Varicose veins can develop in other areas of your body, not just your lower extremities. Pelvic congestion syndrome is caused when varicose veins grow in the pelvic region, especially around the uterus and ovaries. This disorder can cause discomfort on many levels, but talking to your vein specialist about new or worsening abdominal pain and discomfort is essential to your vascular health.
Pelvic congestion syndrome (PCS) is a type of chronic venous insufficiency that causes chronic pelvic pain and lower back and abdominal pain. This condition is caused when damage to vein valves or walls creates varicose veins in the pelvic region, leading to swelling and congestion in the affected area.
When the veins in the pelvic region, especially around the ovaries, become weakened or damaged, it impedes proper blood flow to the groin and pelvis, causing pelvic pain, lower back pain, pressure, swelling, and discomfort.
Individuals with a history of severe period cramps, irregular periods, or a history of painful menstrual cycles may be at risk for developing pelvic vascular insufficiency.
Seeking medical advice is crucial to rule out pelvic congestion syndrome and other potential causes, as early detection and treatment can prevent long-term complications and relieve uncomfortable and painful symptoms.
Women are more susceptible to developing pelvic congestion syndrome than men, but it’s worth noting that men can also develop PCS as well. Risk factors include:
Gender: Women are more likely to develop PCS due to hormonal changes throughout their lifespan, pregnancies, increased estrogen levels, and the use of hormonal birth control or hormone replacement therapy during menopause.
Estrogen causes veins to expand and, over time, become structurally weak and susceptible to venous insufficiency.
Multiple Pregnancies: Prolonged pressure on pelvic tissues and organs caused by many pregnancies increases the likelihood of developing PCS.
Genetics: A family history of obesity, high blood pressure, diabetes, or vascular conditions elevates the risk of pelvic congestion syndrome.
Obesity: Carrying excess weight increases the chances of developing vascular conditions, including PCS.
Sedentary Lifestyle: A sedentary lifestyle increases the risk of developing an unhealthy vascular system
Structural Abnormalities: According to the National Library of Medicine, structural abnormalities in the pelvic organs, such as a tipped or “retroverted uterus,” can increase the risk of developing pelvic congestion syndrome.
Trauma or Injury to the Pelvis: Injuries to the pelvic region, such as a broken pelvis, injured or weak ligaments in the pelvic floor, and even labor and delivery can damage the surrounding veins and cause pelvic congestion syndrome.
The primary symptoms of pelvic congestion syndrome are chronic pain in the lower abdomen, groin, and lower back. Other signs include but are not limited to:
Increasingly painful and uncomfortable menstrual cycles
Abnormal menstrual bleeding
Hip pain that can radiate down the legs
Pelvic pain during and after sexual intercourse
A feeling of fullness or swelling in the pelvic region and genitals
Swelling in the vagina, labia, testicles, or perineal region
Potential presence of varicose veins in the genitals, groin, and inner thigh
Frequent or increased urination
Pain during urination
Fatigue
Stress incontinence or leaking urine when you cough or laugh
Bowel or urinary problems such as constipation or difficulty voiding the bladder
Pelvic congestion syndrome shares symptoms with several severe gynecological, urinary, prostate, and bowel conditions, including endometriosis, adenomyosis, uterine fibroids, ovarian cysts, prostatitis, bowel obstruction, and more. If these symptoms persist or worsen, consult your medical provider to rule out causes other than pelvic congestion syndrome.
Talk to your medical provider about any pelvic symptoms you may be having. Your vascular health isn’t limited to unsightly spider veins or swelling in your ankles, so don’t be self-conscious when discussing varicose veins in the groin or any similar symptoms. It’s best practice to get a pelvic exam and routine imaging, such as a pelvic ultrasound, to rule out other medical concerns.
Medical History: Talk to your medical provider about any pelvic symptoms you’re experiencing. Your vascular health isn’t limited to unsightly spider veins or swelling in your ankles, so don’t be self-conscious when discussing varicose veins in the groin or any similar symptoms.
It’s best practice to get a pelvic exam and routine imaging, such as a pelvic ultrasound, to rule out other medical concerns before addressing pelvic congestion syndrome.
Testing: Pelvic venography is the most conclusive imaging technique for diagnosing pelvic congestion syndrome. While ultrasounds and MRIs are occasionally used to diagnose PCS, pelvic venography is considered the best diagnostic tool for confirming a diagnosis of pelvic congestion syndrome.
This minimally invasive procedure is conducted as an outpatient procedure in a hospital by a vascular specialist. During a pelvic venogram, a catheter is inserted into the venous system through either the groin or neck, using X-ray guidance to move the catheter into the groin and pelvic veins.
Contrast dye is injected to make leaking and varicose veins more visible for X-ray imaging to get visual confirmation of damaged or varicose veins.
While PCS is a chronic condition, many effective treatments are available.
Medication and Self-Care: Women struggling with confirmed cases of pelvic congestion syndrome may be prescribed hormonal therapy by their gynecologist or primary care provider, as estrogen levels can cause pelvic congestion syndrome.
Your doctor may also recommend using over-the-counter, non-steroidal anti-inflammatories for pain relief and a heating pad or hot water bottle to soothe muscle aches and cramps.
Pelvic Floor Therapy: Pelvic floor therapy may help mitigate painful symptoms and discomfort, promoting healthy blood flow through the pelvis and groin by strengthening weakened muscles and reducing stress on the pelvic veins.
While it does not eliminate pelvic congestion syndrome, pelvic floor therapy is a great way to manage symptoms, regain flexibility, increase healthy blood flow to the groin and pelvis, and aid in the prevention of worsening symptoms. Pelvic floor therapy can also help improve posture and relieve pressure on weakened veins.
Minimally Invasive Procedures: Minimally invasive treatment for pelvic congestion syndrome includes embolization of the affected veins. This procedure rarely requires incisions or stitches, and patients can usually return to their regular activities within a week of the procedure. A radiologist or vein specialist will insert a small catheter into the ventral vein of the upper arm, shoulder, or thigh, using X-ray guidance to find the targeted areas of the groin. The healthcare professional will then seal off the damaged veins, allowing blood to flow naturally to health veins in the surrounding region.
Your vascular health isn’t limited to just one part of your body - maintaining healthy habits and lifestyle changes can help you reduce your risk of developing pelvic congestion syndrome and other venous conditions. Preventing pelvic congestion syndrome entirely may not always be possible, as many factors are outside the patient’s control. Still, there are steps you can take to help alleviate symptoms, reduce your risk, and improve your overall vascular health.
Maintain a Healthy Weight: Maintaining a healthy weight keeps pressure off your vascular system and lessens your risk of developing diabetes and high blood pressure, both of which can cause weakened vein walls that lead to varicose veins both in the lower extremities and throughout the body. If you’re pregnant or thinking of becoming pregnant, talk to your provider about maintaining a healthy weight during pregnancy to decrease the pressure on pelvic veins.
Stay Active: Staying active helps keep your vascular system strong, decreases inflammation and swelling, and helps prevent blood pooling in the lower extremities. While some exercises, such as weight lifting and cycling, can exacerbate pelvic congestion symptoms, low-impact cardio exercises like swimming, walking, yoga, or pilates can aid in strengthening the muscles in your pelvis and improve circulation that promotes healthy veins. Staying active will also help you maintain a healthy weight, which also aids in improving your overall vein health.
Adopt Healthy Lifestyle Changes: Incorporating healthy lifestyle changes can help improve your vascular health and potentially reduce your risk of pelvic congestion syndrome. According to the National Library of Medicine, regular consumption of alcohol and tobacco products is likely to increase the risk of varicose veins. Decrease your alcohol consumption and talk to your provider about finding support to quit smoking. Make healthy dietary choices, including high-fiber, heart-healthy foods like fruits, vegetables, leafy greens, and lean protein like chicken or fish.
Pelvic congestion syndrome may not be entirely avoidable for some patients, but adopting healthy habits can only benefit your overall vascular health in the long term.
Pelvic congestion syndrome can cause chronic and sometimes debilitating pain, keeping you from the things you enjoy. You don’t have to live with chronic pain caused by pelvic congestion syndrome.
Center for Vein Resotration’s board-certified vein specialists are here to help guide you through your treatment options and help you get back to a life you’re excited to live. Find a CVR location near you.
We accept most major insurance providers, including Aetna, Amerigroup, Anthem, Blue Cross/Blue Shield, Cigna, MultiPlan, Medicaid, and Medicare.
For personalized assistance regarding insurance coverage, call 240-965-3915 to connect with one of the Patient Services Representatives or request a consultation online.
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