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Understanding Pelvic Congestion Syndrome

written by: R. Elizabeth C. Kitchen • edited by: Leigh A. Zaykoski • updated: 7/31/2009

This article focuses on pelvic congestion syndrome. It defines this condition and discusses the symptoms, possible complications, treatment and misdiagnosis.

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    Pelvic congestion syndrome is a medical condition in which varicose veins develop in the pelvis. These varicose veins tend to develop when a women is pregnant and then continue to increase in size. The cause of this medical condition is unknown and therefore difficult to prevent, diagnose and treat.

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    Why do Varicose Veins Develop in the Pelvis During Pregnancy?

    Why these varicose veins develop is not known, however there are some possible reasons that are thought to encourage the development of varicose veins in the pelvis. These include physiological reasons, estrogen and anatomical changes. From a physiological standpoint, the weight gain and fluid increase that occur during pregnancy may cause certain pelvic veins to engorge with blood. When this occurs, the affected veins become distended and eventually varicose veins develop. During pregnancy, estrogen is known to weaken the vein walls leading to the development of varicose veins. Certain anatomical changes in the veins and other pelvic structures are thought to make them more vulnerable to developing varicose veins. When pregnancy occurs, veins are thought to become more susceptible to the development of varicosities and damage.

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    Symptoms

    Pain is the most reported symptom of pelvic congestion syndrome. In most cases, the pain is not cyclical and is stated to be dull. The pain typically becomes worse during the last trimester of pregnancy, before a womans menstrual cycle, right after or during sexual intercourse, towards the end of the day and after standing for prolonged periods of time. Other symptoms can occur with this medical condition. They vary in frequency and intensity from patient to patient. These other symptoms include vagina/vulva swelling, depression, varicose veins on other areas of the body (such as legs, vulva or buttocks), lethargy, abnormal and painful menstrual bleeding, vaginal discharge, lower abdomen tenderness and back pain.

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    Misdiagnosis

    This medical condition is typically not obvious and its symptoms often mimic other medical conditions. Those with this medical condition are often misdiagnosed. Other medical conditions that may be diagnosed instead of pelvic congestion syndrome include fibroids, uterine prolapse and endometriosis.

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    Treatment

    The treatment of this condition is difficult because the symptoms are so variable. In most cases, the pain that occurs with this condition is what is treated to make a women more comfortable. The pain is treated with prescription pain medications and the type of medication used will depend on the severity of the pain. Other forms of treatment may include physical therapy, acupuncture, transcutaneous electrical nerve stimulation, spinal and epidural nerve blocks, trigger point injections and psychological and behavioral counseling. Embolization and surgery may also be used.

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    Resources

    Vein Directory. (2007). Pelvic Congestion Syndrome. Retrieved on July 31, 2009 from Website: http://www.veindirectory.org/content/pelvic-congestion-syndrome.asp