Chronic pelvic pain is one of the most common issues to affect women, in particular those who’ve had multiple pregnancies, polycystic ovaries or hormonal changes. In fact, it’s such a common issue that a third of all women will suffer from it at some point in their life. While there is a range of issues that can lead to this chronic pain (defined as lasting more than six months and separate to the menstrual cycle), one of the most common culprits is pelvic congestion syndrome. Understanding what causes pelvic congestion syndrome (PCS), what activities aggravate it, and how to best treat and prevent it can make a significant difference in women’s health and general quality of life.

What causes pelvic congestion syndrome?

Pelvic congestion syndrome occurs when varicose veins form around the ovaries. These veins do not function properly, with the valves often failing, vein walls becoming weakened and twisted swollen veins forming.

While PCS isn’t conclusively caused by one single thing, it’s most commonly caused by two primary factors. Enlarged veins and hormones.

While some women have naturally larger veins, usually it’s women who’ve been pregnant in the past, as your veins enlarge during pregnancy to increase blood supply to the womb, and in some cases, this can be permanent. It’s worth noting that not all women with enlarged veins will develop PCS, they’re just at higher risk.

The other common cause is hormones. Oestrogen is one of the hormones common in women from adolescence until menopause and is more common in pregnant women. This particular hormone causes the veins to dilate and weaken blood-flow.

How does PCS affect me?

The primary symptom of PCS is lasting pelvic pain the continues for over six months. This starts most commonly during pregnancy, sometimes worsening after birth. With a pain that can vary between sharp pain or a heavy ache, it’s normally on one side of the pelvis but can flare up on both. The pain is normally worse at the end of the day when the blood has pooled in the veins.

There are some activities that aggravate the pelvic pain, and those with PCS or those who suspect they may have it should be aware of what can make the pain worse, including the activities below.

Having sexual intercourse
Walking
Changing posture, particularly when carrying the weight
Standing for extended periods of time

While pain is the most common and obvious symptom, there are other symptoms that can occur, including back pain, fatigue, pain and excessive bleeding during menstruation, swelling around the vagina or vulva and varicose veins in the lower half of the body, especially around your vulva and buttocks.

How do I treat Pelvic Congestion Syndrome?

The most important step in treating PCS is getting diagnosed. While imaging, urine and blood tests can be used to check for it (and exclude other pelvic conditions), it can still be difficult to confirm, as pelvic pain is common due to a wide range of issues. Finding a doctor you trust who isn’t dismissive of your condition is a helpful step in getting a clear diagnosis.

Once diagnosed, treatment is most commonly done through the use of anti-inflammatory medication as well as chronic pain medication. These will be prescribed by your doctor accordingly depending on the severity of your condition.

In more serious cases where the pain is highly severe or if there are complications or risks to your long-term health or reproductive health, medical procedures to close off or remove the damaged veins may be considered, and in the most serious of cases may require a hysterectomy.

Learn more: Varicose Vein Treatments

So what happens now?

While PCS doesn’t shorten your life, it can diminish your overall life quality, especially if left untreated. Thankfully with current procedures and medication, treatment can make a big improvement if undertaken early. If you suspect you have PCS then speak to your doctor about a diagnosis.

Seek expert advice

The doctors at The Vein Institute specialise in varicose vein treatment. We offer patients a comprehensive program using non-surgical laser treatment techniques. You can learn more in our Definitive Guide to Varicose Vein Treatment.

The benefits of non-surgical varicose vein treatment are: