IP265. Superficial Venous Reflux and Menopause

Abstract

Objective: Chronic venous insufficiency (CVI) is the most common vascular disorder in the United States and disproportionately affects women, especially postmenopausal women. The increased prevalence of CVI in this population is likely to be multifactorial, with attributable risk factors including older age, obesity, and multiple pregnancies. One of the known pathophysiologic mechanisms of CVI is superficial venous reflux (SVR), in which the degree of SVR is proportional to the severity of CVI-related symptoms. This study aimed to identify the difference of SVR severity in premenopausal and postmenopausal women.Methods: During the course of 18 months, we interviewed 480 consecutive female patients with an established diagnosis of CVI. The average age of the patient cohort was 61.9 years; 55 patients had C6 disease, 2 had C5 disease, 138 had C4 disease, 269 had C3 disease, and 16 had C2 disease. Reflux rates from each patient's initial duplex ultrasound examination were retrospectively documented in a single-center registry. All patients were queried on how lower extremity pain related to their menstrual cycle.Results: There were 363 patients, with an average age of 67.5 years, reported to be postmenopausal; 94 patients, with an average age of 42.4 years, reported regular menstrual cycles, of whom 36 (38%) reported worse lower extremity pain during menses. Nine patients reported lack of regular menstrual cycles: six because of prior total abdominal hysterectomy, one because of effects of chemotherapy, one who recently gave birth, and one with menorrhagia. Nine patients reported no pain in association with their CVI, and five declined to answer our questions. The difference in average reflux rates of premenopausal and postmenopausal women can be found in the Table. Conclusions: Great saphenous vein reflux was found to be significantly higher in premenopausal women. Decreased serum progesterone in postmenopausal women may play a role, and these findings warrant further investigation.