Guildford   London   Bristol

Symptoms of Pelvic Congestion Syndrome


Who gets symptoms from Pelvic Congestion Syndrome?

Pelvic congestion syndrome affects women in their childbearing years. It is uncommon for girls to get pelvic congestion syndrome before puberty, as the pelvic organs and blood supply have not increased due to the effect of female hormones. Similarly, it is uncommon to get pelvic congestion syndrome after the menopause, as when the female sex hormones reduce sufficiently, the blood supply to the pelvis also reduces. However it is possible to get pelvic congestion syndrome postmenopausally if the veins have been very dilated.

What are the symptoms of Pelvic Congestion Syndrome?

The symptoms of pelvic congestion syndrome are mainly those caused by the pressure of the venous blood in the dilated pelvic varicose veins pressing on the pelvic organs. As such they can include:

  • aching or dragging feeling in the pelvis, particularly on standing. This is due to the weight of blood in the pelvic varicose veins weighing heavily on the pelvic floor which is made of muscle. It is usually worse around the time of the period
  • irritable bladder sometimes giving stress incontinence, due to the weight of the pelvic varicose veins on the bladder
  • irritable bowel due to the weight of the pelvic varicose veins on the rectum
  • discomfort on sexual intercourse medically referred to as ‘deep dyspareunia’

Although there are rarely any outward signs of pelvic congestion syndrome, occasionally the following can be seen, particularly after pregnancy:

  • varicose veins of the vulval or vagina (bulging veins around the front passage). Often these are visible during pregnancy and look as if they have disappeared after delivery. However this is just because they have got smaller. The underlying venous reflux is usually still there
  • small varicose veins visible at the top of the inner thigh next to the vulva but on the leg, or the backs of the thighs usually around the buttock crease, anus or perineum.

How do I know if I have pelvic congestion syndrome?

Unfortunately many of the symptoms of pelvic congestion syndrome are variable and also can occur with other conditions. Usually patients come to The Whiteley Clinic once they have already seen their family doctors and gynaecologists and have been told that there is nothing wrong with them.

Research performed at The Whiteley Clinic and published in peer-reviewed journals has suggested that the best way to diagnose varicose veins of the pelvis is a specialised venous duplex ultrasound test called the transvaginal duplex ultrasound. Judy Holdstock and Charmaine Harrison, the two most senior vascular technologists at The Whiteley Clinic, have developed the Holdstock-Harrison protocol to diagnose pelvic vein reflux and pelvic varicose veins.

The research suggests that this is more accurate than MRI, CT, venography or any other test that is used currently.

One of the major advantages of transvaginal duplex ultrasound is that the ovaries, uterus and cervix can also be examined at the same time using a test that has no x-rays and has no needles at all and is a truly walk in walk out investigation.