Can Pelvic Congestion Syndrome Cause Heart Problems?

Pelvic congestion syndrome is a lesser-known condition underlying pelvic pain in women. Are you experiencing pelvic pain and unsure what the underlying cause is and what you can do to prevent this from occurring? Keep reading this article to help answer your questions. 

Pelvic congestion syndrome is not known for causing heart problems. It is a vascular disease of the veins in the pelvic region, where the veins in the pelvic region are damaged and enlarged. This was not thought to affect the heart until more recent evidence. A syndrome called postural orthostatic tachycardia syndrome has now been linked to pelvic congestion syndrome. This is not a life-threatening syndrome, but it does affect the heart. 

The rest of this article will explain the common symptoms, causes, and treatment for pelvic congestion syndrome as well as the recent evidence about postural orthostatic tachycardia syndrome related to pelvic congestion syndrome, to provide information about this disease. 

What is pelvic congestion syndrome?

Pelvic congestion syndrome is a condition that causes pelvic pain, due to pelvic venous congestion. This condition is most common in women in the later stages of their life, particularly after giving birth to more than one child.¹ The pelvic veins become damaged and enlarged, leading to chronic pain. Veins in the pelvic region become damaged when blood flow is reduced, leading to a buildup of blood in the veins. This leads to the development of varicose veins. Varicose veins are enlarged, lumpy, blue-coloured veins that are typically associated with the legs, but can also develop due to pelvic congestion syndrome in the upper thighs, vagina, and gluteal region. 

Symptoms of pelvic congestion syndrome

A woman with pelvic congestion syndrome can experience a range of unpleasant side effects.² These can include:

• Chronic pelvic pain, lasting longer than six months 
• Pelvic pain during or after sexual intercourse 
• Excessive discomfort during menstrual cycles 
• Heavy, aching feeling in the pelvic region
• Increased frequency of urination 
• Vaginal swelling 
• Varicose veins (visible, lumpy, swollen veins) in the upper thigh, vagina or gluteal region

A woman with pelvic congestion syndrome does not necessarily experience all these symptoms at the same time. Symptoms can come and go. It is important to remember that every woman is different, so they may only experience mild symptoms or they may be more severe. 

If you are experiencing any of these symptoms and you have any concerns that you may be affected by pelvic congestion syndrome, contact your doctor/GP immediately to seek advice and treatment. 

Causes of pelvic congestion syndrome

Pelvic congestion syndrome arises as a result of pelvic venous congestion. The veins in the pelvic region become congested when the pelvic veins become dilated, leading to an increase in pressure. Varicose veins develop, which are mainly present in the legs but can also develop in the uterus. These veins are twisted, and swollen and can cause a lot of pain to the patient. 

The exact cause of the enlarged veins is yet to be fully established. It is thought that pregnancy increases the chance of veins becoming enlarged as there is an increased need for blood during pregnancy to support the growing fetus, so the veins accommodate that by dilating. Hormones such as estrogen also play a role in dilating veins, and may therefore be responsible for the symptoms. This could also explain why pelvic congestion syndrome is not common in women after menopause, as oestrogen levels are depleted.³ However, it is interesting to note that some women have enlarged veins but do not experience any of the symptoms, so there may be other underlying causes of pelvic congestion syndrome. 

Can pelvic congestion syndrome cause heart problems

The main symptom that occurs due to pelvic congestion syndrome is pelvic pain. This is what is written about in every article about pelvic congestion syndrome. However, there have been recent reports of a syndrome called Postural Orthostatic Tachycardia Syndrome related to pelvic congestion syndrome. In pelvic congestion syndrome, the blood in the pelvic region remains in the dilated veins. This forces the heart to work faster and harder to move this blood from the pelvic region to the rest of the body. It is this increase in effort from the heart that can cause postural orthostatic tachycardia syndrome.⁴  This recent finding from evidence should however not worry the reader, as it is not a condition that can be easily treated with lifestyle changes. 

Diagnosing pelvic congestion syndrome

Diagnosing pelvic congestion syndrome is not easy, as pelvic pain can arise due to many reasons. Doctors may have to run several diagnostic tests to diagnose pelvic congestion syndrome. This can include; 

• Blood tests 
• Urine tests 
• Pelvic and abdominal ultrasounds 
• CT scan or MRI (magnetic resonance imaging) to visualize the pelvic veins 
• Pelvic venography to obtain images of the pelvic veins 
• Laparoscopy to exclude other conditions that may be causing pelvic pain⁵ 

Once a diagnosis is made, the treatment plan can begin in order to reduce pain to the individual and increase their quality of life. 

How is pelvic congestion syndrome treated?

If diagnosed with pelvic congestion syndrome, there are several routes that your doctor may take for treatment. The first line of treatment includes using medication that aims to reduce the pain experienced by women as well as reduce the size of the varicose veins.⁶ 

A more invasive treatment for pelvic congestion syndrome is ovarian vein embolization. During this procedure, the damaged ovarian and pelvic veins are blocked by metal coils or plugs in order to block the flow in the veins. Blocking the blood flow prevents the reversal of blood flow, which leads to a reduction in pressure inside the vein. Following this procedure, the once-damaged veins should have restored normal blood flow within them.⁷

When should I call my healthcare provider?

If any of the symptoms listed above are causing extreme pain or affecting your day-to-day life, your healthcare provider should be called. Ignoring symptoms will only lead to further complications and pain, so it is important to see a doctor as early as possible to limit the damage and start a treatment plan.  

Summary

Pelvic congestion syndrome can lead to painful side effects in women that can affect their quality of life. This is why it is important to contact a doctor if you are experiencing any of the symptoms listed in the article. The sooner the problem is treated, the better the patient outcomes. The most common complications of pelvic congestion syndrome include recurring or permanent pelvic pain and potentially postural orthostatic tachycardia syndrome. ⁸ This is only a recent discovery, it is not a very severe condition and can be easily treated with a few measures, so if the reader has pelvic congestion syndrome, they should not worry.