Chronic Pelvic Pain in Women Causes and Treatment
Chronic Pelvic Pain in Women
By some estimates, CHRONIC PELVIC PAIN IN WOMEN accounts for 10 to 15 percent of all gynecologic visits*. There may be several causes or contributing factors to chronic pelvic pain and vascular conditions are often overlooked.
UP TO 15% OF WOMEN BETWEEN THE AGES OF 20-50 YEARS HAVE INSUFFICIENT VEINS IN THE PELVIS, ALTHOUGH NOT ALL EXPERIENCE SYMPTOMS AND ONLY 60% DO EXPERIENCE SYMPTOMS.
But There’s Good News!
Vascular conditions that cause pelvic pain in women can be diagnosed easily and in a non-invasive manner. Once identified, they can be further evaluated by venography and treated successfully with outpatient-based endovascular techniques.
Causes For Pelvic Pain in Women
Pelvic pain can be caused by a variety of non-vascular conditions*:
- 37% Gastrointestinal
- 31% Urinary
- 20% Reproductive
- 12% Musculoskeletal/Other
After these other, more common causes for pelvic pain have been ruled out, one should consider further vascular evaluation.
Choosing the right specialist is VERY important. The Center for Vascular Medicine is one of the nation’s leading centers for the diagnosis and treatment of Pelvic Congestion Syndrome (PCS) and May-Thurner Syndrome.
- Pelvic Congestion Syndrome
PCS is most commonly characterized by chronic pain in the pelvic region, caused by venous reflux and poor blood flow in the pelvic veins.
- May-Thurner Syndrome
May-Thurner Syndrome is caused by a compression of the iliac vein. MTS may or may not have pelvic pain, but generally will have varicose veins and/or swelling in one leg (typically the left leg).
* Weiss RA, Feied CF, Weiss MA. Vein diagnosis and treatment: a comprehensive approach. New York, NY: McGraw-Hill,2001.
Signs & Symptoms
Many patients with Pelvic Congestion Syndrome (PCS) and May-Thurner Syndrome (MTS) will experience no symptoms. However, chronic pelvic pain is the most common. Because pelvic pain can present with other conditions, it is important to rule those out prior to the diagnosis and treatment of PCT and MTS.
The common symptoms include:
- Chronic pelvic pain, experienced for six or more months
- May be constant or intermittent
- Usually a dull, achy pain in the lower abdomen, pelvic region or lower back
- Generally worsens as the day progresses, particularly with prolonged sitting or standing
- Occasionally accompanied by a sharp pain
- Often on the left side, though it may be generalized throughout the pelvic region
- With May-Thurner Syndrome, there is usually varicose veins and/or swelling of the left leg
- Both Pelvic Congestion Syndrome and May-Thurner Syndrome are more common in women who have had multiple births.
How Is Pelvic Pain Diagnosed
Most patients who come to Center for Vascular Medicine are referred by their OB/GYN for suspected venous conditions or come through our sister company, Center for Vein Restoration for evaluation and/or treatment of varicose veins. A majority of our diagnostic examinations are performed in the out-patient setting. Diagnostic testing is minimally invasive and generally pain free.
We use several techniques including:
- Pelvic ultrasound
- Venography (x-ray of the veins)
- Intravascular ultrasound (IVUS)
Learn more about how we pelvic pain diagnosis
Treatment for Chronic Pelvic Pain
We strive to provide the most conservative and least invasive treatments needed to restore optimal blood flow and relive pelvic pain. Center for Vascular Medicine is one of the leading treatment centers in the United States for the diagnosis and treatment of chronic pelvic pain in women. We offer a full range of treatment options that can be completed in the out patient setting.
There is no one-size-fits-all solution. Treatment options may include:
- Embolization procedure - generally involves injecting a sclerosing agent into the vein. This results in the closing of the affected vein, with blood flow being naturally rerouted into healthier veins. Treatment is very similar to sclerotherapy in the legs.
- Venoplasty procedure - use a balloon like device to expand the vein in the pelvic region. Then use a stent to keep the vein open to improve blood flow.
- Venous stenting - involves inserting a tubular, mesh support into the vein or artery to open the vessel and allow for healthy blood flow.
- Bypass surgery - in some cases, a bypass surgery may be the best option to restore proper blood flow in the pelvic region. This is more invasive and done in the most severe cases.
Learn more about how we chronic pelvic pain treatment.