Pelvic Congestion Syndrome

Vein malfunction can be the origin of numerous health issues. Varicose veins happen when veins amplify and are overloaded with blood, frequently in the lower part of the legs. Although both genders can get this condition, women are more likely to. Pelvic congestion syndrome (PCS) is the same issue in the pelvic region.  

The one-way valves present in veins take an essential part in governing the flow of your blood. These valves are designed to never let the blood to move back. But, when these valves malfunction, the blood can be halted in the veins instead of going to the heart. Due to the increased amount of blood, the veins may widen. This phenomenon is particularly noticeable in the lower limbs because of the gravity that makes it difficult to push the blood up.

This condition has a range of potential instigators, such as menopause, pregnancy, being overweight, and a family history of the condition. It is also more probable to occur in those above the age of 50.  

Syndrome of Pelvic Congestion

A medical condition characterized by chronic pain in the lower abdomen is referred to as pelvic congestion syndrome.  

This chronic condition is comparable to varicose veins; however, it is located in the lower abdominal region near the pelvic floor. Women are particularly susceptible, and those who have had children have a significantly increased risk. Studies indicate that pelvic congestion syndrome is likely the cause of over 25% of all pelvic discomfort experienced by women.  

The valves that manage the flow in the pelvic area can become damaged, leading to veins which have expanded and become twisted. Women with this issue can suffer from a persistent pain that can range from dull to severe. When the pain flares up, it can become unbearable.  

Symptoms That May be Indicative of Pelvic Congestion Syndrome

The agony endured by females due to this illness is often unique. It tends to vary. But, a steady form of ache is commonly present. The typical conditions when the suffering increases are: (1) just before a lady’s period, (2) shortly after sex; sometimes, even before sexual intercourse, (3) in the latter stages of pregnancy and (4) when women stand for an extended period. Certain women have likewise noted an escalation of their pains late in the night.

Apart from pelvic pain, this syndrome may manifest with a few other conditions. These include varicose veins in the legs, buttocks or genitals, mood swings such as depression and schizophrenia, heavy menstrual cycles, painful menstrual cycles (dysmenorrhea), fatigue, lower backache, frequent urination, inflammation of the vulva or vagina, painful bowel movements, and joint pain in the hips. Additionally, the abdomen may become soft. The intensity of the pain is largely dependent on the extent of these symptoms.

Factors Which Could Potentially Create Pelvic Congestion

It has been observed by the medical sciences that women who have already given birth possess a heightened risk factor which increases with each additional pregnancy. Research has identified potential causes, including:  

During gestation, a woman’s hormones experience a surge in production. For example, estrogen – the female sex hormone – is produced in more significant quantities than usual. Unfortunately, this also causes the walls and linings of a woman’s blood vessels to become weaker due to the higher levels of estrogen.   

Studies in the medical field have looked at the different changes that can take place in a woman’s body during pregnancy. The most commonly seen alteration is an increase in body weight. This is because the body is preparing itself to bear the new baby. As the weight and fluids accumulate, the veins struggle to cope with the sudden surge in liquids. This can cause the valves, which control the blood flow, to become strained. This could lead to the malfunctioning of the valve and the subsequent development of varicose veins due to the body’s inability to deal with the changes.  

Generally, during a pregnancy, the pelvis will go through a few alterations. This is the body’s natural way of preparing for childbirth. These alterations, which are typically structural, can have an effect on the circulation of blood through the body. This can have an impact on the blood vessels, their walls, and the functioning of valves.  

The impact of this pelvic congestion condition, especially at advanced stages of pregnancy, can have an influential effect on the unborn baby. This could lead to the baby being heavier and larger, and the extra weight adds to the mother’s pains. These sensations tend to be even more uncomfortable as the extra weight of the baby puts extra pressure on the veins and valves in the uterus. With the already-damaged veins and valves, this adds to the intensification of the pains.  

Determining If Pelvic Congestion Syndrome is Present  

Confirming the existence of pelvic congestion syndrome is not a straightforward process. To diagnose it, your physicians may have to carry out several tests and examinations. These are mostly done to eliminate the chances of other health conditions that can cause pelvic pain or congestion in the area. The most frequent checks conducted to confirm this condition are laparoscopy, ultrasound scan, venogram X-ray, CT scan, and MRI scan.

Ultrasound scans are the primary method used to diagnose pelvic congestion syndrome. It can be used to detect abnormal vein varicosities and malfunctions in the blood circulation system. Venogram is an X-ray procedure which involves introducing a dye, usually containing iodine, that allows medical professionals to observe your current medical state and the size/shape of your veins. One type of venogram, the descending procedure, is used to assess the functioning of your valves.  

To assess the proper functioning of the abdominal and pelvic organs, laparoscopy is a minimally-invasive surgical procedure. It has a low risk of complications due to its small incisions. A thin, long tube with a light and high-resolution camera is inserted into the abdominal lining or walls through a small cut. The tube, as it penetrates deeper into the abdomen, sends images to the laparoscopic console for viewing.  

Using a combination of radio waves and magnetic fields, MRI scans are able to capture images of internal organs. In contrast, CT scans are created with an X-ray source and allow for images of body parts and how they are functioning. Generally, scans are conducted in the later part of the day or in the evening, when pelvic pains are most likely to be more severe.  

What Is The Best Way to Manage Pelvic Congestion Syndrome?  

Unfortunately, there is no full-fledged remedy for this medical affliction. Treatment for this pelvic syndrome is complex and involves reducing pain and other related symptoms. Medications are employed to diminish the aches and lessen inflammation of the veins. A newer approach called embolisation of pelvic veins has been adopted to tackle this dilemma and has been observed to be successful in certain cases. Women whose condition is suitable for the procedure report enhanced relief from the pains connected to pelvic congestion syndrome.  


The use of pharmaceuticals is a common way to treat a variety of ailments. Many drugs are available to address different conditions, and taking them as prescribed by a physician can be an effective way to manage symptoms or achieve a desired outcome. Patients should always talk to their doctor about any medications they are taking or considering taking, in order to ensure safety and efficacy.  

After your physician has thoroughly evaluated your pelvic problem, a treatment plan tailored to you will be constructed. All other alternatives must be ruled out before the doctor begins the plan. The most commonly prescribed drug for pelvic pain is a non-steroidal anti-inflammatory drug (NSAID), but this is usually only given for a short period of time.  

Ibuprofen is a type of anti-inflammatory medication that can be used for a variety of aches and pains. It is available in both over-the-counter and prescription strength and is often used to treat headaches, muscle soreness, and joint pain.  

This drug is used to manage discomfort associated with various pains. It can be employed to relieve pain from conditions like arthritis, pelvic region pains, toothaches, headaches, menstrual cramps, and earaches. This medication is a Non-Steroidal Anti-Inflammatory Drug (NSAID) and its primary purpose is to control inflammation-causing agents such as prostaglandins and cyclooxygenase, thereby reducing pain.  

It is possible to experience drowsiness, nausea, and indigestion as side effects of this medication. Therefore, it is advised to avoid activities that require a great deal of mental concentration, such as driving or operating heavy machinery. If you or anyone in your family has a history of heart issues, kidney issues, or internal bleeding, you should consult with your doctor before beginning a course of this drug. Additionally, it may interact with other medications and alcohol, so you should inform your pharmacist or health care team if you are using beta blockers, diuretics, or heparin.  

Medroxyprogesterone is a medication used to regulate the effects of hormones in the body. It can be employed to treat a range of conditions, from endometriosis to contraception. It works by interfering with the natural production of hormones and is taken in either oral or injectable form.  

This pharmaceutical can help decrease the chances of developing cancers in the uterus. It is usually given to women to control heavy bleeding, particularly those who haven’t gone through menopause yet.  

Essentially, this drug can help re-establish regular periods and lessen hot flashes or other issues connected to menopause.  

Probable side effects include bloating, nausea, and vision blurring. If you or a family member have high blood pressure or liver problems, be sure to inform your doctor. In addition, make sure they are aware of any antifungal or anticonvulsant medications you are currently taking.  

The combination of gabapentin and amitriptyline is a medication regimen that may be prescribed.  

Research in the medical sphere has revealed that the combination of taking gabapentin and amitriptyline has been successful in decreasing pain levels in women. The effects are much more pronounced than when amitriptyline is taken as an individual dose.  

This neuropathic pain reliever, Gabapentin, is designed to reduce pain and spasms in the pelvic region. However, some of the possible side effects include fatigue, coldness, and fever. People with respiratory conditions or kidney issues should consult a doctor before taking this medication. Additionally, it is known to produce unfavorable reactions with some antihistamines and certain medications designed to lower stress.  

For combating sadness and depression, Amitriptyline is a highly effective medication. It works by influencing a few neurotransmitters in the brain, lessening stress. It is also a useful drug for treating some types of pain. This drug belongs to the tricyclic antidepressant group. Dehydration and constipation are the potential side effects of this medication. If you suffer from any mental health problems, such as bipolar disorder or any other mental health issues, it is important to tell your doctor beforehand.  

In cases where the indications of pelvic syndrome don’t alleviate, a radiologist may do a venography test. As previously stated, a contrast material (usually, an iodine-based dye) is injected for a better visual of different parts of the pelvis.  

Blocking of the Pelvic Vein Through Embolization  

Under the guidance of a qualified interventional radiologist, this procedure requires only minimal surgical intervention. The process begins with a catheter insertion, which is done by making a small incision in either the neck or groin area with local anesthesia. This catheter is then placed in the ovarian and pelvic veins for both diagnostic and therapeutic purposes. To ensure the successful outcome of the procedure, it is essential to correctly position the catheter, and this can be done with the help of embolic chemicals. The success of the procedure is determined by the absence of any further damage to the ovarian or pelvic veins.  

In medical science, embolic substances/agents come in different forms – such as glues, sclerosing fluids and coils. Fluids (sclerosing substances or glues) seal off veins by causing them to clot, while coils are made of metal, usually an alloy of steel or platinum, and they are designed in varying sizes to ensure the veins are sealed properly. Since the incision is usually small, it does not require complex suturing. The procedure typically takes between 40 and 80 minutes, with the time taken depending on the complexity of the vein and how easy it is to access. This technique has had a positive impact on women suffering from pelvic congestion syndrome, with improvements usually noticeable within two weeks.  

Despite some risks, this procedure is still sought after due to its minimally invasive nature. It generally does not require an overnight stay in a hospital and has been proven to be an effective method for repairing a damaged vein and reducing pelvic pain. Allergies to the contrast dye used could occur, and in rare cases, bleeding or bruising of the vein, incorrect placement of the sealing agent, and infections may arise. Additionally, it has been reported that in about 10% of women, pelvic congestion may relapse.  

When it comes to women who are suffering from pelvic pains, they should be monitored for any mood changes such as depression. It is essential to also identify any stresses from home life or violence that may be influencing the symptoms. Psychological stress can manifest itself in the form of physical discomfort, particularly abdominal pain.  

Given these situations, in addition to medical or surgical procedures, it is also advised to seek the help of a certified mental health professional. Some medical teams even take a deeper dive into lifestyle habits, such as sleep-cycles, menstrual cycles, and any gastrointestinal issues. Research has connected irritable bowel syndrome (IBS) to pelvic congestion syndrome in women.

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