The pelvic varicose vein is a venous dilation in the genital veins (ovaries, uterus) and develops through veins that have drained the pelvic wall or pelvic viscera. These veins have two forms. The first is an asymptomatic harmless form and doesn’t require any treatment. The second form consists of clinical symptoms that appears after second pregnancy in women. These veins are homogeneous to the varicose veins within the legs. Varicose veins are appeared in the pelvic region, lower abdomen, buttocks, or thighs. Generally, chronic pelvic pain is connected with pelvic varices, commonly called pelvic congestion syndrome. Women are affected mainly by pelvic varicose veins more than men. According to research, almost one-third of women suffer from pelvic pain during their lifetime.
Symptoms Of Pelvic Varicose Vein
These are the signs and symptoms of pelvic varicose vein, which may include:
- Pelvic discomfort
- Pelvic, buttock, and leg pain, cramping or aching
- Pelvic bloating
- Tenderness in the pelvic or abdomen
- Stress incontinence
- Enlarged uterus
- Mood swings
- Ovarian changes
- Thicker endometrium
- Vaginal discharge
- Increased urination
The symptoms can be worse in these conditions, such as:
- Before menstrual periods
- During pregnancy
- Sexual intercourse
Causes Of A Pelvic Varicose Vein
Varicose vein within the pelvis develops when valves in the veins become enlarged, weakened, damaged, and do not close properly. It allows backward blood flow that collects within the veins, causing enhanced force or bulging veins. Varicose veins are present together with lymphoedema and lipoedema because of enhanced force in the venous system. The improved pressure causes vein incompetency. In addition, walking and standing enhance the force within the veins of the lower body. The other causes are as follows:
- Pregnancy: Mainly, pelvic varicose veins develop in women during pregnancy. Pregnancy may cause structural changes in the pelvis. These alterations may affect blood vessels, enhancing the risk factors of forming varicosities. The other reason is that blood volume in the body enhances during a pregnancy. This change expands the veins in the legs. It causes due to hormonal changes and improving pressure on the uterus. Furthermore, a rise in estrogen weakens the walls of blood vessels and causes pelvic varicose veins.
- Family history: People with a family history of pelvic varicose veins have a greater chance of having it. For example, when one parent has pelvic varicose veins, the risk factors are about 40% but if both parents have pelvic varicose veins, the risk increases by about 90% of pelvic varicose veins.
- Overweight: Being overweight increases the risk of pelvic varicose veins. In addition, leg varicosities are common in fat people.
- Hormonal changes: Hormonal fluctuations in estrogen and progesterone are responsible for developing pelvic varicose veins. A rise in estrogen levels causes varicose veins due to enhanced vein distensibility.
- Sedentary lifestyle: Continuously sitting for a long time cause poor circulation of blood in the legs. During sitting, veins work hard to transfer blood to the heart, causing pelvic varices, leg swelling, and deep vein thrombosis. Wearing high heels shoes for a long time may also reduce blood flow in the legs and worsens varicose veins.
Diagnosis Of Pelvic Varicose Vein
The doctor evaluates and recommends diagnostic tests to prevent the symptoms of pelvic varicose vein, which may include:
- Doppler ultrasound: A Doppler ultrasound is recommended as the initial procedure for diagnosing pelvic varicosities. It uses sound waves to detects the varicose veins, makes images of the veins, and evaluates blood flow. An ultrasound shows tortuous and dilated veins and checks blood clots.
- CT scan uses X-rays to give more detailed images of the legs to find deep varicose veins.
- Laparoscopy: Laparoscopy is a type of surgical method used to diagnose pelvic pain. Small cameras are used to see the causes of pelvic pain. It is performed when ultrasound and CT scan don’t give essential i nformation for diagnosis.
- MRI scan: It uses radio waves and magnetic fields to create detailed pictures of the body. It demonstrates the occurrence of the pelvis, vulval, thigh varices, perineal, and dilated veins.
- Blood tests: Blood tests may have done to evaluate pregnancy, anemia, and infections.
- Venogram: A Venogram is a noninvasive procedure that is used for the accurate diagnosis of pelvic varicosities. For this, a long tube (catheter) is inserted in the vein of the leg using X-rays and guides it to the pelvic veins. The damaged veins are visualized properly on X-rays.
Treatment Of Pelvic Varicose Vein
Treatment of pelvic varicose veins depends on the severity of the symptoms in the patients.
Embolization: This procedure treats pelvic varicose veins in the body. Pelvic embolization destroys or removes the varicose vein in the pelvis and ovaries. In this safe procedure, a metal coin is inserted in the damaged vein, such as the ovarian or femoral vein, causing clot formation and stopping blood flow. Embolization helps in relieving leg and pelvic heaviness.
Sclerotherapy: It reduces the discomfort and pain in the legs by closing the damaged veins. Sclerotherapy works best on smaller veins, such as varicose and spider veins.
Medicines are used to relieve the symptoms, such as
- Nonsteroidal anti-inflammatory medications are used to prevent inflammation and relieve pelvic pain. For example, ibuprofen, naproxen, or aspirin.
- Chronic medications: These medications help relieve chronic pain of the pelvis, such as progestin hormone and gonadotropin hormone medications.