Determining the Source of Your Pelvic Pain

Pelvic pain may seem an odd concern for a vascular practice, but it makes sense when you consider pelvic congestion syndrome (PCS), a source of chronic pelvic pain that stems from damaged blood vessels.

At Heart Vascular & Leg Center in Bakersfield, California, our expert team of vascular, wound, and podiatric specialists understands that chronic pelvic pain can be both uncomfortable and frightening. That’s why we provide state-of-the-art diagnostic tools and treatments, so you can find relief and get back to your life. If you don’t know what pelvic congestion syndrome is and what to do about it, keep reading to learn more.

PCS and varicose veins

Varicose veins result from circulatory system damage. Specifically, high pressure in the veins, the part of the system that returns blood to the heart, can damage their one-way valves that prevent blood from backtracking along its path. 

With the valves damaged, flow gets sluggish, and blood starts to pool, causing the vein to become engorged. Since the veins are close to the skin’s surface, what you see is a discolored, ropy protrusion, usually on the backs of your legs.

Varicose veins aren’t limited to the lower extremities, though. High pressure in the abdomen, such as during pregnancy, can lead a pelvic vein to turn varicose. Pelvic congestion syndrome occurs when the abdominal veins become damaged and dilated, often leading to chronic pelvic pain, heavy or prolonged periods, pain after intercourse, and a greater likelihood that more veins will become varicose.

You have a higher chance of developing PCS if your existing varicose veins appear high on the thighs, the groin, and the vulvar region. At highest risk are women of childbearing age who have already given birth at least once, as pelvic veins stretch during pregnancy to support additional blood flow. 

It’s also common for pregnant women to develop varicose veins in the lower extremities, as the additional weight they carry puts extra pressure on the veins.

Determining the source of your pelvic pain

Unfortunately, PCS isn’t easy to diagnose, in large part because pelvic pain is common and can result from many different causes, including problems related to your:

• Reproductive system: ovaries and uterus (e.g., endometriosis, fibroids)
• Urinary system: bladder
• Gastrointestinal system: small and large intestines
• Muscles and bones
• Mental health conditions: particularly depression

To determine what’s causing your symptoms, including your pelvic pain,we perform a complete medical history and physical exam and run a number of tests to determine your vascular health:

• Vascular ultrasound (to measure blood flow in pelvic blood vessels)
• Pelvic venography (X-ray that looks at blood flow through your veins)
• Blood tests (to rule out pregnancy, anemia, and STIs)
• Urine tests (to rule out urinary system problems)

If we rule out all other causes, and your vascular tests reveal a blood flow problem, we can diagnose you with pelvic congestion syndrome.

Treating PCS

If you have PCS, we develop an individualized treatment plan based on the severity of your symptoms and your medical history. We always start with conservative options.

Our first recommendation may be to treat your pelvic pain with hormonal medications. These include gonadotropin-releasing hormones, which block ovarian function and may relieve pain, and progestin, which may also relieve pain.

If this doesn’t work, we may recommend a minimally invasive procedure, such as:

• Ultrasound-guided sclerotherapy using an irritant that causes the vein to collapse
• Radiofrequency ablation to close off or dissolves the vein
• Microphlebectomy to surgically remove the affected vein

We discuss all your options with you during your consultation.

If you’re struggling with chronic pelvic pain, you don’t have to suffer in silence; it may be vascular, and we have treatments that can help. Contact Heart Vascular & Leg Center to set up an evaluation with one of our vascular specialists by calling us at 661-443-5524, or book online with us today.