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Pelvic Congestion Syndrome: What to Know

Medically Reviewed by Michael W. Smith, MD on August 06, 2021

Pelvic congestion syndrome is an ongoing condition that affects the pelvic area or the lower part of your belly. Experts think it’s caused by problems with veins in that part of the body.

Pelvic congestion syndrome can be quite painful, lasting 6 months or more. It’s not connected to your period and can be hard to diagnose.

What Causes Pelvic Congestion Syndrome?

Researchers are still learning. But some think hormonal and physical changes during pregnancy may trigger the buildup of pressure in veins around the ovaries. Estrogen, a reproductive hormone that women make more of during pregnancy, can weaken the veins in the area and cause them to widen.

What Are the Symptoms of Pelvic Congestion Syndrome?

The pain can last for several months and affect your day-to-day life. It’s usually only on one side.

Symptoms include:

  • A dull, aching pain in your pelvic area and lower back
  • Pain that gets worse during your period
  • Irritable or stressed bladder that makes it hard to control your pee
  • Discomfort or pain during sex (dyspareunia)
  • Bulging or engorged veins in front of the vagina
  • Varicose veins on your upper thighs or butt

It might also be painful to stand for long periods of time.

Who’s at Risk for Pelvic Congestion Syndrome?

It mostly happens to women of childbearing age between 20 and 45. It’s more common if you have more than one child.

Other risk factors include:

  • Having a "tipped" or retroverted uterus
  • Full leg veins
  • Polycystic ovaries
  • Hormonal problems

How Is Pelvic Congestion Syndrome Diagnosed?

Many things can trigger pelvic pain, which can make it hard for your doctor to know if it’s pelvic congestion syndrome or something else. If you have severe pelvic pain, your doctor will run several tests to rule out certain causes before they can confirm PCS.

These may include:

  • Urine tests to check for bladder problems
  • Blood tests to check for pregnancy, sexually transmitted infections, anemia, and other conditions
  • Pelvic ultrasound to look for growths in the pelvic area
  • Doppler ultrasound to check blood flow in the pelvic blood vessels
  • CT scan or MRI for more detailed pictures
  • Diagnostic laparoscopy to help rule out other reasons for pain
  • X-rays of the pelvic veins

What Are the Treatments?

Treatment options include:

  • Drugs that release the hormone gonadotropin to block ovarian function and ease pain
  • Progestin hormone drugs to ease pain
  • Procedures to shut off damaged veins (sclerotherapy or embolization)
  • Surgery to take out damaged veins
  • Surgery to take out your uterus and ovaries (hysterectomy)

Many women who’ve gotten embolization say their symptoms got better.

When Should You See a Doctor?

Make an appointment with your doctor if you notice symptoms that don’t go away. If your pelvic pain gets so bad you can’t function, go to the emergency room. They’ll rule out anything life-threatening that could be causing your symptoms. If it’s pelvic congestion syndrome, they’ll work with you to figure out which treatment is best.

WebMD Medical Reference

Sources

SOURCES:

Stony Brook Medicine: “Pelvic Congestion Syndrome.”

Stanford Health Care: “Pelvic Congestion Syndrome (PCS).”

Cedars Sinai: “Pelvic Congestion Syndrome.”

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