Experiencing painful, heavy periods? You might have varicose veins in the pelvic area
You lot may exist familiar with varicose veins in the legs – those pesky enlarged and swollen blood vessels that are often blueish, dark-green or dark majestic in advent.
But did you know yous can get varicose veins in your pelvic area, too?
Like the version seen in legs, these engorged veins in the lower belly are too created when an increased claret pressure blows out the tiny valves in the veins (valves are what let blood to menstruum up against gravity and back to your heart).
When that happens, the period is affected and blood starts to pool in the affected vein, leading to a condition known equally pelvic congestion syndrome (PCS).
READ: What causes h2o retentivity and how to deal with swollen ankles and fingers
If information technology sounds painful, it's because it is – some women who accept these pelvic varicose veins exercise indeed experience painful periods, revealed Dr Sriram Narayanan, a senior consultant equally well equally vascular and endovascular surgeon at Gleneagles Hospital's The Harley Street Middle and Vascular Centre.
WHY PCS IS DIFFICULT TO DETECT?
But it's non easy to find out if one is suffering from PCS. That's because the symptoms can be mistaken for a range of issues, from gynaecological to even gastrointestinal ones, such as the diarrhoea or constipation of irritable bowel syndrome, said Dr Narayanan.
Pelvic pain, heavy and/or prolonged periods and painful intercourse are as well some of PCS' symptoms but they tin merely as well be seen in patients with endometriosis, fibroids or ovarian cysts.
Furthermore, PCS can occur concurrently with ovarian cysts, which is some other reason it often takes several years before a patient is diagnosed, he added. "Some studies bespeak that around one-half of women with PCS have cystic changes on their ovaries."
The nature of the hurting caused by PCS varies widely, too. "It may be unilateral or bilateral; it can exist astute and astringent, or chronic and boring," said Dr Narayanan. The hurting is oft worse at the cease of the mean solar day or afterwards a long flow of standing.
That'due south not all. Inquiry has constitute that about 30 per cent to twoscore per cent of patients are without symptoms, said Dr Narayanan, adding that the vascular issue is sometimes but discovered when patients receive CT scans for other purposes.
And that is if the patient even sees a doctor to begin with. "Women put upwards with a lot of gynaecological issues, partly to avoid embarrassment, partly existence told by their mothers, grandmothers and even doctors that painful periods, uncomfortable or painful intercourse, and postal service-partum incontinence are only role of beingness a adult female," he said.
COULD Y'all BE SUFFERING FROM Information technology?
"As PCS is a chronic status, we would await a patient to have had pelvic pain for at least half dozen months and for her abdomen, especially in the surface area of her ovaries, to be tender," said Dr Narayanan.
Another important clue that a pelvic pain may exist due to PCS is if the patient has visible, surface varicose veins in the legs, peculiarly in the upper thigh or groin surface area, he said. "Those with varicose veins high up in the thighs, groin and vulvar region, and at the back of the thighs have a higher hazard of having PCS."
Your risk is also college if yous have given nascency. The pelvic veins get stretched during pregnancy and may non be able to regain their original shape and size later on childbirth, said Dr Narayanan.
"In most cases, varicose veins of the leg tend to improve in the months afterward delivery as may the veins in the pelvis. Still, in many others, the dilated veins persist both in the legs and in the pelvis," he said.
HOW IS THE Condition DIAGNOSED?
Near patients are referred to vascular specialists after the gynaecologist has ruled out potential issues with the reproductive system afterwards an ultrasound browse. "They may also take either ruled out hormonal and intrauterine therapies or tried them without success," said Dr Narayanan.
READ: Is heavy menstrual bleeding normal? And what does eating pineapple take to exercise with it?
He explained that the vascular team would conduct more ultrasound scans, which can consist of an abdominal scan and a pelvic browse done either transvaginally, or for unmarried patients, externally.
Fifty-fifty though these scans also use ultrasound like the gynaecologist'southward, vascular specialists would study the veins in the pelvis rather than the reproductive organs.
The legs' veins are too assessed equally such varicose veins can sometimes point to bug such as irksome blood flow, abnormally dilated veins or the rare Nutcracker syndrome, said Dr Narayanan.
If problems are detected, a catheter angiography may be used to examine the veins in greater detail. This involves inserting a thin catheter into an artery through an incision in the skin. A dye that's visible by Ten-ray is injected through the catheter into the blood vessels, and an 10-ray auto rapidly takes a serial of images or angiograms of the vessels.
An intravascular ultrasound or IVUS catheter is then used to deliver ultrasound probes to examine the walls of the veins, their sizes and the surrounding disease very precisely, said Dr Narayanan.
"The use of these catheters makes it possible to combine diagnosis and treatment in a single procedure. So, if the angiograms and IVUS confirm the problem indicated past the ultrasound, we can perform the treatment straight away as part of the aforementioned process."
It may take 1 or ii menstrual cycles for the process to be fully effective but after that, about patients are hurting-gratis.
WHAT ARE THE Treatment OPTIONS?
Dr Narayanan said that not all patients with PCS demand procedural intervention. Depending on the severity of the symptoms, the degree of claret pooling in the pelvis, and the stage of the woman'southward life, PCS may exist managed by simpler medical measures.
For instance, a gynaecologist might prescribe hormonal medications to reduce claret flow and congestion of the varicose veins.
READ: Dangerous myth: The extreme diet some women are on to stop their periods
When a process is needed, the near normally used is embolisation, said Dr Narayanan, which seals off or plugs upward the incompetent and dilated varicose veins, so that they are no longer engorged with blood, and cause pain and heavy periods.
If the trouble is a severe compression of the iliac vein (the large vein that drains blood from both the legs and the pelvis), a vein stent may be inserted into the vein to open information technology up, relieve the pressure level and improve the claret flow. "In very severe cases, patients may need both treatments, but such instances are rare," said Dr Narayanan.
He added that the pain acquired by PCS doesn't disappear immediately afterward the procedure. "Information technology may take one or two menstrual cycles for the procedure to be fully effective but after that, most patients are hurting-gratis."
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Source: https://cnalifestyle.channelnewsasia.com/wellness/painful-heavy-periods-varicose-veins-pelvic-area-236781
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