There are many causes of pelvic pain, ranging from infection to problems with the female reproductive organs. It can be debilitating and reduce the quality of life of the people who suffer from it. Although pelvic pain affects so many people, it still remains massively undiagnosed, especially in cases of chronic pelvic pain. To learn more about how pelvic pain can be linked to vascular disorders, keep reading.
A vascular disorder or disease refers to any condition that involves the blood vessels, arteries, and veins. The network of blood vessels is called the circulatory system, and it is responsible for ensuring the circulation of blood throughout your body. In simple terms, your heart pumps blood, your arteries move the blood, and your veins return it. If any part of your circulatory system isn’t working properly, you are likely experiencing a vascular disease.
Vascular disorders can affect anyone, and usually occur in places where there is turbulent blood flow, or where the movement of blood experiences a sudden change. The most common areas people experience vascular disorders are in the brain, heart, hips, legs, and kidneys. Vascular diseases that cause pelvic pain are referred to as pelvic venous disorders, and they include several conditions that are linked to chronic pelvic pain.
Pelvic venous disorders happen when the venous system in the pelvis experiences issues of dilation or compression, leading to chronic pelvic pain. These disorders are usually seen in women who are mostly of childbearing age, but can also be seen in post-menopausal women or those undergoing hormone replacement therapy. Pelvic venous disorders include pelvic congestion syndrome (PCS), pelvic vein thrombosis (blood clots in the pelvis), and pelvic vein obstruction (compressed veins in the pelvis).
Of all the causes of chronic pelvic pain, pelvic congestion syndrome is a common and yet under-diagnosed condition. PCS actually accounts for one-third of pelvic pain experienced by women, second only to endometriosis.
This condition is caused by a formation of varicose veins deep within the pelvic region, below the abdomen, leading to pelvic vein insufficiency. The pain from PCS is very similar to the pain caused by issues such as endometriosis, cystitis, ovarian cysts, and more.
PCS occurs when the veins in your pelvis either widen or become twisted, which causes the valves in the veins to malfunction. This is what creates varicose veins in the pelvis. The pain is caused by the accumulation of blood in the area since it has difficulty moving through the veins. PCS is more common in women who have given birth at least once before since pregnancy can change the structure of the pelvis. Pregnancy also causes a rise in estrogen, which weakens blood vessel walls.
The main symptom of PCS is pain—either a dull ache or a throbbing pain in the lower abdomen. Although the pain is chronic, it can become worse:
● After each pregnancy
● Before menstruation
● At the end of the day
● During or after sexual intercourse
● During certain physical activities like cycling
Apart from these symptoms, women can also experience:
● Leg and lower back pain
● Abnormal vaginal discharge
● Abdominal bloating and tenderness
Pelvic vein thrombosis occurs when there is a blood clot in the pelvic veins that obstructs the flow of blood. These clots can be quite serious since they not only cause problems within the pelvis, but can also potentially travel to the lungs.
Pelvic vein thrombosis commonly includes:
1. Deep vein thrombosis. As the name suggests, deep vein thrombosis (DVT) happens when a blood clot develops in one of the deep veins in the pelvis. DVT can cause swelling, and varicose veins in the legs (usually on the left side), as well as pain.
Women who have been diagnosed with vascular disorders like May-Thurner Syndrome (MTS) have a higher chance of developing deep vein thrombosis since it compresses the left iliac vein, which results in less drainage in the left leg.
The symptoms of DVT are usually pain, varicose veins in the upper (usually left) thigh, and swelling.
2. Ovarian vein thrombosis. Ovarian vein thrombosis is common in women who have just given birth. This clot occurs in the ovarian veins, most noticeably the right ovarian vein. It is a rare condition that can usually be diagnosed in the postpartum period.
Symptoms of ovarian vein thrombosis usually include pelvic pain, fever, and occasionally a mass that can be felt in the affected area.
3. Septic pelvic thrombophlebitis. This is also a rare postpartum complication, although it usually affects women who have had a C-section. It is common after birth, but it can also occur after pelvic surgery, miscarriage, or a gynecological disease.
Septic pelvic thrombophlebitis is characterized by pelvic pain, fever, nausea, vomiting, and occasionally a mass that can be felt in the abdomen.
Pelvic vein obstruction, also known as abdominal vein obstruction, is a disorder that occurs when the veins in the pelvis become compressed or twisted. It is most commonly caused by compression of the iliac vein in the pelvis. The iliac vein is responsible for carrying the blood flow out of the leg and pelvis, so when it gets compressed, it leads to a buildup of blood in the area. The iliac vein usually gets compressed when the vein gets squeezed between the iliac artery and the spine, but it can also be caused by ovarian and uterine cysts, or cancer in the pelvis or abdomen.
Pelvic vein obstruction can also occur in people who previously had blood clotting in the pelvis (pelvic vein thrombosis), which included the iliac veins. Pelvic vein thrombosis could lead to partial or complete obstruction of the vein, depending on the clotting factors.
Pelvic vein obstructions are usually characterized by sudden or unexplained leg pain or swelling, leg ulcers, pain after intercourse, and pelvic pain. A noticeable symptom is that leg pain and swelling become worse for people with compressed veins when they exercise, as exercise increases the amount of blood flow. The other veins in the pelvis will be forced to enlarge to continue carrying blood out of the area, resulting in more pain.
Uterine fibroids are muscle and tissue growths that can grow in and on your uterus. These growths are usually non-cancerous, but can cause a variety of symptoms, including pelvic pain, although it is one of the less common symptoms. Apart from this, it can also be indicated by heavy bleeding during menstruation, pain during intercourse, frequent urination, and back pain.
Fibroids can grow as a single nodule, or in a cluster. Pelvic pain occurs when a fibroid, or fibroid cluster, goes through degeneration, which can cause localized and acute pain. While this pain usually resolves within two to four weeks, it can also become a cause of chronic pelvic pain.
Endometriosis is a usually painful disorder where the tissue from the inner lining of your uterus (the endometrium) grows outside of it instead. This condition usually affects the ovaries, fallopian tubes, and the tissue lining the pelvis. During menstruation, these growths act like the inner menstrual lining, but since it happens outside the uterus, the blood and tissue remain within the abdomen, which can lead to the formation of painful scar tissue.
Also called painful bladder syndrome, interstitial cystitis is a painful condition affecting the bladder that causes pressure and pain in the bladder, and pain in the pelvis. This condition is characterized by a frequent need to urinate, and pelvic pain may increase as the bladder fills.
Musculoskeletal problems are issues experienced in the connective tissue, bones, and joints. The musculoskeletal system provides stability and support so people can perform basic functions like sitting, standing, and walking. Problems in the musculoskeletal system like fibromyalgia, pelvic floor muscle tension, pelvic floor inflammation, pubic symphysis, or a hernia can lead to chronic pelvic pain.
Irritable Bowel Syndrome
Irritable bowel syndrome is a disorder that affects the large intestine and causes cramping, bloating, abdominal pain, and more. It is also one of the most common causes of pelvic pain. According to The International Foundation for Gastrointestinal Disorders, one-third of women with IBS also experience chronic pelvic pain.
If you or someone you love suffers from chronic pelvic pain, please reach out to the Georgia Vascular Institute. We have various locations across the Metro Atlanta area, including Stockbridge, Camp Creek, and Lithonia. Chronic pelvic pain is debilitating, but it is possible to find relief. Call us at (770) 506-4007 or contact us today!