Pelvic Congestion Syndrome

Symptoms

The main symptom of PCS is chronic pelvic pain, lasting at least 6 months. This pain often starts during or after pregnancy and may worsen with subsequent pregnancies. The pain can be:

• Dull or aching
• Sharp
• Throbbing
• Burning
• Pressure or heaviness

The pain is usually worse:

• In the lower abdomen or pelvis
• On one side, although it can affect both sides
• At the end of the day
• With prolonged sitting or standing
• During or after sexual intercourse
• Before or during menstruation

Other symptoms of PCS may include:

• Varicose veins in the vulva, thighs, or buttocks
• Pain during bowel movements
• Painful urination
• Back pain
• Leg pain
• Feeling of fullness or pressure in the pelvis
• Difficulty sleeping

Causes

The exact cause of PCS is unknown, but it’s thought to be related to problems with the veins in the pelvis. These veins may become enlarged and twisted, causing blood to pool in the pelvis. This pooling of blood can lead to pain and other symptoms.

Several factors may increase your risk of developing PCS, including:

• Pregnancy
• Multiple pregnancies
• Hormonal changes, such as those that occur during menstruation or with birth control pills
• Obesity
• Pelvic inflammatory disease (PID)
• Endometriosis
• A family history of varicose veins

Diagnosis

Diagnosing PCS can be challenging because there’s no single test to confirm it. Your doctor will likely ask you about your medical history and symptoms. They may also perform a physical exam to check for pelvic tenderness or varicose veins.

Other tests that may be helpful in diagnosing PCS include:

• Ultrasound
• Pelvic venography
• Magnetic resonance imaging (MRI)

Treatment

There’s no cure for PCS, but there are treatments that can help manage the symptoms. Treatment options may include:

• Lifestyle changes: This may include losing weight, avoiding prolonged sitting or standing, and wearing compression stockings.
• Medications: Medications such as pain relievers, hormonal therapy, and medications to improve blood flow may be helpful.
• Minimally invasive procedures: These procedures can be used to block or close off varicose veins in the pelvis. This may include ovarian vein embolization, which involves blocking the ovarian veins to reduce blood flow (Click here to read more on Ovarian vein embolisation for pelvic congestion syndrome).
• Surgery: In severe cases, surgery may be necessary to remove or bypass enlarged veins.