Varicose Vein Disease in Men – Happel Laser & Vein Center

Varicose Vein Disease in Men – Happel Laser & Vein Center

Holy Varicose Veins Batman – They’re Not Just a Granny Disease

Hidden Truths about Varicose Veins in Men

Which of the following statements is true?

  1. The sun rises in the West.
  2. Spring follows Summer.
  3. Men wait too long to seek treatment for their varicose veins.

As a vein specialist, I can strongly attest to the fact that men usually wait too long to see a doctor about their varicose veins. Some shocking facts about varicose veins need to be discussed before you seek treatment.

When a man comes to my vein office, I know that the chances are good that his veins will be huge and more difficult to treat.

It’s not hard to understand why. It’s very important to understand how to choose the right varicose vein center.

Another One of the Many Differences Between Men and Women

Men are more reluctant to seek medical help when they perceive a problem that they believe is cosmetic.

Often varicose veins don’t cause symptoms until they enlarge.

Hormones may also a part in causing symptoms. Women often notice that their vein symptoms are worse around the time of their periods.

Men with varicose veins tend to visit their family doctor or a specialist at a later stage of the condition than their female counterparts. With men, usually their veins are very painful, clotted, or are starting to cause skin damage.

By waiting until this advanced stage occurs, men are at a higher risk of developing ulceration of the skin, blood clots in the varicose veins (phlebitis), and massive bleeding.

Women are quicker to identify vein problems because their veins are exacerbated by multiple pregnancies.

With each pregnancy, the veins enlarge.

Men are generally slower to recognize venous disease and its gradual progression.

Even when dealing with minor symptoms such as itching, cramping or heavy legs, men tend to be in a state of denial. Men are generally less attentive to their bodies and rarely seek help when questions arise.

In the case of men, venous disease is generally a reflection of genetic predisposition. Possibly obesity or jobs that entail prolonged standing may play a part but that is debatable.

Wearing pants also makes the problem less obvious.

Skirts and dresses display a woman’s legs, so they are constantly reminded of vein issues and the cosmetic effects.

Because of these subtle changes and wearing pants, men are frequently insensitive to the development of scaly, dry skin, which subtly darkens over time in the area of the low calf and ankle, particularly on the inside.

Some men feel that health concerns imply weakness and are even embarrassed to seek help.

This leads to procrastination, which allows these types of problems to progress.

The issue is that serious health problems often show no signs or symptoms until it’s too late.  That’s why it’s important to ask your doctor about conditions that you may consider to be a minor issue.

Sometimes varicose veins, spider veins, and leg swelling can be a sign of a more important underlying condition.

Can I Prevent or Treat My Varicose Veins Myself?

This is one of the most common questions that men ask about their varicose veins.

Often men don’t have symptoms in these veins until they become very large or have complications like clots, skin problems or bleeding.

Unfortunately, there is little you can do to prevent varicose veins or stop them from becoming larger.

Exercising doesn’t help.

Watching your weight probably does.

Standing and sitting for prolonged periods increases the pressure inside these veins. Intuitively, avoiding this would slow down the progression of the problem.

Therefore, watching your weight is important when it comes to preventing your veins from getting worse. It has been established in the medical literature that obesity increases your chances of a recurrence after vein treatment.

Some insurance companies won’t even cover your varicose veins if you are significantly overweight because of the risk of recurrence.

However, the authors of the Edinburgh vein study concluded that there were no strong and consistent life style risk factors for venous reflux and varicose veins.

This is contrary to common belief and regurgitated internet dogma.

What Is the Incidence of Varicose Veins in Men?

 Epidemiological data regarding the incidence of varicose veins in men about the incidence of varicose veins in men is outdated. According to Google Scholar, it is very rare to see any data reporting the incidence of varicose veins in men and women written after the year 2000.

On the basis of estimates of the San Diego epidemiological study published in the Journal of Vascular Surgery, 37 (2003), pp. 1047-1053, more than 11 million men and 22 million women between the ages of 40 and 80 years in the United States have varicose veins.

The costs of reporting this data is not worth the benefit of knowing the true incidence.

That is because the costs of treating varicose veins is skyrocketing. It is unsustainable.

The epidemiological data regarding the incidence of varicose veins in men is old and flawed.

The most widely cited study from the United Kingdom in 1994 showed a female prevalence of 20-25% women vs. 10-15% men.

That landmark article by JJ Smith, AM Garratt, M Guest, and RM Greenhalgh may not be correct regarding the incidence of varicose veins in men. It was written in 1999.

According to the following study, the conventional wisdom and older epidemiological studies suggest that here is a female predilection for the development of varicose veins.

This classic article stated that varicose veins affected up to 15% of men and 25% of women and accounted for around 56,000 operations per year in the United Kingdom.

 Reports of prevalence of chronic venous insufficiency vary from < 1% to 40% in females and from < 1% to 17% in males.

That’s quite a large range.

One study reported that as many as 45 percent of all men will experience varicose veins at some time in their life.

Without a doubt, the biggest cause of varicose veins in both men and women is genetics or family history.

If your parents had varicose veins, you are more likely to have them.

Lifestyle factors as a role in the cause of varicose veins has never been scientifically proven. Some doctors believe the dogma that lifestyle modifications are important to maintain the benefits from treatment.

Some assume that if your job requires you to stand for long periods, such as flight attendants, surgeons, bartenders, sales or restaurant occupations, or factory workers you are more likely to get varicose veins. That has never been proven.

If you travel and spend long hours traveling or sitting at a desk for hours, it is often said that that increases your risk of developing varicose veins. That has never been proven.

It is rare that varicose veins can be the result of previous leg trauma.

Varicose veins can affect men of all ages but the risk increases with age because of the loss of tissue tone and muscle mass, as well as a weakening of the venous walls.

Men have the same symptoms as women. That includes pain, heaviness, aching legs, tiredness, cramping and sometimes swelling.

Like any chronic medical condition, varicose veins will progress without treatment.

Because varicose veins are often painful, it is important to treat them in order to maintain an active lifestyle.

Treatments such as medical grade compression stockings and changes in work habits can improve your symptoms but will not address the underlying cause.

Severe varicose veins can lead to serious complications such as skin breakdown and even blood clots.

Varicose vein treatments are evolving so rapidly that it’s hard to keep up with the latest varicose vein treatment du jour.

Varicose Vein Treatment

The accepted treatments for varicose veins include:

  • Laser
  • Radiofrequency
  • Sclerotherapy
  • Phlebectomy
  • Medical Glue (Venaseal)
  • Mechanico-Chemical Ablation
  • Stripping (still done in some countries in South America and Europe)

Except for stripping, which is not performed in the United States, the treatment is minimally invasive. It is performed in the vein specialist’s office under local anesthesia. Recovery is quick. You can return to work the day after your procedure in most cases.

Are Occupations and Vein Disease Related?

It’s controversial.

Scientific data challenges the often-cited numbers.

The Ediburgh vein study showed the age-adjusted prevalence of trunk varicose veins was 39.7% in men and 32.2% in women. There was also a higher prevalence of deep venous reflux in men.

An African study showed that men and women had a nearly equal prevalence of varicose veins (6% of men and 5% of men).

Firm numbers of the actual per cent of men vs. women with varicose veins in the United States is hampered by the methods used to define varicose veins (different criteria as to size), the samples used to represent the population and other factors.

Most studies have suggested varicose veins are more common in women, with a female to male ratio of between 1.5:1 and 3:1.

The association between occupation and varicose veins is stronger for women compared to men according to the following Danish study.

That’s not just conjecture. Venous disease was among the top ten reasons for hospitalization in Denmark. Many people whom I see in consultation blame their varicose veins on their occupation which involves standing.

Teachers, flight attendants and nurses believe this to be true.

However, there are plenty of bartenders, cashiers, and blackjack dealers who don’t have a visible varicose vein in their legs.

The major risk factor remains genetics or heredity.


When men present for varicose vein treatment, their veins are usually huge. Men often neglect their varicose veins.

Some people even ask, “Can varicose veins occur in men?”

It’s assumed by many that only women suffer from varicose veins.

Dr. John Happel MD stated,

“In my experience, the largest varicose veins that I’ve seen have been in men. Oddly enough, however, many of these same patients did not complain of pain.  Usually they were coming to see me either because their primary care doctor told them, ‘You should have that looked at,’ or because their wife or family told them to have them evaluated.”

It is recommended that men have their varicose veins evaluated before complications occur.

Call our office at 724-969-0600 to learn more.

About The Author

Dr. John Happel

Dr. John Happel has been in practice as a surgeon since 1986 in the Pittsburgh region. He specializes in vascular surgery and has subspecialized in the treatment of varicose and spider veins since 1999. Dr. Happel is board certified in vascular surgery and recertified in vascular surgery in 2012. He was chosen in 1985 to fulfill the position for the vascular surgical fellowship at the world renowned Mayo Clinic.