What is pelvic congestion syndrome?

Pelvic congestion syndrome (PCS) is a chronic condition in women that causes a persistent dull pain in the pelvic area. It is thought to be caused by varicose-type veins that have developed in the pelvic area. It is these dilated ovarian and pelvic veins that are thought to contribute to chronic pelvic pain in some women.

Prognosis of pelvic congestion syndrome

PCS is not life-threatening, but it can affect your quality of life if you are having to deal with chronic pain and the resulting symptoms. However, the symptoms of PCS do vary in severity, so being diagnosed with PCS does not mean you will definitely experience the range of symptoms and pain. Treatments are available to make the symptoms more manageable.

Symptoms of pelvic congestion syndrome

The main symptoms of PCS include:

• pelvic pain in the lower abdomen
• pain during menstruation and sexual intercourse
• back ache
• pain that worsens when standing up for long periods
• pain in the later stages of pregnancy
• increased urination
• visible, swollen veins around the genitals area

Medical tests to diagnose pelvic congestion syndrome

PCS can be hard to diagnose, but an ultrasound is often first used if it is suspected. CT and MRI scans may also be used to assess the pelvic region for enlarged veins. A laparoscopy may be required to examine the pelvis.

What are the causes of pelvic congestion syndrome?

The exact cause of pelvic congestion sydrome is unknown but a hereditary element is thought to be important, and women whose mother experienced PCS are more likely to develop this condition. Women who already have children are also more likely to develop PCS and it is thought that pregnancy could play a role in the development of pelvic congestion syndrome. This is because during pregnancy hormone changes and alterations in the woman’s pelvis are thought to weaken surrounding blood vessels, increasing their likelihood of becoming swollen and dilated.

Treatments for pelvic congestion syndrome

Treatments for pelvic congestion syndrome aim to provide relief and to alleviate the symptoms. Chronic pain can be alleviated with certain pain medications and NSAIDs (nonsteroidal anti-inflammatory medications), however, long-term these aren’t always appropriate. Embolisation of the pelvic veins has also shown promise in alleviating the symptoms of PCS. Embolisation blocks the veins thought to be causing the most pain and discomfort.

Which type of specialist treats pelvic congestion syndrome?

Obstetricians and gynaecologists, vascular surgeons and interventional radiologists would treat pelvic congestion syndrome.