Let's Talk About Pelvic Congestion Syndrome

Around 40% of gynecological visits involve chronic pelvic pain complaints — many of those are likely related to pelvic congestion syndrome. 

In short, pelvic congestion syndrome should be on every woman’s radar.

Drs. John Yoo and Benjamin Wilson at Vascular & Interventional Specialists in Fort Worth, Texas, specialize in treating pelvic congestion syndrome and, more than anything, want their patients to know what they’re up against. 

Here’s your ultimate guide to pelvic congestion syndrome, including how we can help you treat it. 

Let us start at the very beginning

Pelvic congestion syndrome isn’t an often-discussed topic in women’s health, but it should be. Pelvic congestion syndrome (also known as pelvic venous insufficiency) is a chronic pain condition associated with blood flow problems in your pelvic veins. 

Because most women experience pain and symptoms outside of their regular menstrual cycle for longer than six months, it’s considered chronic.

The pain stems from faulty veins in your ovaries and pelvic area. The veins widen, become twisted, and fill with blood, causing blood to pool in your pelvis and lead to pain and discomfort. 

Most women who have pelvic congestion syndrome report dull, achy, or heavy pain, but some experience sharp, intense pain. It’s not uncommon to experience pain only on one side of your body (primarily on the left). Your symptoms may worsen:

• At the end of the day
• Before and during your period
• During and after intercourse
• After standing or sitting for long periods

You may also have varicose veins in your pelvis, buttocks, thighs, vulva, and vagina, frequent bouts of diarrhea and constipation, stress incontinence, and discomfort during urination. 

Causes of pelvic congestion syndrome

We don’t quite understand what causes pelvic congestion syndrome, but we’re most certain that it involves blood flow in the ovarian and pelvic veins.

When everything works properly, blood flows from your pelvic veins toward your heart. The valves in your veins open and close with each heartbeat to prevent blood from flowing in the wrong direction. 

With pelvic congestion syndrome, your pelvic veins have dilated so much that the valves are essentially powerless to keep your blood from flowing backward. As a result, blood gradually builds up in your pelvic veins, causing pain as your veins stretch, twist, and even touch nearby nerves. 

There are a few possible reasons why your pelvic veins become compromised, and one of the most common is pregnancy.

During pregnancy, your blood vessels expand by up to 50% to accommodate the extra blood flow. These rapid changes may cause long-term damage to your blood vessels, inducing unnatural dilation even after you’ve had your baby.  

Other risk factors include a history of varicose veins, being between ages 20-45, and having polycystic ovarian syndrome (PCOS).

Diagnosing and treating pelvic congestion syndrome

You likely receive your diagnosis when you visit your primary care provider or gynecologist. 

Your provider performs a physical and pelvic exam to check for tenderness in your ovaries, cervix, and uterus in an attempt to locate the origin of your pain. Imaging tests like ultrasounds and MRIs can help rule out other causes of pelvic pain. 

Depending on your needs, you may benefit from a course of medications or get referred to us for an ovarian vein embolization.

Ovarian vein embolization is a minimally invasive procedure that treats varicose veins in the pelvic area. First, we administer a gentle sedative to ensure your comfort during the procedure. 

Then, we create a small incision in your neck or groin to gain access to your pelvis. With the assistance of X-rays, we carefully guide a thin tube to the affected veins. 

We inject an embolic agent (medication or tiny coils) to plug the varicose vein and prevent blood from flowing backward. 

Over time, the varicose vein shrinks, and your symptoms gradually improve in a few days or weeks, but the best results develop over a few months. 

Pelvic congestion syndrome may be considered a chronic condition, but if you see us for treatment, you can take your first steps toward a pain-free life. If you’d like more information about treatment, call our friendly staff at 817-321-0951 or use our online booking tool to schedule a consultation today with one of our experts and get more answers to your questions.