Pelvic congestion syndrome (PCS) is a condition of chronic pelvic pain that occurs approximately in one third of all women in their child bearing age. The main reason behind PCS is enlarged veins in the abdomen that has the potential to lead to significant disability. Pain and other symptoms of PCS are caused by veins of the pelvic region that have stopped working from carrying blood from the pelvic area to the heart. This leads to building up blood inside these veins that enlarge, change shape and become like varicose veins. Women who have given birth to more than one child are at higher risk of PCS that may need medical attention like varicose vein treatment in Chennai.
Pelvic vein dilatation causes symptoms of Pelvic Congestion Syndrome
PCS is a complex condition associated with ovarian and pelvic vein dilatation that can result from varicose veins in the pelvis, thighs, gluteal or vaginal areas. Pregnancy is the most common risk factor for PCS. There are many reasons why pregnancy might bring this condition on:
- There are structural changes in the pelvis during pregnancy that can affect some blood vessels, and increase the risk of developing varicosities.
- Body usually gains fluid and weight to support the baby but veins may not be able to cope with the volume of fluid. As a result, veins get engorged and valves get damaged, allowing blood to flow back through them, making them varicose.
- Hormonal alterations along with physical changes during pregnancy are believed to trigger the development of pressure in veins around the ovaries. The reproductive hormone oestrogen is made more during pregnancy, and that has the ability to weaken the walls of veins in the area and cause them to widen.
The presence of venous varices with pelvic pain in premenopausal women may not indicate that they are causally related to PCS. Dilation and incompetency of pelvic veins are common findings even in women with no symptoms of PCS. Hence, identifying patients with chronic pelvic pain due to pelvic congestion syndrome has been challenging in arriving at the right diagnosis.
Pelvic pain is common and there are many different problems with the reproductive system, like ovaries and uterus, or the urinary system, like the bladder or the gastrointestinal system, such as the large intestine or due to muscles or bones of the pelvis that cause the pain. Many possible causes for pelvic pain need to be considered before arriving at a diagnosis because several factors, even mental health conditions, such as depression, can be linked to chronic pelvic pain.
In the presence of chronic pelvic pain, physical examination that finds uterine tenderness, ovarian tenderness and cervical motion tenderness on direct palpation during bimanual examination usually supports the diagnosis of PCS, indicating the need for laser treatment for varicose veins in Chennai.
Pelvic pain is the main symptom of Pelvic Congestion Syndrome
Pelvic congestion syndrome is marked by pelvic pain that starts during or after pregnancy and shows up intermittently or stays constant, lasting for at least 3 to 6 months, the intensity of pain going up with each subsequent pregnancy. Pain is experienced in the pelvic or abdominal region, occurring throughout the menstrual cycle. Any change or activity that increases abdominal pressure, like walking, postural changes, lifting, and long hours of standing position can increase the intensity of pain.
Pelvic pain from PCS is usually felt as a heavy, aching or sometimes a sharp feeling that gets worse after a later pregnancy. Additionally, pain is usually felt only on one side of the pelvis, more commonly on the left side or at times on both sides and the pain seems to intensify and get worse by the end of the day. Other factors that increase the pain are:
1. Change in posture
2. While or after having sex
3. Long hours of standing
4. Walking
5. Pain before or during menstrual periods
Pelvic congestion syndrome (PCS) is generally considered as the condition, if the pain worsens when sitting or standing and is relieved with lying down. Some patients may also experience pain with urination (dysuria) or during/after sexual activity (dyspareunia). Another feature of PCS is pain which is felt while in standing posture as dull, aching or “dragging” pain in the pelvis or lower back gets worse around the time of menstrual period.
Other symptoms of Pelvic Congestion Syndrome
It is believed through studies and research that ovarian vein may cause PCS. Varicose veins that cause PCS may be found on the ovaries and along the female reproductive tract. Many women have varicose veins in their reproductive tract that may cause pain and other symptoms of pelvic congestion syndrome, while others may have no symptoms. Hence PCS requires a multidisciplinary team approach to evaluate and advise varicose vein treatment in Chennai. Signs and symptoms of PCS vary from woman to woman but pelvic pain is often accompanied by other symptoms that include:
1. Swollen vulva
2. Distorted veins around the external genitalia such as vulva/buttocks or thighs and legs
3. Irritable bladder with a feeling of sudden urge to urinate
4. Irritable bowel that can cause recurrent abdominal pain and diarrhoea alternating with periods of constipation
5. Haemorrhoids/piles
6. Low back pain
7. Vaginal discharge
8. Abnormal vaginal bleeding
9. Fatigue/lethargy
In a study conducted on 57 women suffering from pelvic pain, the combination of a history of pain after sexual intercourse, along with tenderness over adnexa during physical examination was observed to be 77% specific and nearly 94% sensitive in differentiating the symptoms of pelvic congestion syndrome from other pathologies of pelvic origin. Symptoms of PCS usually happens in women of childbearing age between 20 and 45 and more common in women with more than one child.
Symptoms of PCS can be eliminated or improved for a higher quality of life. Along with hormonal medications, minimally invasive therapies for nonsurgical embolization such as laser treatment for varicose veins in Chennai can permanently seal off the veins from inside.