Could This Explain Chronic Pelvic Pain?

For the vast majority of women, aching and cramping in the pelvic area are typically associated with menstruation. However, for some women, these symptoms persist day after day, sometimes for decades. The cause could be hiding in plain sight. From our perspective, we often see chronic pelvic pain as a sign of pelvic congestion syndrome. This condition usually affects women of childbearing age, and it may present a host of unpleasant symptoms aside from pain. These include:

• Heavy menstrual bleeding
• Pain in the low back and legs
• Painful intercourse
• Frequent urination
• Deep vein thrombosis (DVT)

The symptoms of pelvic congestion syndrome occur because one or more pelvic veins have narrowed. This inhibits venous blood flow through the pelvic area to the lower extremities. Blood pressure increases in the pelvic venous system, resulting in discomfort. The most common underlying cause for pelvic congestion syndrome is the patient’s anatomy. The internal structure of the body, specifically the pelvic area, can make some people more susceptible to what is commonly referred to as pelvic varicose veins. The iliac vein and iliac artery cross in the pelvis. The artery is thicker and more muscular so can compress against the vein. Surgical procedures to the hip or pelvic area could also be a factor in the development of this condition.

Pelvic Congestion Syndrome Diagnosis and Treatment

Any person who experiences chronic pelvic pain, which lasts six months or more, should consult with their primary care physician. If pelvic pain coincides with other signs of venous insufficiency, such as varicose veins in the lower extremities, a vascular specialist should be consulted. A specialist conducts a comprehensive consultation, review of symptoms, and medical history. Diagnostic imaging may be ordered or performed in the office. This usually involves non-invasive ultrasound or venous scans, which present a clear observation of blood moving through the pelvic venous system.

If venous stenosis (narrowing) is found, treatment focuses on widening the pathway for venous circulation through the pelvis to the lower extremities to relieve hypertension and uncomfortable symptoms. Pelvic congestion syndrome may be treated with medication or a minimally invasive procedure. The specialist may first prescribe hormone therapy to control blood flow more efficiently. Surgical intervention, if needed, may include angioplasty, with or without stenting. Angioplasty is a very common vascular procedure that dilates (widens) a circulatory pathway. If the affected vein is too weak, the vascular surgeon places a mesh tube into the vein to hold it open. Stents are considered permanent and necessary in some cases.

Suffolk Vascular & Vein Center is proud to serve the areas of Port Jefferson Station, Hauppauge, and Riverhead, NY. Contact us today for more information or to schedule your consultation.