SPRING 2026 BLOG: Why Are Women More Likely to Get Varicose Veins?

By Dr. Charles I. Stein M.D. FACOG-OBGYN, FACSLMS, AVF

In the US, there are over forty million women with varicosities known as varicose veins. In fact, women are twice as likely as men to develop varicose veins, especially as they age.

The reason? It mostly comes down to women’s hormones and their effect on veins.

Understanding how varicose veins develop 

Let us begin with the blood pathways. Our bodies receive oxygen from our arterial system. Organs, brain, muscle, and other tissue use this oxygen in the blood from the arteries. Once oxygen rich blood from arteries is used, it becomes deoxygenated and returns to the heart and lungs via the venous system to pick up oxygen from the air we breathe. Our veins are low pressure, more elastic vessels with one-way valves that prohibit the blood from flowing backward. Women’s veins weaken over time due to pregnancy, standing or sitting for prolonged periods, as well as hereditary factors, menopause, and lifestyle. As a result, veins weaken, allowing blood to flow backwards. This is known as venous insufficiency and can lead to varicose veins.

These additional pressures in your leg veins make them more susceptible to becoming enlarged. This process begins to unfold when the one-way valves that keep venous blood flowing forward, become weak and damaged, allowing blood to flow backward.

As blood repeatedly collects below these broken one-way vein valves, it exerts significant force on the surrounding vein wall. Over time, this pressure can cause veins to swell, twist, and distort, eventually forming a visible varicose vein. Smaller spider veins on the surface of the skin can often occur due to underlying weakened larger veins supplying them

Why should women be concerned about varicose veins beyond appearance?

The childbearing years, menopause, post menopause

Varicose veins aren’t only a cosmetic concern but can cause swelling, increased pigmentation, damage to lymphatics and eventually leg ulcers. Women are far more likely to develop varicose veins than men for a significant reason: At higher levels, female reproductive hormones estrogen, progesterone, and relaxin occurring during childbirth can have a negative effect on vein health and function. Also, during and after menopause, reduction of Estrogen, Progesterone can have similar effects. Hormones rise and fall at various times within a woman’s monthly menstrual cycle; they also increase dramatically during pregnancy and reduce during menopause. Women who take hormonal birth control with progestin (synthetic progesterone) or a combination of estrogen and progestin also have higher levels of these hormones in their blood. 

Together, these hormones can have a significant effect on your leg veins:

• Progesterone levels increase during pregnancy and decrease during menopause. Prior to menopause progesterone can increase elasticity and allow vein walls to expand. During and post menopause, low progesterone can reduce connective tissue, impacting elasticity of vein walls and vein valves. This loss of connective tissue also occurs with skin and other soft tissue as we age.
• Hormones estrogen and Relaxin levels increase during pregnancy, with estrogen decreasing during menopause. Both, an increase and decrease, impact vein wall integrity, and subsequent one-way valve function

These hormonal effects on veins make it harder for your veins to keep blood flowing efficiently from your lower extremities back to your heart and lungs. During pregnancy these hormones impact veins elasticity, often allowing veins to expand and swell.

During, and post menopause these hormones decrease substantially, decreasing connective tissue (collagen levels), causing soft tissue including skin to lose elasticity. Veins can become brittle and one-way valve function is compromised.

During both pregnancy and menopause these conditions can create symptoms of venous insufficiency even before varicose veins are seen. Symptoms can include swelling, dry, itchy skin, leg cramps, and skin changes.

Factors that make varicose veins more likely

Other risk factors that make venous insufficiency more likely:

• Family history 
• Being overweight
• Leading a sedentary lifestyle
• Standing still or sitting for extended periods
• Tobacco and alcohol use
• Older age 
• Taller height

As you might suspect, the more “risk factors” you are able to relate to, the more susceptible you are to developing varicose veins. The good news is that there are opportunities for you to take action to reduce your chances of getting varicose veins.

Prevention strategies and treatment options

There are four important actions you can take to reduce your varicose vein risk. Starting as soon as possible, you should aim to: 

• Refrain from all tobacco use
• Reach and maintain a healthy body weight
• As tolerated, 30-60 minutes of moderately intense exercise most days
• Elevate your legs often each day
• Avoid standing still or sitting for prolonged periods

Of significant importance is to wear prescription compression stockings that are medical grade and will maintain a “gradual compression” from foot to top of calf. These are especially important to wear if you have preexisting varicosities, your occupation requires prolonged standing, sitting, or if you are pregnant.

SOLUTIONS AT VASCULAR VEIN CENTERS

If you already have varicose veins, we offer a full scope of treatment solutions to help you get rid of problematic veins for good. A typical treatment plan incorporates minimally invasive vein treatment such as sclerotherapy or endovenous laser therapy (EVLT), along with lifestyle modifications and compression therapy to help prevent recurrence. These procedures do not require surgery and most resume normal activity within a day or two

 Whether you are interested in varicose vein prevention, treatment, or both, our expert team at Vascular Vein Centers can help. We are the only accredited vein center for both diagnosis and treatment, best vein treatment. Call or click online to book an appointment at your nearest office. We have six Central Florida locations in College Park of Orlando, Waterford Lakes of East Orlando, Kissimmee, Davenport/Haines City, Lake Mary, and The Villages, Florida.