Types of Treatments for PCS

PCS - The Elusive Condition

The causes of Pelvic Congestion Syndrome or PCS are not clear.  However, it is known that varicose veins which develop during pregnancy sometimes continue to progress in size creating the pelvic pressure, pain and heaviness associated with PCS.  As the pooling of blood in the veins increases and the vein walls stretch to accommodate it, pain and discomfort increase.  Although the pain is not cyclical, it does increase at different times causing not only physical distress but depression and anxiety as well.

Other conditions can mimic PCS, so careful diagnosis is necessary before any treatment can begin.  Endometriosis, fibroid tumors and prolapsed uterus are some of the conditions which can cause confusion in a diagnosis.  With the use of CT scans and MRIs, radiologists have been able to isolate and diagnose PCS.  However, due to the variability of the symptoms the diagnosis can still be quite difficult.  The degree of pain and discomfort is also variable making a standard treatment protocol for PCS elusive.

Drug Treatments

Despite its challenges, there are several treatment options open to women with pelvic congestion syndrome.  Some of them have been successful and some have left women dissatisfied with the results.  There are surgical, non-surgical, drug therapies and alternative methods for treating this condition.  We'll explore some of them here.

At one time the drug ergotamine prescribed, which helped to narrow the veins.  In conjunction with ergotamine hormones were also prescribed.  Neither treatments were successful in curing PCS and neither is used today.  However, pain medications are still issued to deal with the pelvic discomfort.  Antidepressants have been shown to be effective in controlling pain as well as symptoms of depression and anxiety which often accompany PCS.

Alternative Efforts

Because of the high failure rate of conventional therapy, many women are opting for alternative methods to treat pelvic congestion syndrome.  Physical therapy, electrical nerve stimulation, trigger point injections, acupuncture and spinal nerve blocks have been used successfully.  Also, some women undergo psychological and behavioral counseling to manage the condition without surgery or drugs.

The Last Resort

Surgery is not the first choice of therapy for PCS and is only done after all other methods have failed.  Symptoms must be present and ongoing before it is considered operable.  The surgery itself is as minimally invasive as possible to remove the varicosities.  The results of surgery have not been considered great and recovery takes a long time.  There have been other surgical approaches including the removal of all adhesions in the pelvis, correcting of the anatomy as much as possible and complete hysterectomy.   However, even with a complete hysterectomy the results are not always good and some symptoms may persist.  Before making a decision to have surgery consider obtaining a second medical opinion.