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Treating Pelvic Congestion Syndrome


What causes pelvic congestion syndrome?

Pelvic Congestion Syndrome occurs when varicose veins form around the ovaries. The veins in these areas do not function properly, the valves often fail, the vein walls become weak and twisted with swollen veins forming.

In females there are four major veins involved in pelvic congestion syndrome. These are the right and left ovarian veins and the right and left internal iliac veins.

As with all veins the normal situation is blood is pumped towards the heart. In the large veins such as the common iliac vein it usually is a continuous flow and so valves are not needed and so do not usually appear. However, the internal iliac veins drain blood from the whole pelvic region and the ovarian veins drain blood from the ovaries and uterus. This blood drains slower and therefore valves need to be present to ensure blood is pumped back to the hart efficiently.

Similarly with all varicose veins, the fundamental cause of the pelvic varicose veins is when these valves fail. The valves can fail in any four of these veins. This causes either the veins lower down to dilate leading to varicose veins or causes blood to fall the wrong way in the veins leading to venous reflux.

The most common treatment of pelvic congestion syndrome is to treat the ovarian vein reflux as the ovarian veins are long and easier to scan and treat. Our research at Contour Clinics has shown that only 3% of women with pelvic congestion syndrome have only ovarian vein reflux and the most common pattern is to have both reflux in both the ovarian and iliac veins. Hence our treatment focus on all the veins involved in the congestion and making sure scans are completed on all four of the veins.

Family history again is the main cause of Pelvic Congestion Syndrome however hormones is the other major cause.

When you are pregnant the veins in your pelvis region enlarge to increase blood supply to the womb and in some cases, this can be permanent. Enlarged veins make it harder for the blood to flow back to the heart because there is less pressure and force to keep the blood flowing.

As well as increased blood flow the hormone Oestrogen causes veins to dilate and weaken blood flow. This hormone is common in women from puberty to menopause and is increased even more than usual during pregnancy.

What are the Symptoms of Pelvic Congestion Syndrome?

  • Pain or Aching in the pelvis particular on standing. This is due to the extra weight of blood in these veins which weighs heavily on the pelvic floor muscles.
  • Pain usually worse at the end of the day after the blood has pooled in the veins.
  • Pain started in pregnancy and has now got worse after childbirth.
  • Incontinence in the bladder or bowel due to the increased weight pushing on these structures.
  • Discomfort when having sexual intercourse.

There are some activities that will aggravate the pain in the pelvis. If you believe you may have Pelvic Congestion Syndrome you should be aware of what can make the pain worse, The most common activities that are known to flair up the pain are;

  • Standing for long periods of time
  • Running or Walking
  • Sexual intercourse

While pain is the most common symptom other symptoms can occur. These include back pain, tiredness, and excessive bleeding during menstruation. Other symptoms are swelling around the vagina and varicose veins in the lower half of the body.

Treating Pelvic Congestion Syndrome?

The best way to treat Pelvic Congestion Syndrome is to make sure a correct diagnose is confirmed. The best way to diagnose varicose veins and venous reflux in the pelvis is a specialised venous ultrasound test. This test is called a transvaginal duplex ultrasound.

Unlike treatment for other varicose veins in the legs the pelvic veins are overly sensitive and have vital organs and structures surrounding them. Therefore, we need to avoid using heat in the treatment of this condition. This means Endovenous Laser or Radiofrequency Ablation should not be used. We also advise to avoid surgery as pain and complications from open surgery are not needed and secondly the pelvic veins are very small and deep within the pelvis making surgery extremely difficult.

Treatment is therefore usually a twostep process once diagnose has been confirmed. Initially often pain and anti-inflammatory medication is given depending on the severity of the underlying condition. If this is not helping, we recommend sclerotherapy to close off the damaged veins. In some cases, we may need to insert a specialist metal coil to close off the vein.

Our Specialist Doctor, Dr Jane Cross specialises in Pelvic Congestion Syndrome and can accurately recommend the best treatment plan for you.

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Recent Reviews

Mia D Dec 20, 2020

The absolute best in Sydney. I would not go anywhere else to get anything done. Everyone I have encountered at this clinic has been so extremely warm and professional and put in so much time and effort to truly achieve your desired outcome. Can’t recommend this place enough, do not waste your money elsewhere.

Amanda K Feb 1, 2021

First time at Contour Clinics and was very happy with the whole experience. Easy to find, easy to park, friendly and helpful staff. Highly recommend and will be a regular from now on.

Rekka P Jan 20, 2021

Very happy with my experience at Contour Clinics Newtown. Everyone was so friendly, professional and knowledgeable. I felt very comfortable during my treatment. Dr Josh made me feel so comfortable. I am so happy. I’ll definitely be back!

* Testimonials are from satisfied customers, results may vary. We offer complementary 1:1 consultations to understand your specific requirements before commencing treatment.


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