Pelvic pain is extremely common, and experts estimate that approximately 40% of gynecological visits involve chronic pelvic pain complaints. Up to 30% of these women experience pain because of pelvic congestion syndrome (PCS), but most of these may go undiagnosed because physicians are often unfamiliar with the condition or fail to look for it.
At Heart Vascular & Leg Center, our team of vascular specialists is intimately familiar with PCS and can provide an accurate diagnosis, as well as effective treatments, for women struggling with the condition. Here’s what the team wants you to know about PCS and five helpful treatments for it.
What causes pelvic congestion syndrome?
PCS is a condition that primarily causes chronic (more than six months) pelvic pain. It's thought to be caused by vein problems in the pelvic area, the lower part of your abdomen, and in the ovaries.
Veins are the part of the circulatory system that carries deoxygenated blood back to the heart. Often due to increased blood pressure, the valves within the veins become damaged, and blood pools in the area. The veins enlarge and change shape, leading to pain.
The problem is like varicose veins in the legs where the valves have become damaged, and the vessels engorge. In this case, the veins in the pelvis, rather than the legs, become varicose.
Researchers are still trying to determine all the possible causes of PCS, as many women have enlarged veins in their pelvis but no symptoms. Pregnancy may increase the risk of developing PCS because the veins enlarge during pregnancy to support the increased blood flow to the fetus. If they don’t return to their normal state, the result may lead to chronic pain. In fact, pregnancy is a major risk factor for PCS.
Hormones may also play a role. Estrogen dilates the veins, which may lead to pain. If true, this may explain why the condition isn’t common after menopause, when estrogen levels decrease substantially. Other hormones may affect the vessels as well.
Pelvic congestion as a cause of pelvic pain is a diagnosis of exclusion; the doctor first rules out any more likely causes of pain until PCS is the only cause left.
5 helpful treatments for pelvic congestion syndrome
If you’re diagnosed with PCS, we may treat you with any of five different treatments, depending on your unique situation. At Heart Vascular & Leg Center, we always start with the most conservative options.
1. Hormonal medications
These medications can reduce blood flow and, therefore, the engorgement of the veins. Two possibilities are gonadotropin-releasing hormones, which block ovarian function and may relieve pain, and progestin, which may be effective against pain.
2. Embolization or sclerotherapy
Under ultrasound guidance, we inject an irritating solution into the affected vein, which causes the walls to collapse and the vein to seal itself closed. Your body naturally reroutes blood flow to nearby healthy veins, and the collapsed vein eventually flushes from your system.
3. Radiofrequency ablation
Here we use radiofrequency energy to seal or dissolve the vein to redirect blood flow to nearby veins, so your body can flush the dead tissue from your system.
This is a minimally invasive surgery, where we make a small hole in the skin above the diseased vein, then pull the entire vein out, relieving your pain.
5. Removal of ovaries and uterus
This surgical procedure is considered the treatment of last resort, and we only consider it if all previous treatments have failed and you’re finished having children.
If you’re experiencing pelvic pain, it’s time to come into Heart Vascular & Leg Center for an evaluation by one of our vascular specialists to determine if you have pelvic congestion syndrome. To get started, call our office at 661-443-5524 to schedule, or book online today.