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Does Pelvic Congestion Syndrome Cause Weight Gain

Women are used to pelvic pain during their periods, but there are conditions that cause chronic pelvic pain, such as pelvic congestion syndrome.

Chronic pain is defined as that lasting longer than 6 months, and with pelvic congestion syndrome, it is not associated with either your menstrual cycle or pregnancy. Instead, this chronic pain condition is associated with blood flow problems in your pelvic veins.1

Besides the other side effects, does pelvic congestion syndrome cause weight gain? Here’s a look at this pelvic dysfunction and whether it can mean a jump up on the scale. 

What Is Pelvic Congestion Syndrome?

Pelvic congestion syndrome, or PCS, is a common cause of chronic pelvic pain in women of reproductive age. 

This chronic pelvic pain is defined as:2

  • pain that is intermittent or constant
  • pain that lasts for up to 6 months
  • pain in the pelvic or abdominal region
  • pain that occurs throughout the menstrual cycle—in other words, not just when you have your period
  • pain that has no association with pregnancy

This condition is often misdiagnosed, despite the fact the pelvic pain can be severe enough to result in functional disability and require treatment.2

Consider this.

Nearly 10-20% of gynecologic consultations are due to chronic pelvic pain complaints, and only 40% of them are referred for evaluation by a specialist.2 Other reports put the numbers even higher: 40% of gynecological visits involve chronic pelvic pain complaints, and up to 30% of these are likely related to pelvic congestion syndrome.1

Pelvic congestion syndrome is a pelvic venous syndrome, also known as pelvic venous insufficiency. It’s caused by blood flow problems in your pelvic veins. The pelvic pain often involves faulty veins in your ovaries and pelvis. 

Normal blood flow would run from your pelvic veins upward to your heart via the veins in your ovaries. Valves in your veins prevent blood from flowing backward, but when you have PCS, the veins are so dilated or widened that the valves don’t prevent that backflow—known as reflux. 

Blood then flows backward through the veins, causing them to become overly filled and twisted, and that pooling blood causes pain. This pain could related to the stretching of your stressed veins, or when misshapen veins touch nearby nerves in your pelvis.1

Who Suffers From Pelvic Congestion Syndrome?

This condition is most common among premenopausal women—typically those between the ages of 20 and 45—who have had more than one child. 

Here are other risk factors:1

  1. varicose veins
  2. a family history of varicose veins
  3. having Polycystic ovarian syndrome (PCOS)

It’s rare for women who have already gone through menopause to have pelvic congestion syndrome.

The exact cause of pelvic congestion syndrome is not clear, and probably dependent on multiple factors. The congestion of the pelvic veins can be due to hormones, insufficiency of the valves, and/or obstruction of the veins. The increased dilatation of the veins along with a stoppage or slowdown of that blood is the likely cause of the pain of PCS.2

It’s also possible that an event has damaged your pelvic veins, like fluctuation of hormones, the multiple pregnancies we mentioned, or weight gain. An example during pregnancy is when hormones fluctuate and your pelvic anatomy changes, increasing the volume of blood and estrogen. These conditions can weaken the walls of the blood vessels. Your damaged pelvic veins can also cause swelling of surrounding organs such as the bladder, intestines, and rectum.3

How Do I Know If I Have Pelvic Congestion Syndrome?

Pain is the main symptom of PCS. That pain takes different forms: dull, achy or heavy; and less commonly it’s sharp and intense. The most common location is the left side of your body, but you may feel it on the right side or both sides of your body. The pain often starts during or soon after pregnancy, and then it may worsen with future pregnancies.1 In fact, it’s often confused with menstrual discomfort, but the signs don’t usually appear until a woman gets pregnant.3

Besides the chronic pelvic pain, there are other signs that you may have pelvic congestion syndrome:3

  • pain that gets worse when you sit or stand, especially during menstruation
  • pain that disappears after you sleep at night
  • pain in the lower back and muscles, as well as hips, abdomen, and buttocks
  • irritable bowel that causes persistent abdominal pain and alternating times with either diarrhea or constipation
  • irritable bladder with possible stress incontinence
  • pain or discomfort after or during sex
  • vaginal swelling or vulvae swelling
  • abdominal or pelvic tenderness
  • vaginal discharge that’s abnormally clear or watery
  • painful periods
  • abnormal menstrual bleeding
  • fatigue and lethargy
  • increased urination
  • mood swings such as anxiety, depression, and/or physical worries
  • headaches
  • bloating in the abdomen

With all those possible side effects, it’s no surprise that PCS is often mis-diagnosed. Or, it’s possible that women dismiss some of the symptoms as “normal” things that happen during periods or following pregnancy.  

It’s also hard to diagnose because many women have enlarged pelvic blood vessels on a standard ultrasound or MRI but will have no painful symptoms. As a result, only women who have both enlarged pelvic veins and chronic pelvic pain are given a diagnosis of pelvic congestion syndrome. And the pain must be present for a minimum of 6 months.4

Several tests will aid in providing a diagnosis of PSC:4

  • radiological imaging
  • blood tests
  • diagnostic laparoscopy
  • pelvic ultrasound
  • pelvic venography—when a material is injected into the vein to observe blood flow

Mis-diagnosis for pelvic congestion syndrome includes diseases of the urinary tract, gastrointestinal tract, musculoskeletal disorders, disorders of neurological origin, and gynecological problems. Complicating matters is the fact there are other causes of chronic pelvic pain, such as painful bladder syndrome, interstitial cystitis, pelvic inflammatory disease, endometriosis, and irritable bowel syndrome.2

Does Pelvic Congestion Syndrome Cause Weight Gain?

Once you understand there are a variety of side effects for pelvic congestion syndrome, you may wonder about other symptoms. For instance, does pelvic congestion syndrome cause weight gain?

Typically, the answer is no—PCS does not usually cause weight gain. In fact, one study showed that women with PCS were more likely to have a normal BMI (body mass index) with ovarian vein dilation compared with obese women, who are more frequently affected by varicose veins in the legs.5  

However, the enlargement of the pelvic veins that happens when there is retained blood may make it seem or feel like you’ve gained weight. Also, pelvic congestion syndrome does cause bloating in some patients. Bloating is more commonly associated with menstruation during other conditions, such as fibroids or endometriosis.4

So pelvic congestion syndrome is not generally considered as a cause of weight gain, despite enlargement of your pelvic veins. The weight gain caused by the retained blood in these veins is minimal and would likely not be significant.6 So if you have a sudden weight gain, there could be another cause and it should be investigated. 

How is Pelvic Congestion Syndrome Treated?

Pelvic congestion syndrome isn’t life-threatening, but the pain can be severe enough to impact your quality of life. It also seems it can’t be prevented and it can’t be cured, but medications and medical procedures can help ease your symptoms.1

Your treatment plan may include a doctor specializing in women’s health, perhaps a gynecologist, and possibly a gastroenterology specialist, pain specialist and physical therapist. A first step in treatment could be medications to manage your symptoms before recommending surgery. Options for medication include those that suppress estrogen production to lessen the pain.1

A medical procedure may be the next step. Options include:1

1. Ovarian vein embolization: which blocks the blood vessels causing the blood to flow backward, preventing the blood from pooling. 

2. Laparoscopy: using a small instrument called a laparoscope to tie off the veins, preventing the backflow of blood.

3. Bilateral salpingo-oophorectomy: to remove your pelvic organs—the uterus, fallopian tubes and ovaries—if you do not want to get pregnant again. This surgery is rare for PCS.

Pelvic congestion syndrome also does not impact your life span, but it can be associated with a decrease in quality of life. Some of the symptoms can also lead to decreased physical activity, loss of function, and depression.6 That makes it vital that you seek medical care so you can find the cause of your pain and find relief from it.

See a Doctor 

If you have chronic pelvic pain, or you’ve had a sudden weight gain, use our Physician Finder to find a doctor near you with expertise in women’s health. It’s important to receive a proper diagnosis and treatment plan for your pain so you can get back to an active and happy lifestyle.

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