When 15-20% of women between the ages of 18 and 50 years of age experience some type of long-standing (chronic) pelvic pain, there is a problem. There are various causes of chronic pelvic pain in women, but a common cause that is an often over-looked is pelvic congestion syndrome.
What is pelvic congestion syndrome?
Pelvic congestion syndrome is characterized by veins in the pelvis and ovaries that have become enlarged from weakened valves that do not close properly. This is very similar to varicose veins in the legs. When the veins and valves are too weak to close properly this allows blood to flow backwards and collect in the veins. This creates an increase in pressure and causes the veins to bulge. This often results in pain and can affect the uterus, ovaries and vulva. More than half of the women with pelvic congestion syndrome will have cystic changes to the ovaries and tend have a larger uterus and a thicker endometrium. Although pelvic congestion syndrome is present in about 15% of women, not all women experience symptoms. For those that do however, they can be very uncomfortable and sometimes excruciating symptoms.
Signs and symptoms of pelvic congestion syndrome
Pain is long-standing and located in the lower abdomen and sometimes lower back. The pain is experienced as a dull and aching sensation.
Factors that may increase the symptoms:
- Following Intercourse
- During or just before the onset of a menstrual period
- During Pregnancy
- After a long day of standing
Other reported symptoms include:
- Overactive bladder
- Abdominal bloating
- Abnormal menstrual bleeding
- Vaginal discharge
- Swollen vulva/vagina
- Varicose veins on the groin, buttocks or thigh
- Mood swings
Risk factors for pelvic congestion
- It is most commonly seen between the ages of 20 and 45 years
- It is more common in women with multiple pregnancies eg twins and triplets etc
- Hormonal changes: Estrogen in the body causes vasodilation and can weaken the vein walls. This can result in the accumulation of blood in the veins in the pelvic area.
- It is often seen in pregnant women and those who have just delivered due to the high estrogen levels that are found in a woman’s body during pregnancy
Diagnosis of pelvic congestion syndrome
Pelvic congestion syndrome is often missed during routine exams because when the woman lies down for her pelvic exam , this relieves pressure from the ovarian veins, causing the veins to no longer bulge and stops them from being painful.