Phlebotropic therapy in obstetrics and gynecology: current approaches and clinical scenarios
Sokolova E.I., Potapov M.P., Kozub V.N.
Venous symptoms and chronic venous disorders are common among women and often first appear or progress during periods of hormonal changes, including pregnancy, the postpartum period, and the use of hormonal therapy. In clinical gynecological practice, these conditions may significantly impair quality of life and require a reasonable choice of conservative treatment tactics, especially when invasive interventions are limited or contraindicated.
Phlebotropic agents, particularly diosmin, are used to treat the symptoms of chronic venous disorders and hemorrhoids. They are also used as part of a complex therapy for conditions related to venous congestion and microcirculatory disturbances. This review analyzes Russian and international publications on the use of diosmin in obstetric and gynecological practice, with a focus on the most common clinical situations faced by gynecologists.
The review discusses the potential applications and limitations of diosmin in chronic venous disease of the lower extremities, venous symptoms during pregnancy, vulvar and pelvic varicosities, hemorrhoids, and venous manifestations associated with hormonal therapy. Special attention is paid to safety issues and the evidence-based use of phlebotropic therapy in different patient groups.
Conclusion: In pregnant women with varicose veins, diosmin may be considered as a treatment option for subjective symptoms and edema after a careful assessment of the benefit/risk ratio. It is also reasonable to prescribe this medication when venous symptoms develop or worsen in patients taking menopausal hormone therapy or combined oral contraceptives. Its use in disorders of uteroplacental blood flow and fetal growth retardation remains a focus of clinical research and requires further studies.
Authors’ contributions: Sokolova E.I., Potapov M.P., Kozub V.N. – developing the concept and design of the study, collecting and processing the material, writing the text, editing the article.
Conflicts of interest: The authors declare that there are no conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Sokolova E.I., Potapov M.P., Kozub V.N. Phlebotropic therapy in
obstetrics and gynecology: current approaches and clinical scenarios.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (2): 151-157 (in Russian)
https://dx.doi.org/10.18565/aig.2026.38
Keywords
chronic venous diseases
venous symptoms
phlebotropic therapy
diosmin
microcirculation
venous congestion
pregnancy
postpartum period
hormonal therapy
varicose veins
vulvar varicosities
pelvic venous congestion syndrome
hemorrhoids
obstetrics and gynecology
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Received 04.02.2026
Accepted 09.02.2026
About the Authors
Ekaterina I. Sokolova, PhD, Surgeon, Phlebologist, Yaroslavl Phlebology Center «Doctor Ven» LLC, 37 Slepneva str., Yaroslavl, 150057, Russia, +7(960)542-44-08,yarmini@yandex.ru
Maxim P. Potapov, PhD, Associate Professor, Associate Professor at the Department of Surgical Diseases with a Course in Endocrine Surgery named after N.P. Pamputis, Yaroslavl State Medical University, Ministry of Health of the Russian Federation, 5 Revolyutsionnaya str., Yaroslavl, 150000, Russia, https://orcid.org/0000-0002-4596-6517
Viktoriya N. Kozub, Obstetrician-Gynecologist of the highest qualification category, Senior Consultant, Head of Gynecological Department, Clinical Hospital “RZD-Medicine” Yaroslavl, 21 Suzdal Highway, Yaroslavl, 150030, Russia, +7(4852)42-70-50, ex. 288.
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