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    Pelvic Congestion Syndrome: A Comprehensive Overview

    Published 25 May 2020
    Fact Checked
    Reviewed by Olga Adereyko, MD, Primary Care Physician, General Practitioner, Medical Consultant
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    Pelvic congestion syndrome, also known as pelvic venous congestion syndrome, is a medical problem that negatively impacts the veins in that region. Read on for more detailed information regarding pelvic congestion syndrome and the best ways to tackle it. 

    What is pelvic congestion syndrome?

    Pelvic congestion syndrome (PCS) is a painful disorder affecting between 10–15 percent of women in the U.S. It results in persistent lower abdominal pain and appears especially common in those who previously gave birth or have a family member with PCS. Apparently, the pelvic congestion syndrome risk further increases after multiple births.

    Note that pelvic venous congestion syndrome correlates with varicose veins in your abdomen. Varicose veins are distorted, twisted, or lengthened veins ‒ the capabilities of which have been compromised. 

    Pelvic congestion syndrome symptoms

    Pelvic congestion syndrome symptoms may not present until you become pregnant and can worsen as your uterus expands, and abdominal blood flow increases. The main symptom of PCS is pelvic pain, which also happens to be a common side effect of pregnancy. As such, pelvic congestion syndrome often goes undiagnosed for some time. Note that the pain tends to worsen throughout the day, particularly if you stand or sit still for extended periods.

    Furthermore, delivery won’t necessarily prompt PCS to resolve itself. Many patients notice more intense abdominal pain while menstruating, during or after sex, or following strenuous activities like biking or horseback riding.

    Other typical symptoms of PCS include:

    • Painful menstrual cramps
    • Abnormal period bleeding 
    • Backaches in the lumbar region
    • Fatigue
    • Varicose veins in other places, like your vulva, legs, and buttocks
    • Frequent urination
    • Irritable bowel syndrome (IBS)
    • Tenderness in your lower abdomen

    Not every woman will experience all of these symptoms, and the intensity will vary as pelvic venous congestion symptoms ebb and flow. 

    Pelvic congestion syndrome causes

    The reason for the formation of varicose veins in your lower abdomen is unclear. It’s thought that pregnancy encourages their development due to major body changes and physical strain on your pelvis. Combined with extra blood flow to the area, it leads to the collection of blood and other fluids. Lastly, the hormonal imbalances of pregnancy, not to mention the added weight, exacerbate the situation.

    When pelvic congestion syndrome develops, the valves in your veins no longer function the way they’re supposed to, slowing down blood flow. This, in turn, produces vein congestion, swelling, and enlargement. Your veins simply can’t cope with the demands of moving these excess fluids and eventually sustain damage.

    Contributing factors for pelvic congestion syndrome

    Since there’s a link between pregnancy and PCS, women who have had multiple children carry a greater pelvic congestion syndrome pregnancy risk. Your likelihood of developing pelvic congestion syndrome also increases when there’s a family history of it.

    Diagnosis of pelvic congestion syndrome

    As far as diagnosis, your doctor will ask about the duration of your