How are the symptoms of varicose veins and spider veins (telangiectasia) characterized?

Updated: Sep 25, 2020
  • Author: Robert Weiss, MD; Chief Editor: William D James, MD  more...
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Aspects of symptoms include the following:

  • Subjective symptoms usually are more severe early in the progression of disease, less severe in the middle phases, and worse again with advancing age

  • Symptoms do not correlate with the size or extent of visible varices or with the volume of reflux

  • Not all symptomatic patients are aware of their symptoms, because the onset may be extremely gradual; after treatment, patients are often surprised to realize how much chronic discomfort they had accepted as normal

  • Pain associated with larger varicose veins is usually a dull ache that is worse after prolonged standing

  • Pain caused by venous insufficiency is often improved by walking or by elevating the legs, in contrast to the pain of arterial insufficiency, which is worse with ambulation and elevation

  • Pain and other symptoms may worsen with the menstrual cycle, with pregnancy, and in response to exogenous hormonal therapy (eg, oral contraceptives)

  • A small number of women regularly experience pain associated with their varicose veins after sexual intercourse

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