This past Friday I saw 2 patients who had Pelvic Congestion Syndrome. Both of them females complained about how it took at least 5 years to get diagnosed because this isn't a pathology that gets a lot of attention and many medical professionals and thus it ends up being a

diagnosis of exclusion. Women of childbearing age who have had more than one pregnancy may have the highest risk of pelvic congestion syndrome. It basically presents as a chronic pelvic pain. One patient couldn't even sit or lay down and everything beneath her pelvis was swollen

and inflammed.The characteristic severe dull aching pain of PCS is thought to be a direct result of the presence of ovarian and pelvic varicosities, much like the leg pain resulting from lower extremity varicose veins.

The majority of women affected are premenopausal, and a relationship between PCS and endogenous estrogen levels is suggested, as estrogen is known to weaken the vein walls.Additionally, the left ovarian vein and the left renal vein may by compressed

by the superior mesenteric artery (Nutcracker syndrome) as well. Finally, compression from the right common iliac artery on the left common iliac vein against the spine and pelvic brim is known to cause iliofemoral dvt(May–Thurner syndrome) as well as the pelvic varices of PCS