UH Vascular Specialists Offer Advanced Care for Pelvic Congestion Syndrome (PCS)
Pelvic congestion syndrome is a condition in women that is characterized by generalized pelvic pain that persists for six months or more and is not related to menstruation. It is quite common but, because its symptoms can mimic many other conditions, it often goes undiagnosed. Left untreated, PCS can lead to significant disability in some women.
Your health is important. Get expert care.
To schedule an appointment with a UH vascular specialist, call 216-844-3800 today.
Recognizing the Symptoms of Pelvic Congestion Syndrome
The symptoms of pelvic congestion syndrome can vary widely from woman to woman. If you are experiencing any combination of the following symptoms, it is important to be evaluated so that an accurate diagnosis can be made and the appropriate treatment started. It may not be PCS but all of these symptoms require a medical assessment.
- Chronic pelvic pain and heaviness that worsens when sitting or standing and is relieved with lying down
- Pain during or after sex
- Swelling and/or varicose veins in the genital region
- Lower back pain or heaviness
- Vaginal discharge and/or abnormal vaginal bleeding
- Pain with urination
- Recurrent abdominal pain with alternating diarrhea and constipation
Causes and Risk Factors for Pelvic Congestion Syndrome
The exact cause of pelvic congestion syndrome is unknown, but many experts believe that it may be related to problems with the ovarian vein. If the valves in the ovarian vein do not close properly, the blood can flow backward, a condition known as ovarian vein reflux. When this occurs, the blood can pool in the veins causing the vein to swell and weaken - a condition known as varicose veins. Varicose veins may also develop anywhere along the female reproductive tract, and in the pelvis, thighs, buttocks or vaginal area, contributing to the clinical symptoms of PCS.
Women with any of the following risk factors may be more likely to develop PCS:
- Between the ages of 20 and 45
- Have had multiple (2 or more) pregnancies
- Hormonal abnormalities
- Polycystic ovary syndrome (PCOS)
- A retroverted or “tipped” uterus
- Family history of PCS
A Multidisciplinary Approach to the Diagnosis of PCS
A complex medical condition, PCS requires a multidisciplinary team approach to treatment and evaluation. The vascular specialists at University Hospitals may confer with gynecologists, urologists, oncologists and infectious disease experts to confirm or rule out a diagnosis of PCS.
In addition to performing a physical exam, your doctor will take a complete family and personal medical history. You will be asked to describe the nature and duration of your symptoms and your menstrual and reproductive history will be discussed in detail.
Because there is no single test to identify PCS, your doctor will likely order bloodwork and a number of other diagnostic tests to rule out other causes. If PCS is suspected, the following tests and procedures may be performed:
- Ultrasound of the pelvic region to look for the presence of enlarged blood vessels
- CT or MRI scan
- Venogram – a minimally invasive imaging test that uses a catheter and contrast dye to visualize the veins and detect any abnormalities.
If the imaging tests do not reveal the cause of the pelvic pain, your doctor may perform a laparoscopic exam of the pelvic region. In this procedure, a lighted camera is inserted through a tiny abdominal incision, allowing your doctor to visualize your pelvic organs and look for any abnormalities.
Advanced Treatment Options for Women with Pelvic Congestion Syndrome
Treating pelvic congestion syndrome focuses on symptom relief – reducing or eliminating your chronic pelvic pain. Once the primary cause of the pain is identified, your doctor will personalize a treatment plan designed to address the problem. The recommended treatments will vary depending on the severity of your symptoms but will always have the goal of finding what works best for you and increasing your overall comfort.
If your pain is mild to moderate, the first recommended treatment may be medications like nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. Or, if hormonal abnormalities are a factor, you may be prescribed hormones in an attempt to correct the imbalance.
Women with more severe symptoms may be treated with minimally invasive procedures or surgery, based on the underlying cause of their disease. These may include:
When you meet with your UH vascular specialist, all of your treatment options will be clearly explained to you and all your questions will be answered. We want you to feel comfortable with and confident in the care plan we will develop together.