Many women needlessly suffer from pelvic congestion syndrome.
If you suffer from chronic abdominal or pelvic discomfort or pain that prevails despite a variety of treatments, you could have pelvic congestion syndrome. It is a chronic medical condition in women caused by hard-to-detect varicose veins in the pelvis. The condition often manifests as a constant dull ache, which can be aggravated by standing. It can also cause discomfort or pain during intercourse.
“Pelvic congestion syndrome is highly under-recognized and under-diagnosed which results in needless suffering. We need more awareness about this,” said Dr. Don Doherty, an Interventional Radiologist at Virginia Interventional and Vascular Associates (VIVA).
“We’ve successfully treated patients who have suffered for years. Most have visited a variety of doctors, trying to identify the cause of their pain. They may be getting the wrong treatment,” he added.
Pelvic congestion syndrome (also known as pelvic vein incompetence) is similar to varicose veins in the legs. In both cases, the valves in the legs that help return blood to the heart against gravity become weakened and do not close properly. This allows blood to flow backwards and pool in the vein, causing pressure and bulging veins. In the pelvis, varicose veins can cause pain and affect the uterus, ovaries and vulva.
“Often the women we treat also experience varicose veins and spider veins in their legs, heaviness in their legs and/or leg swelling. Many have had at least one pregnancy,” Dr. Doherty said.
Up to 15 percent of women, generally between the ages of 20 and 50, have varicose veins in the pelvis, although not all experience symptoms. The pain is worse at the end of the day and after long periods of standing, and sufferers get relief when they lie down. The pain is worse during sexual intercourse and can also be worse just before the onset of the menstrual period. The condition can occur as a result of pregnancy.
The diagnosis is often missed during other physical exams because women lie down for a pelvic exam, relieving pressure from the ovarian veins, so they no longer bulge with blood as they do while standing.
If you have pain in the lower abdomen that worsens throughout the day or when standing or experience pain during intercourse, you may want to get a second opinion from an interventional radiologist. Most patients can make appointments directly with VIVA without a referral from another doctor, although VIVA also works closely with other physicians. VIVA accepts most insurance.
Diagnosis at VIVA
The interventional radiologists at VIVA review any prior imaging studies that patients provide. If more imaging is needed, usually a CT Scan is performed on the abdomen or pelvis.
Treatment at VIVA
The treatment is relatively quick and can be performed in 45 to 90 minutes in our outpatient office,” said Dr. Doherty. “Patients usually require only a light sedation.”
Using a Venogram, the interventional radiologist takes an image of the suspected vein from the inside, checking its size and direction of blood flow. The interventional radiologist also checks for other conditions with similar symptoms that may require different treatments.
During the procedure, the varicose vein is closed with coils or foam, causing the blood to reroute to a normal vein. Using this technique, the varicose vein rarely reopens. Recover normally takes one to six weeks, although most patients notice improvement soon after the procedure.