Varicose veins — visible, swollen veins, often blue or purple — can become more noticeable during menopause. A drop in estrogen can weaken vein walls and make it harder for blood to flow efficiently, especially in the lower legs where gravity increases pressure.
Declining progesterone may further reduce vein elasticity, contributing to bulging or rope-like veins on the calves, thighs, or ankles. These veins may feel heavy, achy, or throb after standing for long periods.
HRT may help maintain vein strength, and reduce the appearance of varicose veins, by supporting blood vessel health. Other strategies include wearing compression stockings, elevating the legs, staying active, and limiting prolonged sitting or standing.