Pelvic Congestion Syndrome Symptoms and Treatments

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Pelvic congestion syndrome (PCS) is a condition that causes chronic pelvic pain in women. Chronic pelvic pain is considered pain that lasts more than six months. PCS is caused by varicose veins in the pelvis putting pressure on the pelvic organs. According to Stanford Medicine, PCS accounts for 10-15% of referrals to gynecologists and pain clinics. While chronic pelvic pain is the most common symptom, there are other pelvic congestion syndrome symptoms you should aware of.

Pelvic Congestion Syndrome Symptoms

Pelvic congestion syndrome may cause different symptoms in different individuals. However, these are the most common pelvic congestion syndrome symptoms:

1. Chronic Pelvic Pain

The most prominent pelvic congestion syndrome symptom is pelvic pain. Different women experience this pain differently. For some people, the pain first starts during or after pregnancy and gets worse with each pregnancy. However, not all women who have symptoms of PCS have been pregnant. 

Some people say it is an aching and heavy feeling. Others say the pain is sharp. Or they may experience pain differently over time. Usually, the pain is present on the left side but it may be felt on both sides of the pelvis.

Pelvic pain associated with PCS can get worse throughout the day. Some women have increased pain before or during their menstrual cycles. Other things that may make the pain worse include

  • Walking
  • Standing for long periods
  • Changing posture
  • Having sex

2. Enlarged External Veins

Pelvic congestion syndrome is caused by varicose veins in the pelvic region. In some cases, these varicose veins are internal and can’t be seen outside of the body. However, some women get enlarged veins that are visible on the buttocks, thighs, or vulva (the external female genitalia).

3. Stress Incontinence

The pressure of the varicose veins in the pelvic region may cause stress urinary incontinence. This is a condition in which urine leaks out of the bladder when sudden pressure is applied to the bladder urethra. Common triggers for stress urinary incontinence include sneezing, exercise, laughing, or coughing.

4. Back & Leg Pain

Another one of the common symptoms of pelvic congestion syndrome is a feeling of fullness in the legs or pain in the lower back. Women with PCS often report that their legs feel heavy or that their pelvic pain extends down into their legs. The varicose veins mentioned before may also appear on the upper parts of the legs. Pain originating in the pelvis may also be felt in the lower back. 

5. Other Symptoms

The above symptoms are the most common pelvic congestion syndrome symptoms, but some women experience other symptoms, including:

  • Abdominal bloating
  • Fatigue
  • Headaches
  • Mood swings
  • Abnormal vaginal bleeding
  • Watery vaginal discharge

Treatments for Pelvic Congestion Syndrome

Treatment for PCS depends on how severe the symptoms are. Before treatment can be recommended, some diagnostic procedures may be necessary. Imaging studies like ultrasounds, CT scans, MRI scans, or venograms can help doctors diagnose the condition. In some cases, a minimally invasive procedure called a laparoscopy is performed in order to look for varicose veins in the pelvis.

Mild symptoms of PCS may be treated with over-the-counter pain relievers such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil and Motrin) or naproxen (Aleve). Prescription pain medications may also be used. 

However, the most successful treatment for pelvic congestion syndrome is a minimally invasive procedure called pelvic vein embolization (PVE). Pelvic vein embolization is a non-surgical treatment that blocks abnormal blood flow to the varicose veins that are causing pain. PVE is done in an outpatient setting and only requires local anesthetic or numbing cream. 

During the procedure, a thin catheter is guided into the pelvic to the affected vein. Tiny coils are inserted into the vein and it is sealed off with a material called a sclerosing agent. This material is also used to close varicose veins in other parts of the body. The procedure is safe and effective. According to one study published in the US National Library of Medicine, almost 80% of patients experienced relief from chronic pelvic pain.

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