I Plan to Be Pregnant One More Time, Should I Have Vein Treatment Done Before the Pregnancy or Should I Wait?

I typically encourage my patients to get their leg veins treated before planning on getting pregnant, as the leg veins will only get worse with pregnancy. With treatment, the veins will be smaller to start with before getting pregnant.

If you can wait, it is now preferred to get treated for venous insufficiency before you get pregnant again, as hundreds of studies have shown that at least 3 horones during pregnancy (estrogen, progesterone and annexin) as well as the pressure of the gowing fetus on the venous system especially in the 2nd and third trimesters worsen venous insufficiency and cause more veins to develop. The prevailing recommendation in 2013 is to get treated for venous insufficiency and existing varicose veins before you get pregnant again, as the extent, distribution and size of existing varicose veins and spider veins will get worse if you don't. In the 1960's and 1970's and 1980's and 1990's, they kept women in the hospital after they delivered their last child to perform vein stripping. This is no longer recommeneded and is the wrong thing to do.

Varicose veins and, often times, spider veins are due to leaking (refluxing) valves of the saphenous system.  If you have varicose veins and refluxing valves, then you should have them treated before your next pregnancy since they will only worsen with the pregnancy.  Spider veins can be left alone until after the pregnancy.  If you undergo a closure procedure, an additional pregnancy should not reopen the closed vein if it was treated appropriately.  It could however, cause other valves in other veins to reflux but this could be dealt with at a later time after the pregnancy. Since your veins are symptomatic, it is better to treat them now then have them worsen during your pregnancy.