What is Pelvic Congestion Syndrome?

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May 5, 2021 The Vein Institute

Pelvic congestion syndrome (PCS) is a painful, sometimes even debilitating condition caused by varicose veins.

And because it can be easily confused for menstrual pain, it’s important to know its symptoms and underlying causes so you can seek the best treatment methods.

What Causes Pelvic Congestion Syndrome?

PCS 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. 

Pelvic congestion syndrome is caused by varicose ovarian veins (often connected to varicose veins in the broader pelvis and sometimes the legs), which are in turn caused by vein strain and hormones. That’s why PCS is most common in pregnant women, especially if you’ve had multiple children. See, the strain pregnancy places on your veins, combined with hormonal fluctuations and the increased blood flow your body needs to supply oxygen to your baby essentially creates a perfect storm. 

  • The increased supply of oestrogen and blood dilate your veins
  • Oestrogen weakens your blood pressure
  • Your expanding uterus strains the pelvic veins

Vein walls weaken, and the valves malfunction, so blood that’s supposed to propel back to the heart instead pools, turning your veins varicose. 

What can put me at risk of developing PCS?

Mid shot of woman's pregrant belly, one of the risk factors of pelvic congestion syndrome

Mid shot of woman’s pregnant belly. She is wearing a dark blue dress and standing in a forest.

You’re more at risk if you:

  • Are a woman under 45 
  • Have PCOS (polycystic ovaries)
  • Have a family history of varicose veins
  • Had 2 or more pregnancies
  • Have hormonal dysfunction or excess
  • Have a retroverted uterus (also called “tipped”)

What are the symptoms of PCS?

Woman experiencing symptoms of pelvic congestion syndrome

Woman laying on a couch holding her pelvis as though in pain

While PCS is caused by a varicose vein, the pelvic location means the symptoms, while having some overlap, are a bit different. 

The primary symptom is lasting pelvic pain that continues for over six months. It typically starts during pregnancy, sometimes worsening after birth. The pain varies between sharp pain or a heavy ache. You’ll usually feel it on one side of the pelvis, but it can flare up on both. And it typically gets worse at the end of the day when your blood pools.

While pain is the most common and obvious symptom, there are others you might experience. These include: 

  • 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.

As pelvic varicose veins can also be connected to larger varicose veins in the legs, you may also experience heaviness, itchiness, aches, swelling, or a burning sensation around your legs. 

What can make the condition worse?

  • Having sexual intercourse
  • Walking, jogging, or weightlifting 
  • Changing posture
  • Standing or sitting for extended periods

How do you treat Pelvic Congestion Syndrome?

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

Once diagnosed, your doctor may prescribe anti-inflammatory medication, hormone treatment such as birth control, and chronic pain medication to alleviate your symptoms. 

If your pain levels are severe or if there may be risks to your long-term health or reproductive health, your doctor will consult you on medical treatment options. PSC is treated through Ovarian Vein Embolization, where your doctor will insert a catheter into your ovarian vein and inject a foam sclerosant to seal it off. 

If your case is more serious, however, you may need a hysterectomy. 

Additionally, if the veins are attached to varicose leg veins, you will need to treat the leg veins to prevent the PCS from recurring. We can do this via:

Seek expert advice.

Varicose veins can be a troubling condition anywhere, whether they appear in the legs, pelvis, or both. So if you’re experiencing the above symptoms or think you may be at risk, contact us at 1300 535 017.