Understanding Pelvic Congestion Syndrome

This vascular condition is a cause of chronic pelvic pain for women.

Pelvic Congestion Syndrome

Pelvic congestion syndrome (PCS) is a condition that affects women and occurs from dysfunctional veins in the pelvic region, which causes blood to pool within the pelvis. Because the blood is unable to drain properly, it creates pressure, resulting in chronic pelvic pain. PCS affects approximately 15% of women in the United States.

Risk Factors and Symptoms

PCS tends to affect women aged 20-45 and has several risk factors, including multiple pregnancies, a family history of PCS, or obesity. Polycystic ovary syndrome and frequent hormone fluctuation may also increase the risk of PCS. 

Woman doubled over holding her stomach indicating pelvic congesiton syndrome

Symptoms include pelvic pain and pressure that persists for more than six months, feelings of heaviness in the pelvis, atypical discomfort during your menstrual cycle, and the presence of varicose veins in the lower abdominal areas and thighs. Pain may worsen when sitting or standing and is relieved when lying down.

Treatment and Outlook

Chronic pelvic pain can be a physical and mental stressor for women, but specialists can help treat and prevent symptoms. If you suspect you may have PCS, visit your doctor to rule out conditions that cause similar symptoms. An ultrasound scan can assess and check the blood flow in the vessels to aid in diagnosis. Compression hose or shorts can be worn to help alleviate pain and pressure, and if symptoms persist, your doctor may recommend an endovascular procedure.

Ovarian Vein Embolization

A common endovascular procedure to treat PCS is ovarian vein embolization. This procedure specifically addresses PCS symptoms caused by an abnormal ovarian vein that is producing a backward flow of blood, known as reflux. Ovarian vein embolization involves placing a coil to block the vein and minimize pressure and pain. This procedure is minimally invasive and can be performed on an outpatient basis, meaning you can resume normal activities in only a few days.

An Expert Weighs In

“As a vascular doctor treating patients in this region for over 20 years, some of the most gratifying procedures for patients is successfully treating conditions that create chronic pain symptoms. PCS is a condition found in women, rarely causing serious problems, but often causing significant symptoms of pain, pressure, and heaviness within the pelvis. This can be diagnosed with a transabdominal ultrasound and treated in an outpatient setting with a simple procedure. It is not normal to have unexplained pelvic pain; if you suffer from these problems discuss your situation with your primary care or gynecology providers.”

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