Some women develop varicose veins near the external genital organs, the labia. Usually, these varicose veins become prominent during pregnancy and improve after the baby is born. Labial varicosities often worsen with each pregnancy. Some women develop frequent or continuous pain from labial varicosities.

Evaluation of labial varicose veins initially involves a detailed color duplex ultrasound study of the veins of the abdomen, pelvis, external genitalia, and legs. Sometimes, additional studies such as CT venograms or MRI venograms are helpful in determining the extent of abnormal veins and the underlying cause. Labial varicose veins may be due to iliac vein obstruction from compression or old clots, or they may be due to ovarian vein reflux with pelvic vein varicosities. In some patients, the primary problem is reflux (abnormal reversal of flow) in the veins of the deep pelvis through veins near the vagina into the labia and surrounding tissues.

Treatment depends on the source of the blood flow refluxing into the labial veins. Many patients can be treated very effectively with foam sclerotherapy injections by ultrasound or fluoroscopic (X-ray) guidance to seal shut the abnormal deep pelvic and labial veins. Some patients with more extensive refluxing pelvic veins or with refluxing ovarian veins benefit from treatments which seal shut the larger abnormal veins to prevent reflux into the deep pelvic veins. This process is called ovarian/pelvic vein ablation and is performed with a needle stick technique through a tiny incision with X-ray guidance. Relief of symptoms may occur within hours or may take several weeks.