Endometriosis vs Pelvic Congestion Syndrome

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Chronic pelvic pain refers to any pain between your hips and the belly button that lasts for more than six months. There may be various causes of chronic pelvic pain, including activities like intercourse, sitting for long periods, and medical conditions like endometriosis and pelvic congestion syndrome.

What is Endometriosis?

Endometriosis is a painful condition in which tissue, similar to the tissue found inside your uterus, grows outside it. It can involve your fallopian tubes, ovaries, and the tissue lining your pelvis. The endometrial-like tissue may be found in areas other than the pelvic organ in rare cases. In this disorder, the endometrial-like tissue thickens, breaks down, and bleeds during each menstrual cycle. But since there is no way for it to leave the body, it gets trapped.

The condition can also lead to cysts called endometriomas if the ovaries are involved. The surrounding tissues get irritated and eventually develop adhesions and scar tissue. Endometriosis can lead to fertility problems and severe menstrual pain. 

Symptoms and Diagnosis of Endometriosis

The most common symptom of endometriosis is pelvic pain. This pain can also increase over time. Other signs of this condition include:

  • Back pain during periods
  • Pain while peeing or pooping, especially during periods
  • Heavy or unusual bleeding during the menstrual cycle
  • Blood in the urine or stool
  • Painful intercourse
  • Constipation or diarrhea
  • Chronic fatigue
  • Infertility

Your doctor may suspect endometriosis based on your symptoms and recommend tests and scans to diagnose the condition. Tests that help diagnose endometriosis include:

  • Pelvic Exam - A pelvic exam can help your doctor feel scars or cysts behind the uterus
  • Laparoscopy - The doctor will make a tiny cut in the stomach and put a thin tube with a camera at the end to see where and how big the lesions are. 
  • Imaging Tests - You may be asked to get a CT scan, an ultrasound, or an MRI 
  • Biopsy - The doctor will collect a tissue sample during laparoscopy and get a specialist to examine it to confirm the diagnosis.

Causes of Endometriosis

While the exact cause of endometriosis is not known, there are several factors that may possibly cause the condition. They are:

  • Retrograde menstruation
  • Embryonic cell transformation
  • Transformation of peritoneal cells
  • Surgical scar implantation
  • Endometrial cell transport
  • Immune system disorder

How to Treat Endometriosis

Endometriosis cannot be cured. Treating the condition includes medication or surgery. You may need to try different treatments to understand what works for you. Common treatments for endometriosis include:

Pain Medication

Your doctor may recommend an over-the-counter pain reliever to help with your endometriosis symptoms. Common drugs that are prescribed are NSAIDs like Ibuprofen, Naproxen, and Motrin. 

Hormone Therapy

Hormone therapy will help lower the amount of estrogen in the body. This can stop your periods. As a result, the lesions will bleed less and reduce inflammation, cysts, and scarring. Common hormones that the doctor may prescribe include:

  • Birth control pills, vaginal rings, and patches
  • Gonadotropin-releasing hormone agonists and antagonists like Leuprolide and Elagolix Sodium.
  • Progestin-only contraceptives
  • Danazol

Surgery

In some cases, the doctor may recommend surgery to remove as much of the affected tissue as possible. Surgery can help reduce symptoms and help you get pregnant as well. In some severe cases, the doctors may recommend a hysterectomy to remove the uterus, ovaries, and cervix, eliminating your chances of getting pregnant.

 

What is Pelvic Congestion Syndrome (PCS)?

PCS is a very painful condition that affects the lower part of the stomach or pelvic area. It can lead to pelvic pain that may last for six months or more. Problems in the veins in the body's pelvic region may cause this disorder. It is not connected to your menstrual cycle and can be difficult to diagnose.

Symptoms and Diagnosis

The common symptoms of this condition include:

  • Dull pain in the lower back and pelvic area
  • Pain gets worse during periods
  • Stressed or irritable bladder that makes it hard to control urination
  • Pain or discomfort during sex
  • Engorged or bulging veins in front of the vagina
  • Varicose veins on the butt or upper thighs

Several things can trigger pelvic pain. The doctor may run many tests to rule out certain other disorders before concluding you have this condition. Common tests for diagnosis include:

  • Urine tests for ruling out bladder problems
  • Blood tests for pregnancy, anemia, STDs, and other disorders
  • Doppler ultrasound for checking the flow of blood in the blood vessels of the pelvic region
  • MRI or CT scan 
  • Pelvic ultrasound to check for growth in the pelvic area
  • Diagnostic laparoscopy
  • Pelvic vein X-rays 

Treatment

There are many treatment options for PCS. Common treatments include:

  • Minimally-invasive procedure to open vein stenosis.
  • Minimally-invasive procedures called embolization to close the affected veins

Many women have claimed their symptoms got better after they got embolization.

When to See a Doctor?

You must see a doctor if your symptoms don't go away for long and the pelvic pain interferes with your everyday life and routine. The doctor will rule out anything life-threatening and diagnose the condition, before prescribing treatment.

Are Endometriosis and PCS the Same

While PCS and endometriosis may have some similar symptoms, they are not the same. PCS sometimes may be mistaken for endometriosis, but both these are different conditions. PCS may be caused due to various reasons that affect the structure of the pelvis and the blood vessels, putting pressure on the veins. Endometriosis, on the other hand, is caused due to the tissue similar to the lining of the womb growing outside the uterus, on the ovaries, and in fallopian tubes. 

The Center for Vascular Medicine will help you learn more about chronic pelvic pain and its causes. We specialize in the diagnosis and treatment of various vascular symptoms of chronic pelvic pain and other conditions. Our primary focus is compassionate patient care. We are committed to long-term treatment, monitoring, and prevention of vascular conditions. 

To learn more visit: https://www.cvmus.com/vascular-treatment/chronic-pelvic-pain-signs-and-treatments 

 

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