Pelvic Congestion Syndrome: Managing Your Pelvic Pain at Work
Varicose veins are not uncommon, but during pregnancy the risk of them developing becomes greater. Furthermore, if you are spending a large portion of your day sitting down or walking, the risk increases even more. During pregnancy you may also be at risk of developing varicose veins not just in your legs, but also in your pelvis or groin. If these veins develop, it may feel like a pressure in your pelvic area, and can sometimes develop into a chronic pain. This is known as Pelvic Congestion Syndrome (PCS), and during pregnancy it can be triggered and worsened by a number of factors. Your lifestyle and your job can play a big role in how much pain you experience.
Why Does Pelvic Congestion Syndrome Occur More Often During Pregnancy?
As your body progresses through pregnancy, the baby and the placenta grow larger and require increasing blood flow. Your body responds by increasing your blood volume significantly, which can cause your veins to work harder, as well as creating swelling. The valves inside your veins are dealing with a greater blood flow than usual, and they may not function as efficiently as they need to: this causes blood to flow backwards through the valves, pooling and creating pressure on the vein walls.
In addition, the baby presses down on the pelvic bones, veins, and other structures, and the pelvic shape changes to make room for the baby. This change, combined with the pressure from the baby, can put extra weight onto parts of the pelvic veins.
Pelvic discomfort is not unusual during pregnancy, but it can become a chronic pressure or pain that is beyond what is normal. It may become worse if you exercise a lot, or spend large portions of your day at work on your feet. For many women, pelvic pain stops when the pregnancy ends, but for some it continues, and becomes PCS. If you are experiencing PCS, you may need to seek treatment to alleviate the pain or pressure.
What Risk Factors Make PCS More Likely?
Several factors can make PCS more likely to develop, not least of which is that you may be genetically predisposed to it. If someone in your family has PCS, especially your mother, you may be more likely to develop it yourself. This is because a component of PCS is pelvic shape, which may be passed down to you through your genes. If you have been pregnant before, or if you already have varicose veins, you may also be more at risk.
If you are working in a job that involves heavy lifting, or prolonged standing, this will also increase your risk of developing PCS. This is simply due to the increased pressure down into the pelvis, which can inflame the veins and cause swelling.
Eddie Chaloner, a varicose vein expert, explains that “ultrasound scanning has now shown us that up to 20% of women coming to see a doctor with varicose veins in the legs, do not have a problem with the leg valves at all – rather that the bulging leg veins are in fact filled by faulty valves from within the pelvis.
To a certain extent that is not surprising – the female pelvis has a lot more organs in it than the male one and pregnancy causes significant anatomical and physiological changes in the female pelvis which have long lasting effects. Women with pelvic vein problems causing veins in the legs have often had trouble with veins during pregnancy – either in the legs or in the vulva. Under normal circumstances, when the pregnancy is over, the vulvar veins recede and often completely disappear. The leg veins often persist.”
What Treatment Can You Get?
If a diagnosis of PCS is made, you can look into several different treatments. First of all, in your workplace, if it’s possible to reduce any heavy lifting or time spent on your feet, this may help to alleviate your pelvic pain.
Some typical varicose vein treatments are limited by the fact that the pelvic region may be quite difficult to get into for certain types of surgery. For smaller veins, a good option is a treatment called sclerotherapy. This is when the veins are injected with a type of chemical that lines the veins and seals them up. The main issue with sclerotherapy is that it is often only temporary, and the varicose veins may still come back.
A more effective sealant approach is called Pelvic Vein Embolisation, in which a catheter is inserted into the vein. Once the catheter is inserted, the doctor inserts tiny coils of metal or sponges of material which block the vein and cause it to seal. Most PCS cases can be resolved by a combination of sclerotherapy for smaller veins, and pelvic vein embolisation for larger veins.
PCS can usually be resolved with one of these treatments, and is not something that you have to live with forever. If pelvic pain during pregnancy gets worse or becomes chronic, talk to your care provider to check whether or not you are dealing with PCS.