Phlebologist on the problems of modern phlebology
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Phlebologists and contraceptives
You have varicose veins, you can’t take hormones! Your blood is thick, you can't take hormones! So is it possible to take hormonal contraceptives for venous diseases? And what?
A phlebologist and the choice of a contraceptive are two incompatible things. Why? Yes, because choosing a contraceptive requires quite extensive and special knowledge, both theoretical and in terms of personal medical experience. You need to know modern publications and “be in the know.” And all this knowledge and clinical experience lies outside the competence of a phlebologist.
As an example, I will give an example of a remarkable document. It's called like this:
National medical criteria for the acceptability of contraceptive methods. Adapted document “WHO Medical Eligibility Criteria for the Use of Contraceptive Methods, 4th Edition, 2009”
The text (in Russian) can be found here: Recommendations
The document is based on the 2009 WHO recommendations. I should immediately note that a more recent version, from 2015, is available in English, but I have not analyzed it yet. The text can be found here: Medical eligibility criteria for contraceptive use, 2015
The Russian-language document is 178 pages of text, the English-language document is all 276. This is a whole book, a guide. Personally, I am not able to keep such a volume of non-core information in “RAM” for me.
On the other hand, in practice, a phlebologist is often faced with a situation where a patient comes from a gynecologist asking whether or not she can use this or that contraceptive. And a phlebologist, of course, needs basic knowledge on this issue. Therefore, let’s look at the Recommendations from the point of view of a phlebologist.
How contraceptives are ranked
The final data is in the form of a table at the bottom of the page. But to understand it, a little background information.
The summary tables of the Recommendations use numerical designations for the acceptability of a particular contraceptive. There are 4 categories (levels) of acceptability (column 2 of the table below). Interestingly, in the absence of the opportunity to consult a patient with a specialist or in the absence of the opportunity to carry out the examination necessary for risk assessment, the scheme is simplified to two categories (column 3 of the table)
WHO Eligibility Criteria for Contraceptive Methods 2009
Based on clinical data
If there is a lack of clinical data
A condition in which there are no restrictions on the use of a particular method of contraception
The method can be used under any circumstances
Method can be used
A condition in which the benefits of the method as a whole outweigh the theoretically justified or proven risks
In most cases the method can be used
A condition in which the theoretical or proven risks generally outweigh the benefits of the method.
As a rule, the method is not recommended if there are other, more acceptable and accessible methods of contraception.
Method should not be used
A condition that poses an unacceptably high health risk when using a given method of contraception
The method is not recommended for use
An example (almost verbatim) from the Recommendations:
- A woman who smokes under 35 years of age can use combined oral contraceptives (category 2)
— If a woman is 35 years of age or older and smokes <15 cigarettes per day, these drugs are usually not recommended for her if other methods of contraception are available and acceptable to her (category 3)
- If a woman is over 35 and smokes more than 15 cigarettes a day, she should not use combined oral contraceptives as it is dangerous to her health, mainly due to the risk of myocardial infarction and stroke (category 4)
Who evaluates all the details on contraceptive methods?
Obstetrician-gynecologist (if we talk about basic specialization according to the nomenclature of specialties in medicine)
Do you need a phlebologist or other “specialist” to assess risks?
In general, no. But, of course, it is a completely normal situation when an obstetrician-gynecologist cannot assess the real severity of “our” phlebological pathology. In such a situation, a colleague sends us a patient not with the task “let them look at the vessels, whether it is possible to take COCs,” but with the goal of determining the significance of the problems with the vessels. And we must clearly define it. For example, if there are “grids and stars”, I write something like “the identified changes do not have significant clinical and prognostic significance.” And then the obstetrician-gynecologist, taking into account our opinion in the general mosaic of data, gives the patient recommendations on contraception.
What kind of contraception do the Recommendations cover?
Coitus interruptus
Standard days method
Combined oral contraceptives and minipills
Hormonal patch (Evra)
Vaginal ring (NuvaRing)
Medroxyprogesterone acetate (Depo-Provera)
Combined injectable contraceptives (Lunelle)
Intrauterine contraceptives (IUD, IUD)
Copper-containing, Cu-IUD (ParaGard, T-shaped IUD containing copper)
IUD with levonorgestrel, Lng-IUD (Mirena)
Implants with norgestrel (Norplant, Norplant-2/Jadelle)
Emergency contraceptive pills (ECPs)
CONTRACEPTIVES AND VEIN DISEASES
Important! I selected from the table only the risks of complications from the venous system (risks of DVT and PE). That is, the category of acceptability is general, as in the original table, but column three is distorted to suit the interests of the phlebologist. But the most important thing is that using this tablet it is IMPOSSIBLE to select the optimal method of contraception - firstly, only a few groups of contraceptives were taken from all, and secondly, only part of the risks from a rather large list was considered.
COCs – combined oral contraceptives; PC - progesterone contraceptives (POC - progestin oral contraceptives, DMPA - depot medroxyprogesterone acetate injections, IT - implants)
Obesity (BMI > 30)
History of high blood pressure during pregnancy (now normal)
1) history of DVT/PE, anticoagulant therapy is not used
2) Acute DVT/PE
3) DVT/PE, stabilization on anticoagulant therapy for at least 3 months
4) Family history (among immediate relatives)
5) Major surgery
(a) with prolonged immobilization
(b) without prolonged immobilization
6) Minor surgery without immobilization
7) Immobilization requiring a wheelchair
IDENTIFIED THROMBOGENIC MUTATIONS
(Leiden factor, prothrombin mutation, protein S, protein C and antithrombin deficiency)
SUPERFICIAL VEIN THROMBOSIS
1) Varicose veins of the lower extremities
2) Thrombophlebitis of the superficial vessels of the lower extremities
a) Without lupus anticoagulant
b) With lupus anticoagulant
Interesting data can be noted even with a quick glance at the table. For example, Mirena (an intrauterine system with the release of levonorgestrel) can be used in all “phlebological” cases, except for acute deep vein thrombosis or pulmonary embolism. And COCs need to be replaced/cancelled if a major surgical operation with long-term immobilization is planned. I would especially like to note that the presence of varicose veins is not a contraindication to taking COCs!
There are many notes in the full text of the Recommendations. Sometimes they carry extremely important information. For example, in the situation of previous venous thromboembolic complications (DVT/PE), when the patient is taking anticoagulants, the ban on COCs is not absolute ! I will quote:
Clarification: Women on anticoagulant therapy are at risk for gynecologic complications such as ovarian apoplexy and severe menorrhagia. Hormonal methods of contraception may be useful in preventing or treating these complications. When a contraceptive method is used as therapy and not just to prevent pregnancy, the risk/benefit ratio may differ and should be considered on a case-by-case basis.
In general, the WHO document is impressive in its elaboration. The general list of references is more than 1000 titles. As is customary in polite society, links are included in the text, which makes it possible to familiarize yourself with the primary sources underlying this or that recommendation. A useful thing, as they say, must have in his library cabinets.
Phlebologist, Evgeny Ilyukhin, 07.2016 (c)
For a long time (from 17 years old) now almost 40. I suffer from varicose veins (hereditary factor).
She was operated on in 1994, veins were removed from her left leg.
There were several births. Each time I did a coalogram - the indicators were normal!
Now the veins have come out on the right leg under the inner thigh, and there is swelling in the ankles.
I'm thinking about surgery.
Are any examinations needed before taking contraceptives?
Varicose veins are a risk of blood clots appearing in them with the development of thrombophlebitis. The event is life-threatening and often requires hospital treatment. It is impossible to predict when this will happen - maybe never, or maybe tomorrow. Wearing compression stockings supposedly protects against the progression of varicose veins, but there is no complication.
Today I had an ultrasound (I copied the examination results in a private message)
varicose veins disease of the lower extremity by scattered type.
Condition after phlebectomy on the left in 1994, relapse.
Failure of Dodd's perforator on the left.
CEAR: C 1,2,S,Ep, As, d,Pr,5,10,17,L11
VCSS 5, VSDS1 (right n/k)
VSDS 1 (left n/k)
on both sides at the level of the common femur, deep femoral vein, popliteal vein, anterior and posterior tibial veins, a phasic blood flow synchronized with breathing is recorded.
No signs of obstruction were found:
the lumen is free, echo-negative, completely stained during colorectal dosage. During stress tests, no signs of valvular insufficiency were detected.
The sural sinuses are without features.
on the right is the saphenofemoral junction:
inconsistent, reflux drains along the anterolateral inflow
reflux from perineal veins
So, given this picture, does your answer to my question about the possibility of taking hormonal contraceptives remain the same?
who required wearing a plaster immobilization?
Since the answers to the last questions relate to your personal life and health, you can answer them in a personal message.
The presence of varicose veins is not a factor that increases the likelihood of this complication. Thrombophlebitis of the superficial veins almost always develops in varicose veins. Such veins are like a buried mine - they can lie there for years, or they can explode at any minute.
If you want, you can come to our clinic MEDALP| REACLINIC for an in-person consultation. Let's take a look and decide which method of treating varicose veins is right for you.
the progression of varicose veins is and will be with me.
Of course the concern is the risk of thrombosis.
And, I can contact Siqueiros only after the phlebologist assesses the risk of taking hormonal drugs.
Which is exactly why I asked the question.
Children are my wealth
1. Deep vein thrombosis and thrombophlebitis of superficial varicose veins are different conditions.
2. Taking hormonal drugs increases the risk of deep vein , regardless of the presence of varicose veins. Those. To assess the risks of taking contraceptives, it doesn’t matter whether you have varicose veins or not, and it doesn’t matter what its features are.
3. The risk of taking contraceptives must be assessed by those who prescribe them. And only so. And only in person. The main contraindication is the presence of hormone-associated venous thrombosis in the past.
4. The data you provided does not indicate any additional risk factors for venous thromboembolic complications, other than varicose veins. In general, treatment of varicose veins is recommended to reduce the risks of complications of varicose veins. The tactics are determined in person after examination by a phlebologist.
The formation of varicose veins is a consequence of a sedentary lifestyle, excessive physical activity, hereditary predisposition and a number of other factors, which makes it possible for it to appear in people of different ages and does not depend on gender. Ignoring varicose veins during its initial manifestations leads to its more severe forms and complications.
Pathological changes in the structure of venous vessels cause varicose veins, as a result of which their patency and elasticity deteriorate, and the walls become thinner and specific nodes form.
There are several types of varicose veins:
The expression “varicose veins” is firmly established in everyday life, but in official medicine there is no such concept or diagnosis, since we are talking about varicose veins.
The formation of the symptomatic picture of the disease directly depends on its type. They are united by a cause-and-effect relationship of formation: congenital or acquired insufficiency of the semilunar valves.
The disease, which spreads to the lower extremities, is accompanied by symptoms:
A consequence of the development of varicose veins of the rectum is the appearance of hemorrhoids. It is accompanied by the following symptoms:
The appearance of varicose veins is a consequence of a number of reasons, which together or individually can provoke the development of this disease.
The causes of varicose veins are:
Important! With early manifestations of varicose veins, the role of therapeutic and preventive measures is important; when they are carried out, the chance of preventing further development of the disease increases significantly.
At an early stage of manifestation, varicose veins are indicated by a feeling of heaviness, swelling, and aching pain in the legs. During this period, it is necessary to immediately begin preventive measures: a course of massage, swimming, the use of special foot creams, since all this is effective in preventing the development of varicose veins only at first.
If symptoms and signs of varicose veins appear, you should consult a phlebologist at the clinic at your place of residence. In its absence, an examination will be required and a consultation will be carried out by a vascular surgeon.
Diagnostic procedures include examination, collection of complaints and medical history. An ultrasound scan of the veins is used, which shows whether there is insufficiency of venous blood flow, the condition of the valves and communication with the internal veins is assessed. As a rule, this method is quite sufficient to confirm the formation of varicose veins.
Important! Read our article for more details on which doctor to contact.
Varicose veins can lead to serious complications. At the last stage of development of varicose veins, extreme thinning of the walls of blood vessels is observed, and therefore the risk of trophic ulcers – open, poorly healing wounds on the vessels that occur even with minor traumatization – increases.
The result of varicose vein rupture is the development of thrombophlebitis. During its appearance, thrombosis occurs with inflammation of the vein wall and a blood clot is formed that closes its lumen.
With the development of acute thrombophlebitis, severe pain appears in the area of thrombosed veins, body temperature rises, accompanied by chills. Thrombophlebitis of the superficial veins is characterized by painful compactions with reddening of the skin along the veins. Deep vein thrombophlebitis is accompanied by swelling of the extremities due to a sharp disruption of venous outflow.
Many women experience varicose veins. This is due to the predisposition of women to the disease due to the characteristics of the female hormonal system. In addition, pregnancy and childbirth in most cases become the causes of varicose veins, as there is an impact of increased load and increased blood flow to the pelvic organs.
In addition to varicose veins of the lower extremities, women often develop varicose veins in the perineal area, affecting the external genitalia, which is a consequence of congenital or acquired weakness of the vascular wall and valve insufficiency. Exposure to external (prolonged static stress, significant physical activity) or internal factors (excess body weight, chronic diseases of the pelvic organs) leads to the formation of varicose veins.
Important! The question of the influence of oral contraceptives and hormone replacement therapy remains open.
Carrying each subsequent pregnancy dramatically increases the chances of developing venous insufficiency in women and the formation of varicose veins. This is due to hormonal changes in a woman’s body and a significant increase in the load on the veins.
The main task of a woman during this period is to comply with preventive measures to avoid the development of varicose veins. If there is a predisposition and signs of the initial development of varicose veins are observed, consultation and observation by a phlebologist is necessary throughout pregnancy. Preventive measures should be supplemented by wearing compression garments; in some cases, they must be worn during childbirth. Special models are produced for this purpose.
Varicose veins often occur in men in the form of varicocele - varicose veins of the spermatic cord. Symptoms of the disease:
The development of varicocele becomes the cause of male infertility due to poor circulation and accompanying pathological changes in the normal functioning of the testicles:
Treatment of varicose veins in men consists of surgery if there are indications: pain in the testicular area, infertility, aesthetic defect in the scrotum, lack of growth of the affected testicle during puberty. However, the disease may be asymptomatic and not cause significant discomfort to the man.
In adolescents and children, when varicocele is diagnosed, surgery is necessary at any stage of the disease, this helps avoid the further development of infertility.
Operations are performed both in the usual open and endoscopic manner. It is possible to perform surgical intervention from a mini-access and microsurgical revascularization of the testicle.
Children are also susceptible to the appearance of varicose veins. In them, this phenomenon is extremely rare and in most cases is a consequence of a congenital pathology - angiodysplasia, an anomaly of the peripheral vascular system. The disease mainly affects the lower extremities. As a result, pronounced anatomical functional disorders occur. This leads to irreversible changes and early disability.
Important! The effectiveness of treatment depends on the age of the child. Immediate hospitalization is required at the first signs of varicose veins. In this case, surgical intervention is indicated.
In addition, the development of varicose veins in adolescence has become quite common. This disease mainly affects girls. It can be caused by:
Among the factors influencing the appearance of varicose veins in children are:
For preventive purposes, to avoid the development of varicose veins, it is necessary to monitor the child’s nutrition. The diet should be balanced; it is useful to include foods rich in routine. It is found in large quantities in hazelnuts, horse chestnuts, as well as berries - rose hips, sea buckthorn, black currants. Decoctions and juices from these berries can have a preventive and general strengthening effect for the body.
Varicose veins can also occur in the pelvic area. In this form it occurs in most cases in women, which is due to the peculiarities of the blood supply to the female body. Dilation of the veins causes a feeling of pain and heaviness in the pelvic area, which can be caused by venous stagnation.
The development of varicose veins of the small pelvis occurs for several reasons:
If you have risk factors and symptoms of the disease, you should be examined. In the early stages, varicose veins of the small pelvis can be detected using ultrasound diagnostics. Preliminary diagnosis is also possible during a gynecological examination during a standard procedure.
Treatment of the disease includes taking venotonic drugs, wearing special compression garments, and performing therapeutic and preventive exercises. It is also necessary to exclude risk factors and regularly see a gynecologist. If conservative treatment methods are ineffective, surgical intervention is indicated.
Therapeutic measures for varicose veins consist of conservative medical treatment methods and, in later stages, surgical intervention.
In the early stages and at the first signs of varicose veins, it is recommended to take venotonics - Detrolex.
Important! As preventive measures, elastic leg bandaging, wearing compression stockings and limiting physical activity at all stages of the disease are recommended.
In the later stages, medications and ointments for varicose veins are prescribed:
In the later stages, phlebectomy, surgical removal of pathologically altered veins, as well as sclerotherapy are indicated - the introduction of special drugs that sclerose damaged veins, thereby preventing their participation in venous outflow.
It should be noted that we have already written in detail about which compression garments are better, but at the moment only the surgical method of treatment has proven itself to be the most effective.
Treatment of varicose veins at home is not only possible, but also necessary. In the early stages of the development of this disease, treatment procedures will help strengthen the walls of blood vessels and help prevent its further development.
For these purposes, a physician-phedologist prescribes a course of tablets to improve venous circulation, increase the elasticity of blood vessels and strengthen their walls, as well as to prevent the development of blood clots and, on this background, thrombophlebitis.
Important! Rutin is recommended as a vitamin supplement.
Special gels and ointments can help relieve pain and heaviness in the legs caused by varicose veins. They are unlikely to help get rid of varicose veins, given the local effect and weak penetration through the skin, but they will relieve the symptoms of the disease and alleviate the condition. Among the means for external use the following groups can be distinguished:
Also a mandatory element of the treatment of varicose veins is wearing special compression garments. Such underwear should be selected individually depending on the degree of varicose veins. Based on the diagnosis, the phlebologist should recommend the degree of compression when choosing underwear.
The degree of compression differs depending on the stage of the disease and has different effects. Lingerie with a low degree is usually used for predisposition to varicose veins and for preventive purposes.
A high degree of compression is recommended for severe varicose veins and has a therapeutic effect. It is able to relieve stress from the affected areas of blood vessels, redistributing pressure and stimulating blood circulation, and prevents venous congestion.
Underwear must be worn on a regular basis, especially with increased physical activity, prolonged time on your feet or, conversely, with a sedentary lifestyle. It is available in the form of tights, stockings, and golf. The model is selected taking into account the nature of the location of varicose veins. A line for pregnant women as a therapeutic and prophylactic agent is presented separately.
Traditional medicine recipes for varicose veins are also used to relieve symptoms and as general tonics.
When pain appears in the veins, compresses made from green tomatoes help a lot. To do this, just take the fruit, cut it into slices and place it on the damaged area overnight, securing it with a bandage.
Green tomatoes contain the antioxidant lycopene. Due to its effect, not only pain is relieved, but also blood circulation improves and the phenomena of stagnation are reduced. With regular use, the bumps formed due to varicose veins become less painful and may decrease in volume.
You can also use regular tomatoes in the form of tomato paste for compresses, since it contains the highest concentration of lycopene.
It is necessary to supplement anti-varicose therapy with general restoratives. Freshly squeezed vegetable juices should be consumed daily as a source of nutrients.
Carrot-spinach-celery fresh. To strengthen blood vessels, carrot juice is useful, which contains a high concentration of rutin, a microelement that helps strengthen blood vessels. The composition of spinach leaf juice is rich in oxalic acid. It has a cleansing function in relation to blood vessels and prevents the formation of blood clots.
Important! Celery is involved in accelerating the process of breakdown of fat deposits, removing the products of this breakdown and excess fluid from the body.
Carrot-spinach-beetroot fresh. Beet juice helps improve blood circulation and hematopoiesis, as it stimulates the synthesis of red blood cells, increases hemoglobin levels and prevents anemia. Prepare in the ratio 10:3:3.
The volume of juices for daily consumption is 500 ml between meals. If you don’t have a juicer, you can use a blender or meat grinder, place the resulting ground mass on clean gauze and let the juice drain.
Preventive measures play an important role in the presence of risk factors for the development of varicose veins. Therefore, you should not ignore their compliance even with already diagnosed varicose veins. This will protect against its further development and the need for surgical intervention.
In order to reduce the risk of developing varicose veins, you must:
Prevention and treatment of varicose veins also involves performing therapeutic and preventive gymnastics exercises aimed at improving blood circulation and getting rid of signs of blood stagnation.
Important! It is useful to perform such exercises on a regular daily basis.
It is necessary to begin classes with preliminary preparation of the legs: to do this, you need to lie on your back, placing your legs on a bolster or the back of the sofa. Remain in this position for 10-15 minutes.
Next, while remaining in a lying position, begin performing the exercises:
Varicose veins develop over a long period of time, so when the first signs appear, there is a chance to stop its progression. But the only method to completely get rid of varicose veins is surgical removal of the veins.
Varicose veins are a serious disease that most often occurs in women.
This disease can cause severe vascular complications. Its timely diagnosis and treatment allow the patient to easily overcome the disease.
At the same time, in the advanced stages of the disease, the patient will suffer from severe pain, swelling, etc.
The process of development of varicose veins can be divided into stages that have a direct connection with the symptoms of the disease.
Initially, the disease does not cause any pain or severity. The patient has no complaints. The exception is minor cosmetic violations.
So, when you stay on your feet for a long time, small mounds of veins appear. Often the disease begins with the appearance of spider veins. This is the first stage of varicose veins.
Further development of the disease is associated with the appearance of the following symptoms:
The appearance of these signs indicates that the disease has entered the second stage.
The next stage of varicose veins is accompanied by pigmentation of certain areas of the skin. This happens along the veins affected by the disease. Patients note loss of skin elasticity and dryness.
At the fourth stage, trophic ulcers and vascular replenishment are formed (phlebitis, thrombophlebitis).
Varicose veins have numerous causes. According to statistics, it develops 2-3 times more often in women than in men.
Other reasons for the development of varicose veins include the following:
In the early stages of the disease, it is very difficult to detect. The patient has no complaints. Few people pay attention to minor pain in the legs and swelling after a working day. It is these symptoms that indicate the onset of the disease.
Then these “minor” symptoms are accompanied by a pain syndrome, which seriously begins to bother the patient. Plus, the patient experiences cramps at night. Gradually, pigmentation appears on the affected veins. The skin itself loses elasticity and becomes easily wounded.
The severe course of the disease is manifested by the occurrence of trophic ulcers and various types of inflammation of the veins.
In the first stages of the disease, its symptoms cannot be called obvious. This is why varicose veins can be confused with other ailments, such as flat feet and osteochondrosis.
A timely visit to a doctor will allow you to diagnose a dangerous disease in the early stages and successfully treat it.
There are several types of varicose veins depending on the location. Pathological changes can affect the entire venous system of the body:
Causes of varicose veins on the penis:
The development of the disease will not affect the quality of sexual intercourse until the patient experiences pain.
The development of varicose veins is accompanied by pain in the hands, the appearance of unaesthetic nodes, the veins become heavily engorged with blood and swell. The limbs may become numb, they react to changing weather, and it becomes difficult for the patient to hold objects for a long time.
The development of the disease can contribute to the appearance of the following diseases:
The pain syndrome manifests itself especially strongly after physical exertion, during moments of intimacy and the premenstrual period. The main reasons for the development of varicose veins on the abdomen:
It occurs due to various reasons:
Conservative or surgical treatment may be prescribed depending on the severity of the disease.
Varicose veins are a well-studied disease. However, people have many questions related to the process of its course, as well as some restrictions and prohibitions for patients.
Long-term use of oral contraceptives leads to the development of varicose veins. Diagnosis of this disease should be the reason to consult a doctor to select the safest means of protection against unwanted pregnancy.
Most medications should not be used by patients with varicose veins. They can worsen the progression of the disease.
The fact is that the use of OCs affects the level of hormones in the body. Their increase can lead to the appearance of blood clots in the veins. Doctors recommend completely abandoning hormonal contraceptives.
Doctors recommend using condoms as a means of preventing unwanted pregnancy.
Varicose veins are accompanied by pain, which greatly worries patients. There are several ways to remove it. For example, non-steroidal anti-inflammatory drugs (Diclofenac, Indomethacin).
The medicine can be internal or local. Attacks are “softened” with the help of analgesics. However, they can only dull the pain, but have no effect on the disease itself.
Venotonics are successfully used to alleviate the patient’s condition. They do not have an analgesic effect, but reduce congestion, so that the discomfort gradually goes away.
Compression stockings are used to relieve pain. Thanks to its wearing, the load is removed from the venous walls, blood circulation is stimulated, and tissue nutrition is normalized.
A contrast shower has a beneficial effect on the patient's condition. This procedure is carried out before bedtime. Thanks to water manipulations, the tone of the veins improves and blood stagnation is prevented.
Doctors advise doing yoga for varicose veins. Such physical activity allows you to quickly achieve positive treatment results.
Special yoga-based gymnastics have been developed, which is a kind of prevention of this dangerous disease.
The advantages of yoga over other types of activity are that it is not associated with sudden traumatic movements. All exercises are performed smoothly.
Varicose veins are a dangerous disease that can cause serious consequences and complications for the patient.
Increased physical activity negatively affects the progression of the disease. That is why diagnosing a patient with chronic venous insufficiency of the second degree is the basis for exemption from military service.
Varicose veins at this stage are manifested by pain and swelling after prolonged stress on the lower limbs.
This disease can affect both children and adolescents. Moreover, the disease itself is of a congenital nature. It is found in those children who have pathologies of the vascular system.
Doctors also diagnose acquired varicose veins even at such a young age. This is usually due to the fact that children 5-6 years old attend dance classes or engage in athletics.
In adolescents, this disease manifests itself at the age of 10-12 years. The reasons are the same as for adults. Quite often, the disease develops after an incorrectly selected course of treatment with antibiotics or hormonal drugs.
Vitamins for varicose veins can significantly slow down the development of the disease. They influence the rate of chemical reactions, as well as the absorption of nutrients by the body.
One of the sources of vitamins are fruits and vegetables. However, their use may not be sufficient. Vitamin deficiency is compensated with the help of special complexes. They are assigned by a doctor.
The following vitamins are of primary importance for varicose veins: C, B1, P.
A phlebologist is a doctor who specializes in venous diseases. It is this doctor who diagnoses varicose veins and prescribes conservative methods for treating the disease to the patient.
According to statistics, every third woman in adulthood suffers from symptoms of varicose veins of the lower extremities. About 40% of all patients are men with disruption of normal blood flow in the legs. Unfortunately, most people realize the seriousness of the disease when varicose veins become a source of unbearable pain, as well.
Varicose veins are a lesion of the veins, in which the diameter of the lumen increases, the venous walls become thinner and nodes form. Often conservative treatment does not produce positive results, and surgical intervention helps to cope with the disease. Indications Surgery for varicose veins in the legs is indicated in.
Drug treatment for varicose veins involves the use of two groups of drugs: drugs whose action is aimed at thinning the blood, and drugs used to strengthen the walls of blood vessels. The most effective is considered to be a combination of drugs from both groups. Drug therapy is not.
Compression garments have been used for quite a long time to treat varicose veins, regardless of the age, gender and physique of the patient. It appeared at the beginning of the 20th century and is still very popular. But it is very important to choose the right type and size, follow the recommendations of experts and take into account.
With varicose veins, irreversible expansion and lengthening of the veins occurs, thinning of their walls and the formation of aneurysm-like nodes, which over time causes blockage of blood vessels and insufficient oxygen supply to the affected area. Hirudotherapy can help the patient cope with the disease.
Varicose veins of the pelvic veins in women are a common problem. The main insidiousness of the disease is due to the fact that in the first stages it is difficult to diagnose and can be easily confused with other “female” problems, for example, colpitis. The first manifestations of the disease appear in adolescence, but progress.
During pregnancy, a woman is especially vulnerable. Most often, due to hormonal changes in the body associated with gestation, all the chronic diseases that bothered the young mother before appear. One of the serious problems during this period is the expansion of veins in the groin. It's worth noting that this is.
During the period of bearing a baby, the female body undergoes a serious “strength test”. All sorts of complications are common, one of the most common being varicose veins of the small pelvis during pregnancy. The insidiousness of the disease is that there are no external manifestations, unlike varicose veins of the lower extremities. The only sign.
Varicose veins are a pathological deformation of venous vessels, as a result of which the tone of the vein walls is lost. For good blood supply to tissues, it is required that the blood not only flows under a certain pressure, but also returns back to the great vessels. Strong and elastic vein walls.
It is believed that an active lifestyle is the key to health and success. However, this is not always true. With many diseases associated with excessive physical activity, the body's condition can be significantly worsened. Therefore, many patients with vascular pathology have a question: is it possible to play sports with varicose veins?
Varicose veins are a pathological process that is characterized by an increase in the lumen of blood vessels that provide blood outflow, thinning of their walls and deformation up to the formation of nodes and ruptures. For anatomical reasons, the disease is most often found in the veins of the lower extremities.
External signs of varicose veins are not exclusively an aesthetic problem: spider veins and protruding dark-colored veins are only symptoms of circulatory disorders, which are fraught with life-threatening consequences.
The mechanism of development of varicose veins is associated with a decrease in the functionality of venous valves. They are subject to large mechanical loads, therefore, under the influence of genetic factors, hormonal surges, inflammation in the tissues of the lower extremities and stress, they weaken and do not prevent the reverse flow of blood. Inflammation occurs against the background of stagnation associated with high blood viscosity, physical inactivity or prolonged exposure to a standing or sitting position.
The pressure of excess blood volume on the walls of the veins deforms them, depriving the functionality of the muscular and nervous venous wall, which ensure its stable tone. Stagnation of blood, overstretching of blood vessels and inflammation of their walls often lead to the formation of accumulations of blood cells that block the lumen of the veins.
Varicose veins in the legs, therefore, are not a superficial problem associated with mechanical damage to the subcutaneous vessel or temporary phenomena, but a deeper circulatory disorder that has developed in a patient prone to the disease under the influence of risk factors.
Drug therapy for the disease is aimed at:
In the absence of adequate treatment, the dangers of varicose veins of the lower extremities can become a reality for each of the patients with this disease.
In 80% of cases, women suffer from varicose veins on the legs. The main danger of varicose veins in women is the likelihood of early development of the disease due to hormonal fluctuations during puberty or pregnancy. During pregnancy, only gentle therapy that does not have a teratogenic effect is possible. Additional stress on the legs, lack of intensive treatment and stress during pushing can stimulate the worsening of the disease.
As a rule, thrombophlebitis and other dangerous consequences of varicose veins occur at the 3rd stage of venous insufficiency. Symptoms of late stages of vascular insufficiency:
Poor circulation in the extremities is caused by dermatitis, eczema, and skin inflammation.
Telangiectasia is the least dangerous consequence of venous insufficiency. The condition is characterized by the appearance of vascular “networks” and “stars”, which are accompanied by swelling, fatigue of the legs, regular occurrence of a feeling of numbness and night cramps in the calves. An aesthetic defect is one of the reasons why women often turn to phlebologists in the early stages of varicose veins. In an effort to keep their legs beautiful, patients also take care of their health.
Thrombophlebitis is thrombosis due to inflammation of the venous wall and stagnation of blood in the dilated vessel. The developed disease is characterized by induration and painful palpation (palpation) of the affected vessel, as well as redness of the skin around the blood clot. Thrombophlebitis develops in approximately 25% of patients diagnosed with varicose veins. Blood clots located in superficial veins have a low risk of rupture causing harm to health, however, if the clot moves along the subcutaneous or perforated vessel, immediate hospitalization is necessary.
Deep vein thrombosis is much more dangerous than varicose veins and thrombophlebitis. Blood clots formed in the deep vessels of the lower extremities are capable of tearing off and blocking the pulmonary artery, which leads to death. Characteristic symptoms of deep vein thrombosis are severe swelling of the limb that occurs in a short time and sharp bursting pain in the calf or thigh muscle. The spread of the pathological process to the deep vessels of the lower extremities can be observed in the later stages of varicose veins.
A trophic ulcer is a deep defect in the dermis that forms in the later stages due to impaired blood flow in the superficial layers of the skin. It is a long-healing painful wound that is difficult to treat.
Varicose veins of the lower extremities are among the risk factors for the development of similar pathology in other vessels of the pelvic organs of men and women.
Treatment of complications of varicose veins in the legs, as a rule, begins with drug therapy for the primary disease.
To reduce the deformation of blood vessels that dilate due to decreased tone, venotonics based on hesperidin, diosmin, esculin and other active ingredients are prescribed. Trade names of drugs:
For inflammation of the venous walls, drugs from the group of NSAIDs (non-steroidal anti-inflammatory drugs) - Indomethacin, Diclofenac, etc. - are prescribed in the form of tablets and gels. Oral administration of NSAIDs is recommended for thrombophlebitis.
A decrease in blood viscosity is achieved through topical application of ointments with anticoagulant components (for example, heparin ointment or Hepatrombin G cream) and oral administration of rutin and methylxanthine derivatives, which have aniagregant properties (for example, the drugs Ascorutin, Troxevasin, Trental).
Superficial manifestations of varicose veins on the legs (including telangiectasia) are eliminated by sclerotherapy (gluing the walls of the affected vessel using a special drug). The procedure does not cause significant harm to health and does not disrupt blood flow, because During rehabilitation, the functions of the superficial veins are transferred to the deep vessels.
For deep vein thrombosis, bed rest, intravenous administration of anticoagulants (heparin, traxiparin) and antiplatelet agents (methylxanthine) with blood viscosity control are prescribed. Surgical treatment for deep vessel thrombosis and thrombophlebitis (including the great saphenous vein) is indicated if there is a high risk of blockage of the pulmonary artery.
Treatment of trophic ulcers is aimed at stimulating wound healing and treating the primary disease.
Prevention of complications of varicose veins includes the following measures:
Early diagnosis of varicose veins, timely adequate treatment and reduction of the influence of risk factors prevents the development of complications of the disease. The use of minimally invasive surgical methods in some cases eliminates not only aesthetic problems, but also the likelihood of worsening the pathological process.