Chronic pelvic pain is a common condition and reports indicate that 1/3 of women will experience chronic pelvic pain during their lifetime. While there are many causes of chronic pelvic pain, pelvic congestion syndrome (PCS) is becoming increasingly recognized as a cause of chronic pelvic pain. PCS is associated with pelvic varicosities, or abnormally dilated veins, which are often present in women with unexplained pelvic pain.
While nobody knows for sure why some women develop pelvic varicosities there are several possibilities including: anatomic factors, hormones, pregnancy and genetics. Pelvic veins tend to be thin walled and are unsupported by the relatively weak attachments between the veins and adjacent supporting tissues. These characteristics make pelvic veins vulnerable to varicosity formation, stasis and reflux. Hormones, particularly estrogen compounds, are known to contribute to the dilation of veins. The pelvic veins typically enlarged in those with PCS tend to be near the uterus and ovaries and are exposed to high concentrations of estrogen compounds produced by the ovaries. Physiologic changes of pregnancy include increased blood flow to the uterus and dilation of pelvic arteries and veins to support this increased blood flow. In some women these changes can persist after childbirth. It is the enlargement, stretching, reflux and resultant congestion within these pelvic veins that are postulated to be the cause of chronic pelvic pain in women with PCS.
Studies show that 30% of women with chronic pelvic pain have pelvic congestion syndrome (PCS) as a sole cause of their pain and an additional 15% have PCS along with another pelvic pathology. Up to 15 percent of women, generally between the ages of 20 and 50, have varicose veins in the pelvis, although not all experience symptoms. Many women with pelvic congestion syndrome, spend many years trying to get an answer to why they have this chronic pelvic pain. Living with chronic pelvic pain is difficult and affects not only the woman directly, but also her interactions with her family, friends, and her general outlook on life. Because the cause of the pelvic pain is not diagnosed, no therapy is provided even though there is therapy available.
