It is true that women seek out varicose vein treatment more often than men. In part, this is because women have a slightly higher incidence of varicose veins than men. Generally speaking, approximately fifty-five percent of all women get varicose veins, whereas up to forty-five percent of all men get varicose veins. However, it’s also true that historically men did not seek varicose vein treatment, even when they needed it badly, due to cultural norms. It was not considered “manly” to do so, but thankfully, that’s all beginning to change.
At any rate, the slightly higher incidence of varicose veins in women is due to hormonal changes that take place during pregnancy and due to menopause. It’s also true that multiple pregnancies puts a women at an increasingly higher risk for varicose veins with each subsequent pregnancy so this complicates the interpretation of the statistics a bit. However, what is beginning to become clear is that men are affected by hormonal changes throughout life too, just like women! Men with certain patterns in their hormonal changes tend to need varicose vein treatment than other men.
It is important to note first that both estrogen and testosterone play a role in whether or not a person develops varicose veins that are bad enough to need varicose vein treatment. This is true for both women AND men. Further, even though estrogen is typically thought of as a “female hormone” and testosterone is typically thought of as a “male hormone,” both sexes have both sex hormones and they vary throughout life in both genders.
In women, it has long been known that they often develop varicose veins when they are pregnant. There are several pregnancy factors that lead to this but estrogen surging in the blood serum, in the form of estradiol, the most potent form of estrogen, is one of the biggest factors. In fact, even when estradiol is high in non-pregnant women for some reason, including during hormone replacement therapy, they have a higher risk of developing varicose veins.
Men do not have ovaries to produce estrogen, like women, but they have an enzyme called aromatase that can convert testosterone into estrogen! This enzyme has been found in fat tissue, the brain, the gonads, the blood vessels, and even in bone and skin! If a man produces too much testosterone, such as when he exercises too much, his body will automatically convert some of this excess testosterone into estrogen, estradiol specifically.
In both men and women, extra estrogen in the serum causes the vein valves to break down. It also causes a degradation of vein walls and this causes them to expand beyond what is normal. These actions cause destruction in the vein systems that can lead to one needing varicose vein treatment. Scientists first thought that declining testosterone levels in men as they aged is what triggered varicose veins in men. However, it turns out to be more complicated than that.
Research over the last decade has proven that in men, it’s actually the RATIO of their testosterone to estrogen that can lead to the formation and acceleration of varicose veins and the need for varicose vein treatment. In a young healthy man, the ratio of testosterone to estrogen is about fifty to one. However, in an older man, this ratio of testosterone to estrogen can fall to somewhere around eight to one.
In 2010, a group of German researchers published a study on forty men in the Journal of Vascular Surgery. Half the men had varicose veins and reflux (backward flow of blood) in the great saphenous vein. The other half of men had no signs of varicose veins and normal flow in their great saphenous vein. After carefully measuring the serum levels of testosterone and estradiol in all male participants, they found that the men with varicose veins and vein reflux not only had significantly lower testosterone, they also had elevated estradiol levels. In fact, the worst cases had very low rations of testosterone to estradiol! It was the RATIO of these two hormones that predicted whether they had varicose veins and vein reflux but that simply declining testosterone levels.
Although more research needs to be done, working with a larger group of men, there is already serious concern that low testosterone to estradiol ratios could not only cause the need for varicose vein treatment but could affect how doctors view giving men hormone replacements. Estrogen replacement therapy in women is already known to induce a higher risk of developing varicose veins and or exacerbating varicose veins that already exist.
If you are a man, before you take any medications, including natural supplements, that could potentially affect your hormone levels, testosterone or estradiol, it would be a good idea to get your veins checked out by the vein doctors at Metro Vein clinics. They will likely want to do a duplex ultrasound to see if you have any hidden damage to your vein valves, any vein reflux, any damage to your vein walls, and or any blood clots. Metro Vein Clinics offer a free consultation on your first visit and there is no obligation to get treatment if you do.