Changes in trunk veins of the lower limbs in women with premenstrual leg heaviness and swelling.

Abstract

The aim of this study was to investigate vein changes during the menstrual cycle in parous women with premenstrual leg heaviness. А total of 39 women with heavy legs before menstruation were examined. Great saphenous vein (GSV) in the groin, femoral vein (FV) and popliteal vein (PV) were examined with ultrasound scanning before 10 a.m. and after 6 p.m. on days 1 to 4 (menstrual phase) and 25 to 28 (secretory phase). To characterize biophysical features of veins we used: 1) interphase gradient of the diameter (IGd), i.e. the difference in vein diameters during the secretory and menstrual phases; 2) orthostatic gradient of the diameter (OGd), i.e. the difference in vein diameters measured in the evening and in the morning. Diameter changings for GSV, FV and PV were similar. GSV diameter increased from the morning during the menstrual phase to the evening during the secretory phase on average by 26.2%. OGd was 0.73 mm (95% CI: 0.59-0.87) during the menstrual phase and 0.62 mm (95% CI: 0.54-0.71) during the secretory phase. IGd was 0.73 mm (95% CI: 0.61-0.86) already in the morning. During the secretory phase 43.6% patients had the GSV reflux. During the whole menstrual cycle GSV diameter in the reflux zone increased on average by 40.6%. IGd of GSV in this zone reached 1.25 mm (95% CI: 1.02-1.48) in the morning and 1.30 mm (95% CI: 1.25-1.35) in the evening. Women with premenstrual leg heaviness have a minimal vein diameter in the morning during the secretory phase. The maximal diameter is revealed in the evening during the secretory phase. Clinically manifested expansion of veins, including GSV refluxes, is found during the secretory phase due to increased expansibility of veins. However, because of increased creeping ability one observes expansion of veins during the whole menstrual cycle in these women.