Last updated on February 17, 2026
Varicose veins can affect both women and men, but the reasons they develop and the way they appear often differ between the two. These differences are influenced by a range of factors, including hormones and anatomy. In this latest blog, we explore how varicose veins in women differ from those in men, the role hormonal changes play, and the symptoms each group is more likely to experience.
What Are Varicose Veins?
Varicose veins are enlarged, twisted veins (usually in the legs) that develop when the valves responsible for directing blood back toward the heart become weak or ineffective. As blood begins to pool, the vein stretches, widens and eventually becomes visible beneath the skin.
Typical symptoms include heaviness, aching, ankle swelling, restlessness in the legs and noticeable bulging veins. While men and women often experience similar symptoms, the underlying reasons they develop can differ.
Varicose Vein Causes in Women vs Men: What Makes Them Different?
Varicose Vein Causes in Women
Hormonal influence
Hormonal activity is one of the primary reasons varicose veins develop more frequently in women. Oestrogen and progesterone naturally relax and soften the venous walls, which can reduce elasticity and make venous valves more vulnerable to weakening. As women experience regular hormonal shifts, their veins are exposed to more cyclical changes that influence their firmness and stability.
Many women notice that symptoms worsen around their menstrual cycle, during pregnancy or throughout perimenopause and menopause. Hormonal contraceptives and hormone replacement therapy (HRT) may also affect vein function, particularly in those who already have underlying venous weakness. This hormonal influence explains why varicose veins are both more common and often appear earlier in women.
Pregnancy
Pregnancy places significant strain on the venous system. As blood volume increases and the uterus expands, pressure builds on the pelvic veins, reducing the efficiency of blood flow back to the heart.
This combination makes varicose veins particularly common during pregnancy, with many women developing them for the first time. Some women experience improvement after giving birth, but for others, the veins persist or tend to worsen with later pregnancies.
Varicose Vein Causes in Men
Occupational and lifestyle factors
Although men develop varicose veins less often than women, the condition is often more advanced by the time they seek medical attention. This is partly because early symptoms such as heaviness, aching, or swelling may be mistaken for muscle fatigue or general wear-and-tear, leading to delays in diagnosis and treatment.
Occupational and lifestyle factors can also play a role. Jobs or activities that involve prolonged standing, long hours on the feet or frequent lifting increase pressure within the leg veins. Over time, this added strain can weaken the vein walls and valves, contributing to venous reflux and the development of varicose veins. When these patterns are combined with delayed care-seeking, varicose veins in men may appear more pronounced by the time they are identified.
Physiological differences and later presentation
Men generally have stronger calf muscles, which enhance the efficiency of the “muscle pump” that helps return blood to the heart. While this can provide some early protection, it may also mask initial signs of venous weakness. As a result, symptoms may go unnoticed until the condition becomes more severe.
When varicose veins do appear in men, they are often larger, deeper or more uncomfortable than in women due to this delayed presentation and longer period of underlying venous strain.
Although women and men share common varicose vein symptoms, the way they appear and when they become noticeable differ.
How Varicose Vein Symptoms Differ in Women and Men
Although women and men share common symptoms such as heaviness, aching, swelling and visible bulging veins, the way these symptoms appear and when they become noticeable often differ between women and men.
Symptoms in Women
Women tend to experience symptoms that fluctuate with hormonal changes. Many notice their legs feel heavier or more swollen around their menstrual cycle, during pregnancy, or throughout perimenopause and menopause. Veins may also become more visible near the skin’s surface, appearing as blue, purple, or twisted lines on the legs.
As women naturally have softer connective tissue and a different fat distribution pattern in the legs, visible vein changes may appear earlier. This can make cosmetic changes more noticeable sooner, prompting earlier evaluation or treatment.
Symptoms in Men
In men, symptoms often develop gradually and may be deeper or more pronounced by the time they are recognised. Rather than visible surface veins, men are more likely to first experience sensations such as leg heaviness, tightness, throbbing after activity, or swelling around the ankles.
As men may attribute discomfort to physical strain, exercise or work-related fatigue, varicose veins often go untreated for longer. As a result, the veins that eventually become visible may be larger, more uncomfortable and associated with more advanced venous insufficiency.
Key Symptom Differences Between Women and Men
Women typically notice visible surface veins and cyclical flare-ups related to hormones, while men more often report deeper, persistent discomfort that progresses without obvious external signs at first. These differences in symptom patterns influence how early the condition is detected and why men often present with more advanced disease despite having a lower overall prevalence.
There are various treatments for varicose veins, including sclerotherapy, medical glue treatment and ambulatory phlebectomy.
What Are the Treatment Options for Varicose Veins?
Regardless of whether varicose veins occur in women or men, the condition requires medical treatment. At Vein Doctors Sydney, we offer a range of minimally invasive treatments, which include:
Sclerotherapy involves injecting a specialised solution into the affected vein, causing the vein walls to collapse and gradually seal shut. This technique is most effective for smaller varicose veins and surface-level veins.
Endovenous Laser Ablation (EVLA) & Radiofrequency Ablation (RFA)
EVLA and RFA both use targeted heat to seal a faulty vein from the inside. A thin catheter is guided into the diseased vein, and either laser or radiofrequency energy is applied to close it. These treatments are designed for larger veins or those affected by venous reflux.
Medical Glue Treatment (VenaSeal)
VenaSeal uses a medical-grade adhesive to permanently close the problematic vein without the need for heat or tumescent anaesthetic. This modern, non-thermal option allows for quick recovery and minimal discomfort.
Ambulatory phlebectomy is a minor surgical procedure that removes bulging or surface varicose veins through tiny punctures in the skin. It is performed under local anaesthetic, and the small incisions typically heal with minimal scarring.
Medical-grade compression stockings help improve venous return by applying graduated pressure to the legs. They are often recommended alongside treatment to reduce swelling, ease discomfort and support circulation. For some individuals with early or mild symptoms, compression stockings can provide meaningful relief on their own.
How to Book an Appointment
At Vein Doctors Sydney, we are committed to providing personalised and compassionate care for patients seeking treatment for varicose veins. For more information on our services or to schedule a consultation at our clinic, please contact our friendly staff by either calling us on (02) 9023 9970, via our online form or by sending us an email.
Frequently Asked Questions
Are varicose veins more common in women?
Yes, varicose veins are more common in women, with studies suggesting they’re roughly twice as likely to develop them compared to men.
The main reason comes down to hormones. Oestrogen and progesterone can weaken vein walls and affect valve function, and because these hormones fluctuate throughout the menstrual cycle, pregnancy and menopause, women’s veins are under more strain over time. Pregnancy also carries additional risks, as increased blood volume and pressure from the growing uterus add to the load on pelvic and leg veins.
Do men get varicose veins too?
Yes, although varicose veins are more common in women, around one in four men will develop them at some point. Research suggests that men often present with more advanced symptoms by the time they seek treatment, which can increase the risk of complications. Lifestyle factors may also play a role, with prolonged standing, smoking and higher alcohol consumption all contributing to more severe cases.
Are symptoms different between men and women?
The core symptoms of varicose veins are the same regardless of gender: aching, heaviness, swelling, fatigue and visible bulging veins. Where they can differ is in timing and triggers. Women may notice their symptoms fluctuate or worsen during hormonal changes, such as during their menstrual cycle, pregnancy or menopause. This is due to the effect that oestrogen and progesterone have on the vein walls and valve function.
For men, symptoms tend to be more consistent but may go unnoticed until they become more pronounced. Regardless of gender, early intervention is key to managing symptoms and preventing further complications.
Does hormone therapy affect vein health?
Hormone therapy can increase the risk of developing varicose veins. Treatments containing oestrogen or progesterone, whether for contraception or menopause management, can weaken vein walls and affect how well the valves function. This makes it harder for blood to flow efficiently back to the heart, increasing the likelihood of pooling and vein damage over time. If you’re on hormone therapy and concerned about your vein health, it’s worth discussing your options with your doctor.
This information is not intended to be used for diagnosis or treatment. It is aimed at presenting a perspective only and is not a substitute for a prescription. Anyone experiencing a medical condition should consult their doctor.
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