I hate wearing shorts in the summer because I have varicose veins. They also hurt! What’s the best way to get rid of them?
Varicose veins are not only unsightly and in some cases painful, but they can also be dangerous. Varicosities come from a weakness in the wall of the vein, or in the tiny valves that prevent blood from flowing in the wrong direction as it travels up from the legs back to the heart. The veins enlarge, become painful, and, in advanced cases, can allow fluid to leak from the veins out into the tissue so that the ankles and legs become swollen, particularly after periods of prolonged standing.
Varicosities can either be in the venous system that is close to the skin (superficial) or in the deeper veins of the legs. Since the damaged vein wall can cause the formation of blood clots (called thrombosis) varicose veins are not simply a cosmetic problem. While a venous thrombosis in the superficial system can usually be treated with leg elevation and warm soaks, clots in the deep venous system are more serious. When these deep clots extend above the knee, they need to be treated with blood thinning medication.
The symptoms of varicose veins include
- Unsightly dilated, tortuous blue-colored blood vessels in the legs.
- A sensation of pressure, heaviness, or even a dull ache in the legs after standing for long periods of time.
- Swelling of the ankles and legs.
- Ulceration of the skin over veins because of blood pooling in the area.
The treatment for varicose veins varies depending on the severity of the problem. In milder cases, frequent elevation of the legs and the avoidance of long periods of standing can help to keep symptoms under control. Elastic or “support” hose can also help to avoid leg and ankle swelling. Although many brands of support hose are sold over-the-counter, I recommend that patients see a vascular specialist to have their support hose expertly measured and designed specifically for them. Individually tailored products fit better, are more comfortable, and provide better support.
In more severe cases, your physician will refer you to a competent vascular surgeon for a consultation. In some cases, the surgeon may decide to perform a procedure called slower therapy in which she injects into the veins a solution that permanently occludes it and then applies a compression bandage to the site. Within a short time, the vein disappears. Stripping, or actually removing the troublesome vein, is another surgical option that eliminates the problem. The downside with this procedure, however, is some women may be left with a series of small, unsightly scars. You and your surgeon will decide which procedure will work best for your particular situation.
Marianne J. Legato, MD, Ph. D. (hon. c.), FACP is an internationally renowned academic, physician, author, lecturer, and pioneer in the field of gender-specific medicine. She is a Professor Emerita of Clinical Medicine at Columbia University College of Physicians & Surgeons and an Adjunct Professor of Medicine at Johns Hopkins Medical School. Dr. Legato is also the Director of the Foundation for Gender-Specific Medicine, which she founded in 2006 as a continuation of her work with The Partnership for Gender-Specific Medicine at Columbia University. She received an honorary PhD from the University of Panama in 2015 for her work on the differences between men and women.
At its core, gender-specific medicine is the science of how normal human biology differs between men and women and how the diagnosis and treatment of disease differs as a function of gender. Dr. Legato’s discoveries and those of her colleagues have led to a personalization of medicine that assists doctors worldwide in understanding the difference in normal function of men and women and in their sex-specific experiences of the same diseases.
She began her work in gender-specific medicine by authoring the first book on women and heart disease, The Female Heart: The Truth About Women and Coronary Artery Disease, which won the Blakeslee Award of the American Heart Association in 1992. Because of this research, the cardiovascular community began to include women in clinical trials affirming the fact that the risk factors, symptoms, and treatment of the same disease can be significantly different between the sexes. Convinced that the sex-specific differences in coronary artery disease were not unique, Dr. Legato began a wide-ranging survey of all medical specialties and in 2004, published the first textbook on gender-specific medicine, The Principles of Gender-Specific Medicine. The second edition appeared in 2010 and the third edition, dedicated to explaining how gender impacts biomedical investigation in the genomic era, won the PROSE Award in Clinical Medicine from the Association of American Publishers in 2018. A fourth edition is forthcoming.
She also founded the first scientific journals publishing new studies in the field, The Journal of Gender-Specific Medicine, and a newer version, Gender Medicine, both listed in the Index Medicus of the National Library of Medicine. She has founded a third peer-reviewed, open access journal, Gender and the Genome, which focuses on the impact of biological sex on technology and its effects on human life.
Dr. Legato is the author of multiple works, including: What Women Need to Know (Simon & Schuster, 1997), Eve’s Rib (Harmony Books, 2002), Why Men Never Remember and Women Never Forget (Rodale, 2005), Why Men Die First (Palgrave, 2008), The International Society for Gender Medicine: History and Highlights (Academic Press, 2017), and most recently, The Plasticity of Sex (Academic Press, 2020). Her books have been translated into 28 languages to date.
As an internationally respected authority on gender medicine, Dr. Legato has chaired symposia and made keynote addresses to world congresses in gender-specific medicine in Berlin, Israel, Italy, Japan, Panama, South Korea, Stockholm, and Vienna. In collaboration with the Menarini Foundation, she is co-chairing a symposium on epigenetics, Sex, Gender and Epigenetics: From Molecule to Bedside, to be held in Spring 2021 in Italy. She maintains one of the only gender-specific private practice in New York City, and she has earned recognition as one of the “Top Doctors in New York.”
