Chronic Venous Insufficiency: This condition is characterized by the veins having problems returning blood from the legs back to the heart due to valve issues or blockage. It's a common cause of varicose veins, especially in women of this age group, and can be exacerbated by factors such as obesity, pregnancy, or prolonged standing.

Hormonal Changes: Hormonal fluctuations, especially those occurring during menopause, can lead to changes in blood vessel walls, making them more susceptible to varicosity.
Obesity: Excess weight can increase pressure on veins, leading to varicose veins.
Prolonged Standing or Sitting: Occupations or activities that involve long periods of standing or sitting can increase venous pressure and contribute to varicose vein development.

Deep Vein Thrombosis (DVT): Although DVT typically presents with swelling, pain, and warmth of the affected limb, it's crucial not to miss this diagnosis due to its potential for pulmonary embolism, a life-threatening condition.
Pelvic Tumor: A tumor in the pelvis could compress veins, leading to sudden onset varicose veins. This would be an unusual but critical diagnosis not to overlook.
Thrombophlebitis: Inflammation of veins due to a blood clot, which can cause sudden onset of varicose veins and is a serious condition requiring prompt treatment.

Klippel-Trenaunay Syndrome: A rare congenital condition characterized by varicose veins, port-wine stains, and soft tissue or bony hypertrophy, typically presenting at birth or in early childhood but could potentially become more apparent in adulthood.
Parkes Weber Syndrome: Another rare condition similar to Klippel-Trenaunay but with the addition of arteriovenous fistulas, which could lead to varicose veins due to abnormal blood flow.
Venous Malformations: Abnormal formations of veins that can cause varicose veins, which might not be immediately apparent and could require specialized imaging for diagnosis.