Varicose veins in our body are not just localized on the feet. The pelvic area is another place where varicose veins can also occur. The pathological condition, in which there are dilated veins in the small pelvis, usually occurs in women and is accompanied by discomfort and intermittent painful pain in the lower abdomen. In men, pelvic varicose veins also occur, but this is mainly manifested by dilation of the veins in the sperm (varicocele). This pathological process can be accompanied by an uncomfortable feeling in men, the difficulty of the scrotum, and the pain of intimacy.
According to statistics, pelvic varicose veins, also known as chronic pelvic pain syndrome, occur mainly in young women between the ages of 18 and 48 years. As the age progresses, the number of patients with this disease multiplies. The statistics are disappointing. Thus, at the age of 18–19, pelvic varicose veins are seen in 15–18% of women, and by the age of 48, their number is increasing to 70–80%.
Causes of pelvic varicose veins
The first cause is physical inactivity. This includes the specificity of the patient's work, "sitting" or "standing". Due to a person’s prolonged orthostasis, venous outflow is disrupted, leading to pelvic congestion. In pathologically dilated veins, the valves no longer adhere tightly to each other, a gap is formed between the valves and blood flows under the influence of gravity. In such veins, the blood thickens and this can lead to thrombosis.
The second reason is pregnancy. During pregnancy, the uterus grows, starting to suppress the underlying veins. During pregnancy, the hormonal background also changes, increasing the amount of circulating blood in the pelvis.
But to reassure women preparing for conception and pregnancy, such varicoses do not pose an immediate danger. In the case of pelvic varicose veins, childbirth is usually not observed. Unpleasant moment - in 30-40% of pregnant women, the veins of the vulva and perineum become enlarged. But we must remember that immediately after childbirth, these veins shrink significantly and disappear completely after a year. Postpartum varicose veins remain in only 2-6% of patients.
The third reason is the presence of various gynecological pathologies that are treated with hormonal drugs.
The fourth reason is smoking. Smoking is very dangerous while taking hormonal contraceptives. Smoking thickens the blood just as much as hormonal contraceptives. Hence the many ridiculous accidents known in medicine in which girls taking hormonal contraceptives died of thrombosis.
The fifth cause is obesity. In case of overweight, the load on the pots increases significantly.
The sixth reason is the ecological situation of the region of residence, air pollution in cities, especially in large cities, increases the risk of developing varicose veins.
The main symptoms of pelvic varicose veins
- painful periods;
- recurrent pain in the lower abdomen as well as in the pelvic area radiating to the sacrum, lower back, the barrier;
- pain and discomfort in the vulva or vagina during and after intimacy;
- copious mucous secretions from the vagina, usually in the second half of the menstrual cycle;
- visible dilation of venous blood vessels in the genital area of the groin. "Stars", "mesh" on the buttocks and back of the thighs.
What to do if you have symptoms of pelvic varicose veins?
If you find all of the above within yourself, do not delay your visit to the doctor, otherwise any complications will not wait long.
The first doctor you need to see is a gynecologist.
It will perform an investigation, selecting all the required investigations. All pelvic varicose veins are suspected and are subjected to an ultrasound examination of the abdominal organs.
The patient is referred to a phlebologist to clarify the diagnosis. Ultrasound duplex scanning (USDG) of the veins in the lower extremities is performed, allowing you to get a complete picture of the venous outflow.
In severe cases, the phlebologist may prescribe additional test methods (CT, MRI, or diagnostic laparoscopy). These tests are sufficient to make an accurate diagnosis and determine the extent of the disease.
The rate of return in the pelvis
- 1 degree - the veins of the small pelvis are up to 5 mm in diameter (damage to any venous plexus of the small pelvis is observed), the course of the vessel already gives a curvy appearance;
- 2 degrees - the size of the veins is 6-10 mm; ultrasound varicose veins are all visible throughout the pelvis and may affect only the ovarian plexus, or the veins of the uterus, or the veins of the myometrium;
- Grade 3 is all varicose veins in the pelvis, with varicose veins exceeding 10-12 mm in diameter.
How to treat pelvic varicose veins?
Non-pharmacological treatments
- Fight against hypodynamics. If the work involves a long sitting or standing position, warm up after 1-1, 5 hours;
- Quitting smoking, quitting alcohol (especially if you are pregnant! );
- Wearing compression underwear (stockings, stockings) to improve venous outflow of the lower extremities;
- Wearing comfortable shoes, avoiding high heels;
- Diet (exclusion from the salty, spicy, fried diet). Salty foods always retain fluid in the body, which leads to edema, an increase in blood pressure - thus impairing the flow of blood through the veins. It should contain more fiber in the diet (fruits, vegetables, herbs);
- Contrast shower (especially in the thigh, perineum, lower abdomen);
- Physiotherapy and breathing exercises.
Drug treatment
- Phlebotonics - improving the tone of varicose veins, reducing their permeability;
- Horse chestnut extract - to relieve inflammation and swelling;
- Troxerutin - improves blood outflow from varicose veins, increases venous tone, reduces inflammation and edema;
- Vitamin C - strengthens the walls of blood vessels, reduces their fragility.
Venous gels and ointments are not used to treat pelvic varicose veins due to the internal location of the affected veins.
Doctors recommend a mandatory combination of medication by wearing compression stockings (stockings, stockings). Compression clothing is especially needed during pregnancy.
Surgery
Surgery is an extreme measure that is used when medical correction is impossible and ineffective, and the disease is very advanced and can cause a number of complications.
Different techniques are used depending on the incidence, location, and diameter of the abnormal veins. In the event that surgery is required, the choice of type of surgical assistance is individual, as it all depends on localization and prevalence.