Pregnancy, Oral Contraception, Hormone Replacement Therapy and the Occurrence of Varicose Veins: Edinburgh Vein Study

Abstract

Objective: To determine the relationship between varicose veins and duration of menstrual life, age of menopause, pregnancy, oral contraceptive use and hormone replacement therapy (HRT). Design: Cross-sectional study. Setting: City of Edinburgh, UK. Participants: Eight hundred and sixty-seven women aged 18-64 years randomly selected from 12 general practices. Methods: After completing a questionnaire, which included questions on reproductive history, the women underwent a comprehensive clinical examination including the assessment of varicose veins (trunk, hyphenweb and reticular varices), followed by duplex scanning of their legs. Results: Women who had been pregnant at least once were more likely to have minor hyphenweb or reticular varices than women who had never been pregnant (p < 0.05). Women aged 35-54 years who were current users or ex-users of the oral contraceptive pill had a lower prevalence of trunk varicose veins than women who had never taken the pill (p < 0.10). HRT was also associated with a lower prevalence of trunk varices (p < 0.05). Conclusions: These results suggest that alterations in the balance of the sex hormones may have a role in the aetiology of varicose veins.