Pelvic congestion syndrome, most commonly found in women, is a chronic condition characterised by pain in the pelvic region. Let us look at the common symptoms, causes, and treatment for this condition.
What is Pelvic Congestion Syndrome and its causes?
The pelvis is found in the lower abdominal area, and the pelvic congestion syndrome affects the veins in the pelvic region. When veins fail to carry blood back into the heart, the blood starts to collect and build up in the veins, causing the formation of varicose veins. This is the primary reason for pain due to pelvic congestion syndrome.
This condition is normally found in women between 20 and 50 years of age, and in those women who have given birth multiple times. It is less commonly seen in women who have not given birth. A family history of pelvic congestion syndrome also increases the chance of having it. Women with Polyendocrine metabolic ovarian syndrome (PMOS), phlebitis, and prolapsed uterus are at risk of having pelvic congestion syndrome. The exact cause of this syndrome is yet unknown; however, several factors might be considered as a cause including,
- Hormone – Estrogen causes the veins to dilate to increase the blood flow. This may be a reason for the enlargement of the veins and cause pelvic congestion syndrome.
- Menopause – After menopause, there will be a drop in estrogen levels, and most women experience menopause after turning 50. This is one reason why this condition is less common in postmenopausal women.
- Pregnancy – Blood vessels expand during pregnancy, which can lead to damage and permanent enlargement of the veins, causing pelvic congestion syndrome.
Symptoms
Prolonged pain in the pelvis and lower back for over 6 months is one of the main symptoms. The pain worsens during menstruation, at the end of the day, after sex, and during pregnancy. Sitting and standing for long periods or lifting heavy weights can also worsen the pain.
Apart from pain, other symptoms include varicose veins in the buttocks, thighs, or genital region, abnormal vaginal discharge, pain in the legs, painful periods, sudden urge to urinate, and an irritable bladder.
These conditions can cause severe difficulty in your day-to-day life, causing fatigue, discomfort, and depression. Pelvic congestion syndrome isn’t fatal or doesn’t cause a medical emergency; however, if the pain becomes severe, you may contact a healthcare provider soon.
Diagnosis of Pelvic Congestion Syndrome
Pain in the pelvic region may be due to several factors, and it might be difficult to diagnose pelvic congestion syndrome solely based on the pelvic pain. To diagnose the condition, your healthcare provider will first learn about the symptoms and do a series of tests and scans. Some of the scans include,
- Ultrasound: Helps understand if the pelvic pain is caused by other conditions.
- Doppler ultrasound: To detect the blood flow, its speed, and direction in the veins.
- Pelvic venogram: Used to see the blood flow and understand whether the veins are dilated or twisted. This provides an accurate diagnosis of the condition.
- MRI: This is a non-invasive imaging method that provides images of pelvic veins in detail.
Further tests include a urine test and a blood test to check and rule out other conditions.
Treatment for pelvic congestion syndrome
Your doctor can make treatment plans according to the symptoms. Medications, compression therapy, and physical therapy are recommended to relieve the pain. The procedures to treat the abnormal veins include sclerotherapy or ovarian vein embolization therapy, or laparoscopy to prevent reflux. Gonadotropin-releasing hormone drugs and Progestin hormone drugs are used to relieve the pain.
Embolization is another treatment option for pelvic congestion syndrome, in which the specific damaged blood vessels are blocked. Another not-so-common treatment option is Bilateral salpingo-oophorectomy, where the pelvic organs are removed.
Conclusion
Pelvic congestion syndrome is caused by vein enlargement in the pelvic region. This condition is characterised by severe pelvic pain, and it is most commonly found in women between the ages of 20 and 50. Women who have had multiple pregnancies may be at risk of having this condition. The most common symptom is severe pelvic pain; however, a person cannot be diagnosed with pelvic congestion syndrome solely based on this symptom. Doctors will run a few tests and scans to confirm the condition, and after confirming, will provide a treatment plan.
FAQ
No, pelvic congestion syndrome cannot be diagnosed on a standard pelvic exam, as the enlarged veins decompress upon lying down.
You can consult an OB/GYN, and for further diagnosis, you will be referred to an Interventional Radiologist.
Pelvic congestion syndrome is not fatal bu it can disrupt the affected person’s quality of life.
Activities involving standing or sitting for a long period of time or lifting heavy weights are to be avoided, as these can exacerbate the pain.
Yes, though rare, men can get pelvic congestion syndrome when varicose veins develop in the scrotal region.
