Varicose veins and haemorrhoids are a poorly publicised fact of life for many women, particularly, during pregnancy. Pat Thomas offers some soothing remedies

When you think of varicose veins and haemorrhoids – if you ever think of them at all – you probably think of elderly women in droopy support tights. So when you’re pregnant, it may come as a shock to realise that you’re one of a significant number of women who develop varicosities. They run in families, and pregnant women are particularly prone, if they’re carrying twins or have to stand or sit for long periods of time, for instance at work.

How they happen

The body’s veins are responsible for conducting blood back to the heart, and veins in the legs work against gravity to do their job. To assist this process, leg veins have valves that close between heartbeats to prevent the blood flowing backwards. A varicose vein occurs when a valve weakens, putting more pressure on other valves, and causing blood to stagnate. Varicosities, whether on the leg, in your bottom or vulva, appear as soft, swollen, dark blue bulges, and are often itchy and painful. Haemorrhoids, or piles, are varicose veins of the rectum.

Genes, obesity, lack of exercise, a low-fibre diet, vitamin deficiency, liver malfunction, pregnancy, or constipation, all cause these nasties.

But why during pregnancy?

Increased blood volume puts your veins under pressure. In addition, hormonal changes relax the muscular walls of the blood vessels. This makes it even more difficult for your veins to move blood from the lower body, back to the heart. The increasing weight of your uterus will put more stress on the pelvic veins, and if you’re constipated, this can also interfere with your pelvic circulation. As a result, blood may pool in your lower body, and you may get the bulging, painful varicose veins on the legs, vulva or rectum.

Treatment for varicose veins involves surgery to remove the protruding veins – but this is usually reserved for severe, chronic varicosities.

Conventional treatment during pregnancy

Centres around diet, rest and support tights, because these varicosities tend to be temporary (though they may return with each pregnancy). Since constipation can aggravate haemorrhoids, your doctor will suggest you include more liquids and fibre in your diet.

Instead of adding wheat bran to everything, try adding more fresh fruits and vegetables in your diet. Wheat bran is not a water-soluble form of fibre and can be irritating to the gut, whereas the fibre in fruits and vegetables is water-soluble and works to bulk up stools and make them easier to pass. Fruit and vegetables also have the advantage of helping to strengthen the vascular system, and will help varicosities in other parts of your body as well.

Try some of the following suggestions as well:

• Wear support stockings and avoid squatting or standing for long periods. Your growing uterus can put additional stress on the pelvic veins, so put your feet up as often as you can. At rest, avoid crossing your legs. At work, get up and walk around frequently and, while sitting, flex and extend ankles often. If you can, try elevating the foot of your bed 10 cm to help blood flow back to the heart.
• For quick relief and to reduce swelling, apply an ice pack, or a pack of frozen peas. A discreet way to ease piles is to soak a few sanitary towels in water and freeze them. Use as necessary to relieve the pain.
• Cherries, blackberries, European blueberries (bilberries) and hawthorn-berries are all rich in flavonoids and chemicals called oligomeric procyanidines, which reduce vein fragility, increase the muscular tone of the veins and strengthen the venous walls. Foods such as raw garlic, onions and parsley will improve the elasticity of your veins. Include these foods liberally in you daily diet.
• Try homeopathic Hamamelis 6 three times daily for up to a week, or until symptoms improve. Calcarea fluorica 6 taken three times daily for up to a week may also improve tissue elasticity.
• A herbal ointment made from horse chestnut will reduce swelling. Or try one tablespoon of arnica tincture or lotion diluted in a litre of cold water – apply twice daily to the affected areas using a saturated washcloth.

• Alternatively, you can make your own ointment by blending several essential oils. Try mixing 10 drops each of essential oils of cypress and lavender (or geranium) and 5 drops each of rosemary (or juniper) and chamomile. A massage oil can then be made by adding 15 drops of this mix to an ounce of carrier oil, which should be rubbed gently into the legs, above the varicose area, several times a day. For haemorrhoids, mix 10 drops of the essential oil blend into one tablespoon of KY jelly, then apply.
• A cool sitz (a shallow bath in which only your bottom and hips are immersed) may help improve circulation. Add distilled witch hazel to reduce swelling. Another trick is to alternate a hot and cold shower spray several times over the affected area.
• Deficiencies in vitamins E (found in sunflower seeds, soya, broccoli, wheat germ and salmon) and C (found in citrus fruits, berries, kiwi fruits, peppers and watercress) have been linked with varicosities. You should have 400iu E and 1000mg C daily.
• Acupuncture and shiatsu massage will improve circulation, and so will regular exercise.

If you are prone to varicosities and hope to avoid haemorrhoids post-natally, remember that the way your child is born will also affect whether you get piles, and how easily they are dealt with after birth – a good reason to avoid forceps and ventouse deliveries and really strenuous ‘pushing’; believe it or not the baby will come out without them.