Pelvic Congestion Syndrome Causes?

PCS is a complex medical condition that’s thought to be caused by vaginal varicose veins as well as varicose veins in the pelvis, thighs and buttocks. Normal ovarian veins propel blood from the pelvis up toward the heart, and functioning vein valves prevent blood from flowing backwards.nnWhen the ovarian vein valves become faulty, they dilate without closing properly. This results in a backward flow of blood (reflux), and the pooling of blood in the pelvic region. This is what leads to pelvic varicose veins and the associated chronic pain.nnIt should be noted that PCS tends to occur during or after pregnancy, and can become progressively worse after each child. Most women affected by PCS are between the ages of 20 and 45, with multiple previous pregnancies.nnOne possible explanation for the pregnancy connection is that hormonal fluctuations combined with weight gain and changes in the pelvic structure during pregnancy cause increased pressure in the pelvic region. Under the influence of estrogen, the ovarian walls weaken, becoming dilated and bent out of shape.

What puts you at risk of pelvic congestion syndrome?

Being a woman under 45 in her childbearing years, Multiple pregnancies ( 2 or more), Hormonal dysfunction or excess, Retroverted uterus (also called “tipped”), PCOS (polycystic ovaries), The fullness of the leg veins, Vaginal varicose veins and pelvic varicose veins.

What are the Symptoms of Pelvic Congestion Syndrome?

The symptoms of pelvic congestion syndrome can sometimes be confused with menstrual pain however one key thing to note is that symptoms of PCS generally do not develop until a woman becomes pregnant, the symptoms often then continue after the pregnancy, and the pain can be continuous – lasting for up to six months. nnDull ache or pain in the pelvis or lower back: this condition may intensify when standing or sitting, particularly around the time of menstruation. The pain of PCS usually goes away after sleeping at night.nIrritable bowel: recurring abdominal pain, with alternating periods of diarrhea and constipation.nIrritable bladder: with the possible incidence of incontinence.nDyspareunia: pain or discomfort during sexual activity.nPelvic varicose veins: bulging veins around the vulva, vagina or thighs.nSome women occasionally experience clear or watery vaginal discharge with pelvic pain. PCS may also cause mood swings, fatigue, headaches and abdominal bloating.

How to diagnose pelvic congestion syndrome

PCS should be diagnosed by a professional veins specialist or Phlebologist. The diagnosis normally starts with a thorough review of your medical history and physical exam. Next, your specialists will use ultrasound technology to see directly into the body to detect reflux and identify dilated pelvic veins or vaginal varicose veins.

What is Pelvic Congestion Syndrome?

Q: What is pelvic congestion syndrome?

PCS affects the pelvis region (lower torso) and is associated with the pooling of blood in the veins of the pelvis, which have become dilated, swollen and distorted. nnApproximately one-third of all women will suffer from chronic pelvic pain at some point in their lives. Chronic pain is defined as lasting six months or longer. In most cases, the pain is not related to a woman’s menstrual cycle but it can get worse during her period.nnThe pain can intensify when sitting or standing, particularly at the end of the day. It can start with a dull ache at first, developing into a sharp, throbbing pain that’s only relieved by lying down. nnSome patients may also experience pain when urinating (dysuria) or after engaging in sexual activity (dyspareunia).

Pelvic congestion syndrome (PCS) is a painful, sometimes even debilitating condition caused by varicose veins.

And because it can be easily confused for menstrual pain, it’s important to know its symptoms and underlying causes so you can seek the best treatment methods.

What Causes Pelvic Congestion Syndrome?

PCS is one of the most common issues that affect women, in particular those who’ve had multiple pregnancies, polycystic ovaries, or hormonal changes. In fact, it’s such a common issue that a third of all women will suffer from it at some point in their lives.

Pelvic congestion syndrome is caused by varicose ovarian veins (often connected to varicose veins in the broader pelvis and sometimes the legs), which are in turn caused by vein strain and hormones. That’s why PCS is most common in pregnant women, especially if you’ve had multiple children. See, the strain pregnancy places on your veins, combined with hormonal fluctuations and the increased blood flow your body needs to supply oxygen to your baby essentially creates a perfect storm.

The increased supply of oestrogen and blood dilates your veins
Oestrogen weakens your blood pressure
Your expanding uterus strains the pelvic veins

Vein walls weaken, and the valves malfunction, so blood that’s supposed to propel back to the heart instead pools, turning your veins varicose.

What can put me at risk of developing PCS?

Mid shot of woman's pregrant belly, one of the risk factors of pelvic congestion syndrome

Mid shot of woman’s pregnant belly. She is wearing a dark blue dress and standing in a forest.

You’re more at risk if you:

Are a woman under 45
Have PCOS (polycystic ovaries)
Have a family history of varicose veins
Had 2 or more pregnancies
Have hormonal dysfunction or excess
Have a retroverted uterus (also called “tipped”)

What are the symptoms of PCS?

Woman experiencing symptoms of pelvic congestion syndrome

Woman laying on a couch holding her pelvis as though in pain

While PCS is caused by a varicose vein, the pelvic location means the symptoms, while having some overlap, are a bit different.

The primary symptom is lasting pelvic pain that continues for over six months. It typically starts during pregnancy, sometimes worsening after birth. The pain varies between sharp pain or a heavy ache. You’ll usually feel it on one side of the pelvis, but it can flare up on both. And it typically gets worse at the end of the day when your blood pools.

While pain is the most common and obvious symptom, there are others you might experience. These include:

Back pain
Fatigue
Pain and excessive bleeding during menstruation
Swelling around the vagina or vulva and varicose veins in the lower half of the body, especially around your vulva and buttocks.

As pelvic varicose veins can also be connected to larger varicose veins in the legs, you may also experience heaviness, itchiness, aches, swelling, or a burning sensation around your legs.

What can make the condition worse?

Having sexual intercourse
Walking, jogging, or weightlifting
Changing posture
Standing or sitting for extended periods

How do you treat Pelvic Congestion Syndrome?

The most important step in treating PCS is getting diagnosed. While imaging and urine and blood tests can be used to check for it (and exclude other pelvic conditions), it can still be hard to confirm, as pelvic pain can stem from various issues. Finding a doctor you trust who isn’t dismissive of your condition is a helpful step in getting a diagnosis.

Once diagnosed, your doctor may prescribe anti-inflammatory medication, hormone treatment such as birth control, and chronic pain medication to alleviate your symptoms.

If your pain levels are severe or if there may be risks to your long-term health or reproductive health, your doctor will consult you on medical treatment options. PSC is treated through Ovarian Vein Embolization, where your doctor will insert a catheter into your ovarian vein and inject a foam sclerosant to seal it off.

If your case is more serious, however, you may need a hysterectomy.

Additionally, if the veins are attached to varicose leg veins, you will need to treat the leg veins to prevent the PCS from recurring. We can do this via:

Sclerotherapy
Endovenous Laser Ablation
Radiofrequency Ablation
VenaSeal
Or ClariVein, depending on the vein’s size and your condition.

Seek expert advice.

Varicose veins can be a troubling condition anywhere, whether they appear in the legs, pelvis, or both. So if you’re experiencing the above symptoms or think you may be at risk, call us on 0420 202 637, or fill out our booking request form.

Learn more: Varicose Veins in Men vs Women