Pelvic congestion syndrome is a little-known and commonly undiagnosed condition that can cause extreme pain and other symptoms in some women.

About 15 percent of U.S. women of childbearing age report experiencing persistent pelvic pain that lasts six months. For many women, gynecological abnormalities such as endometriosis or fibroids are found to be the cause. But other women struggle to find a reason for their pain even once those possible factors are ruled out. 

If you’ve been dealing with undiagnosed pelvic pain, it may be time to ask a doctor about pelvic congestion syndrome (PCS), a vascular disorder in the veins around the ovaries, vulva, vagina, inner thighs, and sometimes the buttocks. Similar to varicose veins in the legs, PCS results from damaged valves unable to push blood back to the heart. This backup of blood within the veins leads to enlarged, or “congested,” veins, often accompanied by pain. 

Many women may be unaware they have PCS because they experience no obvious external symptoms. Often, the condition begins during pregnancy and continues following delivery. Besides pelvic pain, common signs of PCS include pain during intercourse, pain while standing that goes away after resting, and pain after certain activities, such as biking or horseback riding.

PCS typically doesn’t show up during a routine physical exam or a hysteroscopy, a test that views the uterus with a hysteroscope. Some women with PCS have varicose veins in the legs, while others do not. More extensive diagnostic techniques are typically needed to confirm PCS.

Diagnosing and Treating PCS

Ultrasound and CT scans are useful in diagnosing PCS, but a venography is considered the most precise test to detect the condition. In a venography, a radiopaque contrast solution is injected into a vein in the groin. X-rays of the pelvic area are then taken to expose any congested veins.

For pain relief, women may be prescribed medroxyprogesterone, a synthetic form of the female hormone progesterone, which is also used to treat endometriosis. Anti-inflammatory non-steroidal medications can alleviate discomfort, too. These medications mainly reduce blood flow and congestion in groin-area varicose veins. To completely eliminate the underlying cause of PCS, however, minimally invasive surgical techniques, similar to what are recommended for varicose veins in the legs, might be a necessary step.

PCS treatments usually involve “embolization,” or blocking off the damaged vein with coils or sponges. This is done by inserting a catheter into a large vein in the upper arm, shoulder, or thigh, and maneuvering it to the pelvic area. Another treatment option is sclerotherapy. During this procedure a foam substance is injected into the vein with the guidance of an ultrasound instrument. The vein then collapses and blood diverts to healthy veins.

Embolization and other procedures centered on pelvic veins are performed by an interventional radiologist, or a medical professional specializing in the treatment of blood vessels outside of the heart, including arteries and veins in the pelvic area. More specifically, interventional radiologists perform angioplasty and stenting of veins above the waist.

Treating PCS with embolization has a high success rate, with one study concluding that all women who had undergone embolization for ovarian and pelvic congestion syndrome reported a reduction in symptoms. Before any procedure, women should consult with a vein specialist to decide on a course of treatment. 

We Treat PCS

At Vein911, we diagnose and treat PCS. We understand many women suffer with PCS without knowing a cause and endure years of pain. By making an appointment, we can give you answers and improve your quality of life with the right therapy. Or contact Vein911 Vein Treatment Center today for a telemedicine consultation, if you prefer. We’re here to ensure your vein health.