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All About Pelvic Congestion Syndrome

The pelvis is a complex area of the body. When everything is functioning well, the organs of the pelvis control both eliminating waste and your menstrual cycle and, of course, will also carry your baby when pregnant. However, because of this complexity, many women will develop pelvic floor disorders over the course of their lifetime. 

In fact, about one third of all women will suffer from chronic pelvic pain at some point (meaning pain that lasts longer than 6 months, unrelated to the normal menstrual cycle).1 If you experience long term pelvic pain, you may be suffering from a little understood condition called pelvic congestion syndrome (or PCS). 

Of course, there are many reasons you may be experiencing pelvic pain, such as endometriosis, urinary tract infections, and adenomyosis. To learn whether it may be PCS affecting you or a loved one, please keep reading. 

What Is Pelvic Congestion Syndrome

Pelvic congestion syndrome happens when the veins in the lower abdomen stop working properly.  Because blood flow is affected, blood may start to build up inside the pelvic veins (or, become ‘congested’ as the name suggests), causing them to enlarge and change shape. Among other issues, this can also be painful. 2

At this point, the exact causes of PCS are unclear, although one theory points to hormonal changes and weight gain from pregnancy putting pressure on ovarian veins. 3

Risk Factors for Pelvic Congestion Syndrome

PCS may be genetic, meaning you may be more at risk if other family members have the condition. Having two or more pregnancies, a tipped uterus, hormonal dysfunction or polycystic ovaries are other risk factors. 

Note that most women with PCS are younger than 45. 

Symptoms of Pelvic Congestion Syndrome

As we’ve discussed, the main symptom of PCS is pelvic pain lasting for longer than 6 months. Some ways to differentiate it from other types of pelvic pain is if the pain worsens as the day goes on, especially after standing, walking or having sex. And for women with PCS, the pain is often improved by lying down. 

Other symptoms of PCS include painful menstruation, irritable bladder and the sudden need to urinate, and irritable bowel. You may also have varicose veins on the top of your inner thighs or the back of your thighs, or enlarged veins around your vulva and buttocks. 

Treatment for Pelvic Congestion Syndrome

Because there are so many potential causes of pelvic pain, it can be difficult to diagnose PCS. Moreover, many doctors are unfamiliar with this condition. For these reasons, if you are experiencing chronic pain, you may want to seek out help from a doctor who specializes in pelvic floor disorders (use our Physician Finder https://pelvicawarenessproject.org/physician-finder/ to locate one in your area). 

Diagnosis and treatment of PCS will often require a multidisciplinary team. You may be given an ultrasound or a magnetic resonance imaging (MRI) test, as well as urine and blood tests. Remember, your doctor has to rule out lots of other conditions. They can also perform what is called a pelvic venography, a minimally invasive procedure that takes an x-ray of your veins themselves. 

Treatment for PCS often begins with medication, either hormonal or to relieve pain. If these do not help, your doctor may recommend a nonsurgical embolization (or plugging) of the veins, which is a minimally invasive, outpatient procedure. Surgery to remove damaged veins, and in more serious cases your uterus and ovaries, may also be needed. 

We believe that no women should have to suffer in silence through pelvic floor disorders, including pelvic congestion syndrome. If you are experiencing chronic pain, please seek help.

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