Pelvic Congestion Syndrome

What is Pelvic Congestion Syndrome?

Studies have found that nearly 30 percent of the women’s population suffers from chronic pelvic pain. The chronic pelvic pain suffered by women is actually associated with a medical condition called pelvic congestion syndrome (PCS).Women who have previously given birth are slightly at risk to develop this condition.

Pelvic congestion syndrome is primarily brought about by the formation of varicose veins especially below the abdomen, around the pelvic region to be exact. The characteristic of the pain in PCS is said to be dull and this is believed to be exacerbated when a woman is standing. Health care specialists are still on the lookout for the main reason of the development of such condition. There are some findings that include pregnancy as one of the primary culprits for such. This has been pointed out to further enlarge varicose pains causing more pain. About 15 percent of women are believed to have varicose veins somewhere in the lower abdominal region. Nonetheless, some of them remain asymptomatic. While the causes of some of the reported cases have already been identified, there are still those whose cause remains unknown. Women in their reproductive years, usually those aging 20 to 45, are at risk of developing this condition especially if they have multiple pregnancies. It is imperative for women to know something about this condition.


Women with pelvic congestion syndrome generally complain of dull ache around the pelvic region. The intensity of the pain is specifically amplified under different circumstances, including:

  • Standing for long periods
  • Days before the onset of menstruation
  • At the end of the day
  • Pain during and after intercourse
  • During the later stages of pregnancy

You must also take note that pain is not the only symptom that may be present in PCS. It is also possible to encounter other symptoms but these vary between individuals. These symptoms often interfere with the sexual relationship of affected women. Among the common complaints of women with PCS include the following:

  • Backache
  • Bleeding abnormally during menstruation
  • Depression
  • Dysmenorrhea (Painful menstrual periods)
  • Dyspareunia (Painful sexual intercourse)
  • Lethargy
  • Presence of vaginal discharge
  • Presence of varicose veins around the buttocks, legs and the vulvar region
  • Tender abdomen
  • Vaginal/vulvar swelling


Pelvic congestion syndrome is primarily thought to be due to the presence of varicosities in the lower abdomen and the inguinal area. In healthy veins, the blood usually circulates in a single direction and without any impediments. In certain instances in which the valves suddenly become damaged, the blood is then allowed to backflow. The valves are actually responsible for propelling blood only into a single direction because they act like flaps. The backflow of blood causes the vein to become engorged. The swelling of the vein then compresses surrounding nerves which then would elicit pain just like in pelvic congestion syndrome. More specifically, the possible causes of PCS are enumerated and briefly discussed below.

Anatomical Changes

One of the possible causes of PCS is believed to be the anatomical changes which take place in the pelvic and the veins as well. The structural alterations that have taken place in the pelvic region increase a woman’s risk of developing varicosities. Pregnancy has been sited to be one of the possible causes because this, too, leads to some changes in the anatomy of the pelvic and certain blood vessels.

Physiological Changes

Pregnancy does not only cause some anatomical changes but physiological as well. To sustain the needs of the developing fetus, the woman’s body usually gains more fluid and weight. When the fluid amount is beyond what the veins can accommodate the latter usually become engorged to the extent that valves are damaged and blood is allowed to backflow leading to the formation of some varicosities. Over time the condition worsens especially when this is just being left untreated.


Estrogen Levels

One of the probable reasons why the walls of veins are weakened is the increasing levels of estrogen. During pregnancy there’s actually a rise in the levels of estrogen. Thus, pregnant women are at risk to develop varicosities due to the weakening of the blood vessel walls. Men’s chance of developing this condition can be considered nil because they do not experience increase in estrogen levels.


PCS is among those medical conditions that are difficult to diagnose. Thus, prior to making any diagnosis, all the other possible causes must first be ruled out. Further diagnostic procedures must also be conducted which include:

  • CT scan
  • MRI
  • Ultrasound
  • Venogram

Among the diagnostic procedures mentioned above, ultrasound is most preferred because this can excellently detect the presence of any varicosities and as well as assess the blood flow in the affected area.


The majority of medical professionals often find it difficult to treat PCS. Although a diagnosis of PCS is already made, finding the exact treatment for each woman can be tough as the clinical manifestations and the severity of pain greatly vary. Not all possible treatments would work effectively for the rest. There’s actually a variety of treatments available for PCS ranging from certain medications to a possible surgical operation. The following are the commonly utilized treatments for PCS:


  • Painkillers
  • Ergotamine (which was found out to help narrow veins)
  • Hormones – The effectiveness of using hormones to treat PCS has not yet been established.
  • Antidepressants – Among the commonly used medications for PCS, anti-depressants have been found to be greatly effective in relieving the symptoms associated with the condition.


Surgery is actually not a preferred way of dealing with PCS. This is not at all times indicated to patients and when it is, the operation is just minimally invasive which is primarily done to remove varicosities. Surgery is not also encouraged because patients may still remain symptomatic even after it. Surgery does not improve the condition of affected women. In fact, about 60 percent of those who underwent surgical operation reported dissatisfaction of the outcome.

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