Pelvic pain is a common problem that doesn’t always have a simple or clear solution. It’s not often discussed but has serious consequences that can interfere with a woman’s ability to do normal activities like working, exercising or having sex.
Although we don’t know exactly how many women experience chronic pelvic pain, a study in Obstetrics & Gynecology found that roughly 15 percent of women of childbearing age in the U.S. have pelvic pain that lasted at least six months. If you’re one of those women, you understand how debilitating this condition can be.
“Pelvic pain can be described in many ways – sharp and stabbing or a dull pain that exists across the pelvic area. Some women report feelings of heaviness or pressure in the pelvis that requires resting or being off their feet more than they’d like,” says Michael Greer, MD, vascular surgeon with University Surgical Associates. “Pelvic pain can result from different conditions, including scar tissue resulting from surgery or infections, endometriosis, uterine fibroids, irritable bowel syndrome and other pelvic floor disorders. But one under-diagnosed cause of pelvic pain is a condition known as pelvic vein congestion (PVC).”
PVC occurs when veins in the pelvic area that carry blood back to your heart become enlarged or stop working like they should. When blood fills up in the ovarian or pelvic veins around the uterus, they can change shape – just like varicose veins in your legs. Swollen and enlarged veins like these can lead to chronic pelvic pain.
Treatment & Recovery
Although the condition is difficult to diagnose because swollen and dilated veins in the pelvis aren’t easily identified with routine imaging studies, a non-surgical, minimally invasive transcatheter approach called pelvic vein embolization is available to relieve the symptoms that can be dramatic in some patients.
“During the procedure, a catheter is used to inject a dye into the dilated vein, giving us a road map of what’s happening inside. A synthetic material or medication called an embolic agent is used to seal off the abnormal blood vessels. Sometimes coils are used to block larger vessels, causing blood to be rerouted to other smaller veins and relieve pressure caused by stagnant blood flow,” says Dr. Greer. “Pelvic vein embolization is a highly effective way of blocking the blood vessel, without the need for open surgery – resulting in less pain and a quicker recovery than an open procedure.”
Most women who undergo pelvic vein embolization spend one night in the hospital to help keep their pain well controlled during the first 24 hours. After three days, patients will experience significant relief. Because the procedure has stopped blood from flowing in the wrong direction, pelvic varicose veins will gradually shrink, reducing pelvic pressure and pain.
Who’s at risk for PVC?
The primary risk factor for PVC is pregnancy, resulting from the increased blood flow that’s needed by your body to support a growing life. Multiple pregnancies also increase your risk. According to Dr. Greer, a compressed vein in the pelvis can also result from an anatomical abnormality that’s present at birth. Some women who have this condition don’t experience any symptoms, and treatment is not necessary in these instances.
“PVC is routinely under-diagnosed, and if your gynecologist has not found a source for your pelvic pain, it’s important for you to raise this issue as a possibility,” says Dr. Greer. “And because it’s not always easily seen on routine imaging tests, a more thorough evaluation may be needed to determine if this is the cause of your pain and which approach we need to effectively address the problem.”