Pelvic Congestion Syndrome (PCS) is a leading cause of chronic pelvic pain in women, yet it remains widely misunderstood and misdiagnosed.
This condition occurs when veins in the pelvic region become enlarged and dysfunctional, leading to poor blood circulation and persistent discomfort. Women of reproductive age, particularly those who have had multiple pregnancies, are at the highest risk (Smith et al., 2021).
Despite its prevalence, PCS is often mistaken for endometriosis, fibroids, or other gynecological disorders, delaying diagnosis and treatment. Many women suffer for years without understanding the root cause of their pain (Adeoye & Okonkwo, 2021).
This article explores the causes, symptoms, diagnosis, and treatment of PCS while highlighting its public health impact in Nigeria and Africa.
What is Pelvic Congestion Syndrome (PCS)?
Pelvic Congestion Syndrome is a vascular disorder caused by dysfunctional valves in the pelvic veins. These weak valves allow blood to flow backward and pool, leading to vein swelling, pressure, and chronic pain (Ogunlade et al., 2022).
This condition is similar to varicose veins but occurs internally, around the uterus, ovaries, and bladder.
Women with PCS often experience pelvic pain that worsens after prolonged standing, before menstruation, or during intercourse. Due to symptom overlap with other conditions, PCS is frequently overlooked in medical evaluations (Eze et al., 2022).
Causes of Pelvic Congestion Syndrome
Several factors contribute to the development of PCS, including:
- Hormonal Influence
High levels of estrogen can cause vein dilation, increasing the likelihood of PCS. This explains why the condition is more common in women of reproductive age and worsens during pregnancy and menstruation (Smith et al., 2021).
- Pregnancy and Childbirth
Pregnancy increases blood volume and pressure on the pelvic veins, sometimes leading to permanent vein damage. Women who have had multiple pregnancies face a higher risk due to repeated strain on the veins (Brown et al., 2020).
- Genetic Factors
A family history of varicose veins or venous disorders increases susceptibility to PCS. Weak connective tissues can make vein walls more prone to dysfunction.
- Lifestyle Factors
- Prolonged sitting or standing leads to blood pooling in the pelvic veins.
- Obesity increases pelvic pressure, worsening congestion (Chinwe & Onwumere, 2021).
- Lack of physical activity contributes to poor circulation and vein dysfunction.
Symptoms of Pelvic Congestion Syndrome
The most common symptom of PCS is chronic pelvic pain lasting six months or more. This pain is often dull, aching, or throbbing and worsens under certain conditions:
- After standing or sitting for long periods
- Before or during menstruation
- During or after sexual intercourse (dyspareunia)
- In the late afternoon or evening
Other symptoms include:
- Vaginal or labial swelling
- Frequent or urgent urination
- Varicose veins on the thighs, buttocks, or vulva
Many women ignore these symptoms, assuming they are part of normal reproductive health issues, which leads to delayed diagnosis and unnecessary suffering (Eze et al., 2022).
