How To Sleep with May-Thurner Syndrome
November 11, 2024
Imagine dealing with a persistent and dull ache. Your lower abdominal pain worsens and just won’t go away. It gets worse when standing or sitting for long periods and even disrupts intimate moments of sexual intercourse.
This is the reality for many women who suffer from a chronic pelvic pain medical condition called Pelvic Congestion Syndrome (PCS), or Pelvic Venous Insufficiency. Worse than the pain, the condition is often misunderstood and misdiagnosed, leading to a delay in treatment.
Pelvic Congestion Syndrome is characterized by pain in the pelvic area due to varicose veins. These bulging veins can become enlarged and twisted similar to varicose veins found in the legs. Severe pelvic pain can impact a woman’s quality of life, making it crucial to understand and recognize this disease.
Let’s examine the causes, symptoms, and treatment options for sufferers of Pelvic Congestion Syndrome. Whether you are suffering from this condition yourself or supporting a loved one who is, this guide aims to shine a light on the complexities of PCS and offer the hope of management and relief.
Pelvic Congestion Syndrome is just one of several conditions that cause chronic pelvic pain. Understanding these other pelvic venous syndromes is important, as they may lead to a mistaken PCS diagnosis. Let’s review some key conditions to be aware of.
May-Thurner Syndrome occurs when the right iliac artery compresses on the left iliac vein, restricting blood flow and increasing the chance of blood clots. This condition causes leg swelling, pain, and varicose veins when blood pools in the blood vessels. Imaging studies will help to differentiate between PCS and MTS.
Nutcracker Syndrome involves the compression of the left renal vein between the aorta and superior mesenteric artery. This may cause blood flowing backward to back up in the kidney and pelvic veins. Symptoms include pain in the buttocks, blood in urine, and pelvic pain.
Ovarian vein Reflux happens when valves in the ovarian veins fail. This causes blood to pool in the veins in the pelvic area. A vascular specialist will use special imaging procedures like pelvic venography or Doppler ultrasound to distinguish between OVR and PCS.
While not a venous condition, endometriosis is a common cause of chronic pelvic pain. People can easily mistake it for Pelvic Congestion Syndrome.
Understanding all the above conditions is vital for medical caregivers to make an accurate diagnosis and treatment plan. If you experience chronic pelvic pain, it’s important to seek the help of a specialist who can conduct a thorough examination and document all clinical symptoms
Pelvic Congestion Syndrome can present with a variety of symptoms in varying intensities. Recognizing these symptoms is crucial for early diagnosis. Let’s see some of the most common symptoms associated with PCS.
The main symptom associated with PCS is chronic pelvic pain. A patient’s specific pain may present as a dull ache that persists for months or longer. Pain worsens often at the end of the day, during long periods of standing or sitting, during sex, or menstrual periods.
Women with Pelvic Congestion Syndrome may develop pelvic varicose veins or on the thighs and buttocks. The pooling of blood in the pelvic area can also cause pain in swelling in a lower extremity or the lower back.
Pelvic Congestion Syndrome may cause gastrointestinal symptoms in women with symptoms like IBS, bloating, and lower abdominal pain. It can also cause urinary symptoms like increased frequency and urgency or pain and discomfort.
Certain factors may increase the chance of developing Pelvic Congestion Syndrome (PCS). Being aware of these risk factors is the first step in taking steps to lower your risk level.
Because of the changes that happen during pregnancy, it is one of the most significant factors for developing PCS. Increased blood flow and hormonal changes cause veins in the pelvis to enlarge and become more susceptible to congestion syndrome. Multiple pregnancies increase the risk further.
Hormonal changes, especially estrogen levels, can weaken vein walls and valves. This is another factor in why women of childbearing age are more prone to this disorder.
A family history of varicose veins or venous obstruction disorders can increase a woman’s risk of developing Pelvic Congestion Syndrome. Genetics may strengthen the structure of vein walls.
Other health risk factors can include having medical conditions like polycystic ovaries, which can trigger hormonal changes that make PCS more likely.
A sedentary lifestyle can contribute to poor circulation. Excess weight can put extra pressure on the pelvic veins and lead to enlargement.
How is Pelvic Congestion Syndrome diagnosed? A detailed medical history will need to be performed as a first step, followed by a review of symptoms. The healthcare provider will ask about pelvic pain and things that make it worse or alleviate it. They will also question you about your menstrual cycle, sexual activity, and previous pelvic surgeries.
Expect a physical exam to search for signs of varicose veins in the midsection. Additionally, the doctor will also inspect you for tenderness and alternative possibilities for pain.
The medical professional needs to visualize the pelvic veins and the best way to do this is through common imaging procedures. For example, a pelvic ultrasound is a non-invasive test that uses sound waves to create images of the pelvic organs and blood vessels. A transvaginal ultrasound may need to be performed to get a closer look.
Computed tomography (CT), magnetic resonance imaging (MRI), and magnetic resonance venography are three possible tools that can be used in conjunction with radio waves or X-Rays.
Since Pelvic Congestion Syndrome is such a complex disorder that shares symptoms with a variety of other potential causes, a specialist may need to rule out other risk factors first before settling on PCS. Therefore, conditions like endometriosis, ovarian cysts, urinary tract infections (UTIs), and other abnormalities may need to be excluded through appropriate testing.
Treatment options for Pelvic Congestion Syndrome involve several approaches designed to relieve symptoms and address the pelvic veins’ insufficiency.
Medications may help manage symptoms of PCS, especially pain and hormonal imbalances. Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen may be a first step in reducing pain and inflammation.
Hormone therapies help to address one of the causal factors of PCS. Common prescriptions include:
If other treatments are ineffective, surgery may be used by a vascular surgeon to directly address problem veins. Here are some of the most common procedures used to alleviate PCS:
Pelvic Congestion Syndrome (PCS) is a complex and often misunderstood condition. Therefore, its similarity to other medical conditions means it can be misdiagnosed without a proper and thorough diagnosis process. This disorder can significantly impact a woman’s quality of life with chronic pain in the pelvis.
Women can find relief by diagnosing PCS properly and exploring treatment options open to them. Find the right care and support while you walk the path to a better future free from pelvic pain.
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