Pelvic congestion syndrome (PCS) is a chronic condition that occurs when varicose veins form below the abdomen within the pelvic region. Varicose veins are veins that become swollen, twisted, and lengthened as a result of poor vein function.
The syndrome often causes constant dull pain in the pelvic area that’s said to worsen at different times and in varying situations. It’s more likely to develop in people who have previously given birth.
Experts believe it can be the source of pain in up to
People with PCS generally report that the dull pain is chronic but that it worsens in certain situations, including:
- after standing up for a long time
- in the days leading up to menstruation
- in the evenings
- during and after sexual intercourse
- in the late stages of pregnancy
Besides the pain, people may experience other PCS symptoms as well as different combinations of these symptoms. The severity can also vary quite widely between individuals. These symptoms can include:
- dysmenorrhea (painful menstruation)
- abnormal bleeding during menstruation
- varicose veins around the vulva, buttocks, and legs
- abnormal vaginal discharge
- swelling of the vagina or vulva
- tenderness of the abdomen
- increased urination
- irritable bowel symptoms
Pregnancy is currently thought to be the most common cause of PCS. There are many reasons why pregnancy might bring this condition on:
- Pregnancy can cause structural alterations in the pelvis. These changes can affect some blood vessels, and that increases the risk of developing varicosities.
- Another reason is that the body usually gains fluid and weight to support the baby. Sometimes the veins can’t cope with the volume of fluid. They then become engorged to the extent that the valves are damaged and blood can then flow back through them, which causes them to become varicose.
- A reason pregnancy is thought to cause PCS is because the rise in estrogen weakens the blood vessel walls.
While pregnancy is the main risk factor for anyone, there are other risk factors for developing PCS. These risk factors include:
- more than one pregnancy
- hormonal changes
- having a “tipped” or retroverted uterus
- polycystic ovaries
- extra weight in the legs
PCS can be quite difficult to diagnose, and doctors often need to carry out multiple diagnostic procedures to eliminate other possible causes for your symptoms. These procedures can include:
- laparoscopy (a surgical procedure that uses small cameras to look inside the pelvis)
- CT scan
- MRI scan
The ultrasound is often preferred as the first step in diagnosing PCS as it’s possible to detect the varicosities as well as assess the blood flow.
Treatment for PCS is usually aimed at reducing and alleviating symptoms. There’s no definite cure for the condition, and it can be challenging to treat.
Medications available to help relieve your symptoms can include:
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- chronic pain medications (such as gabapentin plus amitriptyline)
Currently, the most successful treatment is a minimally invasive surgical procedure called pelvic vein embolization (PVE). This procedure blocks off certain varicose veins that are believed to be the source of pain.
Studies have shown
The symptoms of PCS often get worse in the late stages of pregnancy as the baby gets bigger and heavier. Additional pressure is put on the varicose veins in the pelvis, which often leads to an intensification of the pain caused by the condition.
PCS isn’t a condition that affects your life expectancy, but it does have the potential to significantly affect your quality of life.
Symptoms like chronic pain, pain during sexual intercourse, and dysmenorrhea can lead to a decrease in physical activity, loss of function, and depression.
A diagnosis doesn’t necessarily mean you’ll be affected to this extent — PCS varies greatly in terms of severity.
Keep in mind that there are treatments available to minimize your symptoms and help you cope with this condition. Talk with your doctor about your options.
It’s also important to talk with your doctor about counseling, if needed, to help you cope with the significant chronic pain that can go along with having PCS.