditions using minimally invasive procedures, including foam sclerotherapy, endovenous laser treatment, radiofrequency ablation and cyanoacrylate glue closure.

Most procedures are performed under local anaesthetic as walk-in, walk-out treatments with minimal disruption to normal activities.

If you are concerned about blue veins around the vagina, pelvic discomfort or ongoing varicose vein symptoms, a specialist vascular assessment can help identify the cause and discuss appropriate treatment options.

Prefer an AI Summary?