Leg pain from varicose veins tends to worsen just before menstruation.

Many women who suffer from varicose veins or venous reflux disease (without any visible signs of disease) commonly experience increased leg discomfort, leg fatigue and swelling prior to menstruation.  The reason for this is the hormone progesterone. Progesterone rises about a week before menstruation. Progesterone has a significant effect on the veins. Progesterone causes the vein walls to relax, allowing more blood to pool within them. The increased pressure caused by the excessive pooling of blood worsens symptoms.  Saphenous veins, the large superficial blood vessels found in legs, are particularly susceptible to varicosity due to extra progesterone. This is also a reason pregnancy contributes to the development of varicose veins. We have had several patients who have reported their first sign of pregnancy was leg and varicose vein pain (because of the hormone changes).

Symptoms prior and during menstruation can be treated conservatively, with leg elevation, exercise, compression therapy, ibuprofen, and ice packs.