Pelvic congestion syndrome: what it is, what the symptoms are and how to treat it

Pelvic congestion syndrome is a condition that severely affects a woman’s quality of life. Understanding this disorder is the first step towards recognising the symptoms, seeking a diagnosis and ensuring the necessary care to prevent future problems.

What is Pelvic congestion syndrome?

Pelvic congestion syndrome is a chronic disorder that affects mostly women and, although it is widely unknown, it significantly impacts wellbeing.
This condition occurs when the body develops varicose veins in the pelvic region, in other words, dilated veins around organs like the uterus and ovaries. As with varicose veins in legs, these veins lose the ability to circulate blood efficiently, causing blood congestion that creates pressure and pain.
This is not a common case of fatigue; this is a disorder that can cause a feeling of constant suprapubic “heaviness” and major discomfort. Although in most cases these varicose veins do not pose immediate danger, they require specialised medical supervision.

What are the symptoms of Pelvic congestion syndrome?

To better understand this condition and its real impact on everyday life, it’s important to know the most common signs:

Chronic pelvic pain

A dull ache or feeling of heaviness in the lower abdominal region that lasts for more than six months.

Worsens throughout the day

Discomfort tends to worsen after spending long periods standing or sitting, as circulation becomes compromised and impairs venous return (the circulation that returns blood to the heart).

Discomfort after contact or exertion

Many women feel more pain after physical activities or sexual intercourse, which interferes with their personal life, emotional wellbeing and quality of life.

Sensitivity and pain to touch

The affected areas can become painful when palpated, causing a feeling of internal ‘tightness’ that makes simple everyday tasks difficult.

Visible varicose veins and bruises

In some cases, dilated veins can appear on the thighs, buttocks or vulva, along with a greater tendency to bruise for no apparent reason.

Urinary symptoms

Due to the proximity of the dilated veins to the bladder, it’s common to feel a sudden or more frequent need to urinate. In some cases, mild stress urinary incontinence may occur (when coughing or laughing).

Vaginal discharge and swelling

Some women report an increase in vaginal discharge (unrelated to infections) and a distinct feeling of bloating or tension in the pelvic and abdominal area.

How is Pelvic congestion syndrome diagnosed? 

The diagnosis of pelvic congestion syndrome is based on a physical examination and assessment of the symptoms described by the patient.

•    Detailed anamnesis: the physician analyses the medical and family history to determine the onset and development of pain;
•    Doppler Ultrasound: this exam is essential to observe blood flow and confirm vein dilation;
•    Pelvic venography: a specific exam that helps identify precisely which veins are congested;
•    Advanced imaging exams: MRIs or CT scans can be used to obtain a detailed view of the vascular network;
•    Rule out other causes: the specialist ensures that the pain does not arise from other conditions, such as endometriosis.

What are the differences between Pelvic congestion syndrome and endometriosis? 

Although both can cause chronic pelvic pain, pelvic congestion syndrome and endometriosis are different conditions, with different origins and treatments.

Pelvic congestion syndrome

This is a vascular condition caused by dilation and dysfunction of the veins in the pelvic region, leading to accumulation of blood and increased venous pressure. 
The pain is usually described as a feeling of heaviness or discomfort in the pelvis, which tends to worsen at the end of the day, after spending long periods standing or sitting, or after sexual intercourse. 
This condition can also be associated with varicose veins in the pelvis or lower limbs.

Endometriosis

This is a gynaecological disorder characterised by the presence of endometrium-like tissue outside the uterus. Endometriosis causes inflammation and pain, often associated with the menstrual cycle. 
The most common complaints include severe menstrual cramps, pain during sexual intercourse, persistent pelvic pain and, in some cases, difficulty conceiving.

While they share some symptoms, these are different disorders that require different diagnostic and therapeutic approaches. In the event of persistent pelvic pain, it’s essential to seek a medical assessment to identify the cause and begin the right treatment.

How is Pelvic congestion syndrome treated?

The treatment for pelvic congestion syndrome depends on the severity of the symptoms, impact on quality of life and medical characteristics of each patient. 

In most cases, the symptoms can be controlled through personalised approaches, which may include:

•    Pharmacological treatment: used above all in the early stages or mild cases, this can include painkillers, anti-inflammatories or hormone therapy, in order to relieve pain and reduce venous congestion.
•    Conservative measures and lifestyle changes: strategies such as exercising regularly, avoiding spending long periods standing or sitting, and controlling weight can help minimise symptoms and improve venous return.
•    Vein embolization (minimally invasive treatment): a procedure performed by a Vascular Surgeon, in which the affected veins are occluded to reduce congestion and relieve pain, with a quick recovery and no need for open surgery.
•    Surgical treatment: reserved for specific situations or when other approaches are ineffective, this treatment involves correcting or removing the affected veins; this approach is less frequent today due to new minimally invasive techniques.

The therapeutic plan should always be determined by a specialised medical team, after clinical and imaging analysis, to guarantee the best treatment for each case.

How to prevent Pelvic congestion syndrome? 

There is no sure way to prevent pelvic congestion syndrome, but some habits can help reduce the risk of developing this disorder or prevent symptoms from worsening.

•    Adopt an active lifestyle: exercising regularly is good for blood circulation and helps prevent venous stasis;
•    Avoid a sedentary lifestyle: reducing time spent sitting or standing without moving is an important measure to protect your venous health;
•    Maintain a healthy weight: being overweight can increase the pressure on pelvic veins, causing symptoms to appear or worsen;
•    Mind your vascular health: controlling risk factors, such as circulatory or hormonal problems, can be an important part of prevention.
•    In the event of persistent symptoms, seek a medical assessment: an early  diagnosis allows treatment to begin promptly and prevents the disorder from progressing.

Count on specialised care at Joaquim Chaves Saúde 

Pelvic congestion syndrome is a chronic and often underdiagnosed condition that can severely affect the daily life of those afflicted with this disorder. This is why seeking specialised care is essential to restore your wellbeing. 

Joaquim Chaves Saúde features multidisciplinary teams to provide the assessment, treatment and follow-up this condition requires. Schedule a consultation and improve your quality of life.