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.