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Pelvic Congestion Syndrome - 5 Things Women May Not Know

Put your hand up if you’ve heard of pelvic congestion syndrome (PCS). The chances are that you haven’t, which means that you probably don’t know it exists.

While this in itself may not seem like a big deal, PCS affects around one-third of all women and accounts for 20% of all outpatient gynecology appointments. Because it’s such a common condition, it’s important to be aware of PCS.

What is Pelvic Congestion Syndrome?

Pelvic congestion syndrome occurs when there are changes in the veins in the pelvis. These damaged veins can affect how blood flows, sometimes causing it to pool or flow backward.

What are the signs of PCS?

The main symptom is persistent pelvic pain, which can vary in intensity. Individuals may also experience a sensation of abdominal heaviness. Symptoms may worsen at specific times, such as:

In addition to chronic pelvic pain and a feeling of pressure, other possible symptoms include:

How is PCS diagnosed?

Diagnosing pelvic congestion syndrome involves ruling out other potential causes of chronic pelvic pain. Doctors may use imaging tests such as ultrasound, CT scans, or MRI to visualize pelvic veins and identify abnormalities. Venography, which involves injecting dye into the veins to assess their function via X-ray, can detect weakened areas. Laparoscopy, a minimally invasive procedure using a camera to examine the pelvic area, may be necessary to rule out gynecological issues, with pelvic congestion syndrome being a potential cause in a portion of cases.

Here are 5 things about PCS that women may not know

  1. Women mostly suffer from PCS

PCS is more common in women. Based on research 15% of women aged 20 to 50 have some kind of pelvic vein issue, but not everyone with this problem feels symptoms. Among those who do feel chronic pelvic pain, about 30% of them are diagnosed with pelvic congestion syndrome.

Pelvic congestion syndrome typically arises before menopause and during the reproductive years, often influenced by estrogen levels. Estrogen's ability to relax veins can contribute to the condition.

Following menopause, a decrease in estrogen levels may result in symptom relief for many individuals.

Additionally, there may be a genetic predisposition, with approximately half of those diagnosed having a family history of the syndrome.

Men can also have chronic pelvic pain due to poor blood flow in deep veins, often from iliac vein compression. Yes, really! Their symptoms might differ, but they may still feel heaviness or pain in the pelvic or abdomen area.

  1. Pregnancy increases the risk of pelvic congestion syndrome

Pelvic congestion syndrome (PCS) frequently begins during pregnancy. During pregnancy, your blood volume rises to support your growing baby's needs.

This increase in blood volume causes your veins to naturally expand, increasing their capacity by a whopping 60%. Consequently, the walls and valves of these veins stretch, which can result in valve dysfunction.

When these valves fail, blood can pool and back up, causing veins to swell and become painful, known as varicose veins.

The risk of chronic pelvic pain from a vein-related cause rises with each pregnancy, especially in women carrying multiple babies like twins or triplets.

Once pelvic congestion syndrome (PCS) sets in, it doesn't improve, meaning your pain persists. You might notice that the pain worsens after long periods of standing or sitting, after sex, or during your menstrual cycle.

  1. Varicose veins appear in unusual places

While most people are aware of varicose veins in the legs, PCS can result in varicose veins in unexpected places such as the vagina, vulva, buttocks and thighs. Because these veins are highly visible, they may be the first indication that you have PCS.

  1. It’s best to visit your gynecologist first with pelvic pain

Pelvic congestion syndrome (PCS) isn't usually the first thing doctors think of for chronic pelvic pain. Other factors need to be checked by an Ob/GYN, and a vascular specialist may do a separate pelvic ultrasound. It's essential to see your gynecologist before jumping to conclusions about this condition. They can rule out any other reason including endometriosis, fibroids, and other issues. You might need various tests while experts figure out the best treatment plan.

  1. Embolization provides long-lasting pain relief

Following a thorough examination and diagnostic tests to confirm the presence of pelvic congestion syndrome (PCS), we typically suggest a minimally invasive procedure known as ovarian vein embolization.

During this procedure, a small incision is made, and a catheter is inserted into a blood vessel in your thigh. The catheter is then guided to the affected ovarian veins, where substances are released to seal the blood vessel.

This action results in permanent closure of the treated vein, and your body naturally redirects blood flow through other functional veins. The procedure restores proper circulation, effectively alleviating the pain associated with PCS.

If you have any further questions about PCS here is a blog we wrote some while back, that you may find useful.

Don’t suffer in silence

If you are experiencing chronic pelvic pain but don’t have an underlying  gynecological condition, it’s in your best interests to meet with one of our Board Certified Vascular and Interventional Radiologists at MINT Stl, to find out if PCS is the cause of your problem. Get in touch today to schedule a consultation. 

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