Flavanones, a subclass of flavonoids primarily found in citrus fruits (notably as hesperidin and diosmin), have scientific support for their use in managing symptoms of chronic venous insufficiency and varicose veins. Multiple randomized controlled trials and meta-analyses have evaluated micronized purified flavonoid fraction (MPFF)—a combination of diosmin and hesperidin—for the treatment of venous disorders. These studies demonstrate that MPFF can reduce symptoms such as leg heaviness, pain, swelling, and cramps associated with varicose veins and chronic venous insufficiency. The mechanism is thought to involve improvement of venous tone, reduction of capillary permeability, and anti-inflammatory effects on the vascular endothelium.

Clinical guidelines, such as those from the European Society for Vascular Surgery (2022), recommend MPFF as an option for symptomatic relief in patients with chronic venous disease. The evidence base includes several well-designed trials, including the VEIN ACT Program and international consensus documents, which report moderate to significant improvements in patient-reported symptoms and quality of life compared to placebo. Adverse effects are generally mild and infrequent.

While the majority of studies are industry-sponsored and long-term data are limited, the consistent results across independent and sponsored trials provide a robust scientific rationale for the use of flavanones, especially in the form of MPFF, in the symptomatic management of varicose veins.