How does Pelvic Congestion Syndrome impact women during pregnancy and how to treat it?

Pelvic Congestion Syndrome is just one of many names for a common condition affecting women during and after pregnancy. It is most common in young women who have already had two or more children.

The condition is often caused by blood flowing backwards through the veins around the pelvic area after valves which should prevent this from occurring become overworked. During pregnancy the ovarian vein can be compressed by the growing womb or enlarged by increased blood flow. The capacity of veins can increase by around 60% during and immediately after pregnancy which can pile pressure onto the valves, eventually leading to reverse blood flow and the development of Pelvic Congestion Syndrome.

Beyond a history of multiple previous pregnancies, there are certain factors which can increase the risk of Pelvic Congestion Syndrome including fullness of leg veins and whether the individual suffers from polycystic ovaries.

For many women, the most serious symptom associated with Pelvic Congestion Syndrome is the severe pain that can occur in the pelvis and lower abdomen. In most cases, women will usually experience this pain or discomfort predominately on one side of their body but it can occur on both simultaneously. This pain is the most common symptom of Pelvic Congestion Syndrome and women can often suffer for up to six months.

Other symptoms that pregnant women may experience include a feeling of fullness in the legs, similar to a sensation of swelling that can cause discomfort. Pelvic Congestion Syndrome can also lead to a worsening of other conditions such as Irritable Bowel Syndrome or incontinence.

The most obvious external symptom is often visible varicose veins around the pelvic area and some sufferers may have had a history of varicose veins during the term of their pregnancy. Varicose veins can appear around the vulva, vagina, inner thigh, buttocks and down the leg.

All of these symptoms are often worse during pregnancy but can also peak during menstruation or after sexual intercourse. Sufferers of the condition also often report that the symptoms are more acute when standing or lifting and lying down can usually help to relieve some of the pain. The symptoms of Pelvic Congestion Syndrome vary greatly between individuals and can sometimes only appear after the pregnancy.

So how can you treat Pelvic Congestion Syndrome and control the pain that you might suffer from?

Ultrasound is one of the most effective methods for detecting reverse blood flow and diagnosing Pelvic Congestion Syndrome. An expert at vein surgery specialists Radiance Vein Clinic explains that ultrasound reveals that up to 20% of women experience issues with varicose veins in the legs, are actually suffering from problems occurring in the pelvic veins, often as a result of pregnancy.

Pelvic venography can also be used to assess and decide on an appropriate treatment method and involves a dye being injected into a vein which can be viewed through x-ray.

There are medical drug treatments, such as medroxyprogesterone acetate or goserelin, which boast a 75% success rate at reducing the swelling and size of veins, and therefore the pain suffered. There are also invasive procedures that can treat Pelvic Congestion Syndrome including laparoscopic surgery which effectively “ties” the veins to prevent the blood flowing backwards. This is usually a last resort as the procedure requires general anesthetic and therefore a longer recovery period.  

However, the most common treatment is pelvic vein embolization which involves an injection to seal the veins which are causing the issues. Embolic agents, including metal coils, liquid agents which cause clotting and liquid glue which hardens to block veins, are injected. One of the biggest advantages of this treatment is that the procedure lasts under 90 minutes and it does not usually require an overnight hospital stay.

This approach is an effective treatment to block veins which will relieve sufferers of pain and improve the appearance of varicose veins, with 85% of women seeing an improvement within two weeks of treatment.

Of course, there are also some considerations that women, especially those who are pregnant must take into account. As with most treatments there is a very minimal risk of infection as well as other side effects including an allergic reaction to the dye that is injected during the diagnosis. Additional bruising or bleeding can sometimes occur during and after the treatment.

Unfortunately, up to 10% of women experience a recurrence of varicose veins but, in the vast majority of cases, just one treatment is necessary. Finally, pregnant women will understandably be concerned about any effects of radiation exposure on their ovaries during the x-ray. However, there is no evidence to suggest that this has any impact on fertility or periods.

Pregnant women will no doubt have heard about Pelvic Congestion Syndrome; even if they are not already suffering from the pain it causes, it may be a condition that develops after pregnancy. However, there are plenty of options and support for women who are dealing with this pain on a daily basis.