As a physician who has spent years treating vein conditions, I often hear the same question: “Why do I have varicose veins?” Many people assume they’re just a cosmetic issue, but varicose veins are actually a sign of an underlying circulation problem. They develop when the tiny one-way valves in your leg veins stop working properly, allowing blood to pool and stretch the vein walls. Over time, this leads to those twisted, bulging veins that many people notice on their legs.

Let’s take a closer look at the main reasons why varicose veins form and what you can do about them.

Genetics and Family History

The single biggest risk factor for developing varicose veins is your family history. If one or both of your parents had varicose veins, your chances of developing them are significantly higher. Genetics influence how strong your vein walls and valves are. If they are naturally weaker, they’re more likely to fail under pressure, allowing varicose veins to form.

Age and Natural Wear and Tear

As we age, our veins experience years of wear and tear. The valves that once held strong can become weaker and less effective. This is why varicose veins are far more common in people over the age of 40. The longer your circulatory system has been working against gravity, the more likely problems will appear.

Hormones and Gender Differences

Hormones play a major role in vein health. Women are more likely to develop varicose veins than men, partly due to hormonal changes. Estrogen and progesterone, the female reproductive hormones, can relax vein walls and make valves less effective. This is why varicose veins often appear or worsen during pregnancy, menopause, or when taking birth control pills.

Pregnancy and Increased Pressure

Pregnancy places unique strain on a woman’s veins. Not only do hormonal shifts occur, but blood volume also increases dramatically to support the growing baby. On top of that, the uterus puts pressure on the large veins in the pelvis, which makes it harder for blood to return from the legs. For many women, varicose veins first appear during pregnancy or worsen with each subsequent pregnancy.

Occupation and Lifestyle

What you do every day matters. People who stand for long periods—like teachers, nurses, or retail workers—are at higher risk for varicose veins because standing increases pressure inside the leg veins. Sitting all day, especially with your legs crossed or dangling, can also contribute to poor circulation. Without regular movement, blood has a harder time making its way back to the heart.

Obesity and Extra Pressure on Veins

Carrying extra weight puts additional strain on your veins. The more pressure inside the legs, the harder your vein valves have to work to keep blood moving upward. Over time, this extra burden can weaken the valves and contribute to varicose veins.

History of Blood Clots or Vein Injury

If you’ve ever had a blood clot or injury to the veins, the valves may have been damaged. Once damaged, they may not close properly, leading to backward blood flow and varicose vein formation. This condition is known as chronic venous insufficiency, and it’s the root cause of most varicose vein problems.

Are Varicose Veins Just Cosmetic?

It’s important to stress that varicose veins are not just a cosmetic problem. They can lead to leg pain, heaviness, swelling, restless legs, skin discoloration, and even ulcers if left untreated. Addressing them early can improve both how your legs look and how they feel.

Treatment Options in St. Louis

The good news is that varicose veins can be treated safely and effectively with modern, minimally invasive techniques. At Sheen Vein (Aesthetics and Functional Medicine), we offer treatments like:

• Endovenous Laser Therapy (EVLT): Uses laser energy to seal faulty veins.
• Ultrasound-Guided Sclerotherapy: Injects medication to close problem veins.
• Foam Sclerotherapy: A specialized foam targets larger veins.

These treatments are performed in-office, require little downtime, and provide lasting results.

Supporting Your Vein Health

While genetics and aging can’t be avoided, you can support better circulation by:

• Staying active and walking regularly
• Maintaining a healthy weight
• Wearing compression stockings if recommended
• Elevating your legs when resting
• Avoiding long periods of standing or sitting without movement

The Bottom Line

Varicose veins develop because of valve weakness inside your leg veins, often worsened by genetics, aging, hormones, pregnancy, and lifestyle factors. They are more than a cosmetic nuisance—they are a circulation problem that deserves medical attention.

If you’re noticing heaviness, aching, swelling, or bulging veins in your legs, don’t wait for things to get worse. At Sheen Vein (Aesthetics and Functional Medicine) in St. Louis, we specialize in diagnosing and treating vein disease with a compassionate, patient-centered approach.

Learn more about our vein treatments or call our office today to schedule a consultation.

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