Women have unique health issues. Some of these unique health issues can include pregnancy, menopause, and conditions of the female organs. At the Metropolitan Vascular Institute, we specialize in treating some of the unique health conditions that can affect the female population.
Ovarian Vein Embolization (OVE) for Pelvic Congestion Syndrome
What are the symptoms?
Dull, aching pain is usually felt in the lower abdomen and lower back. You may experience:
- Deep pelvic pain when sitting or standing, worsening throughout the day
- Bulging veins on the vulva, buttocks or thighs
- Painful/irregular menstrual cycles
- Pain during/after intercourse
- Irritable bladder
Who’s at risk?
- Women less than 45 years old
- Women in their childbearing years
- Women who have had two or more pregnancies
- Women with hormonal dysfunction
- Women with polycystic ovaries
What is Pelvic Congestion Syndrome?
Pelvic congestion syndrome, also known as ovarian vein reflux, is the second leading cause of chronic pelvic pain in women, after endometriosis, and can potentially lead to significant disability resulting from the presence of varicose veins in the pelvis. Like varicose veins in the legs, pelvic congestion syndrome is related to malfunctioning valves within the pelvic veins. Valves in these pelvic veins normally allow blood to flow towards your heart. When the veins become weakened or the valves do not close properly, the blood can flow backward toward the pelvis. Blood in the weakened pelvic veins pools, causing the veins to bulge and push against nearby structures. This can result in pain and pressure in the uterus, ovaries, vulva and back. It is described as “non-cyclic” pain lasting greater than six months in duration. Diagnosis of the condition is done through one of several methods including; pelvic venography, magnetic resonance imaging (MRI) and pelvic and transvaginal ultrasound.
Chronic pelvic pain is very common in women and can potentially lead to significant disability. Approximately one out of every three women will suffer from pelvic pain at some point during their lifetime.
Diagnosing Pelvic Congestion:
The diagnosis is often missed because women lie down for a pelvic exam. This relieves pressure from the ovarian veins, so that the veins no longer bulge with blood, as they do while the woman is standing. Once other abnormalities or inflammation has been ruled out by a thorough pelvic exam, pelvic congestion syndrome can be diagnosed through several minimally invasive methods. These methods include MRI, pelvic ultrasound or transvaginal ultrasound.
What is Ovarian Vein Embolization?
Ovarian vein embolization (OVE) is a minimally invasive treatment for pelvic congestion syndrome that is used to close off faulty veins so they can no longer enlarge with blood, thus relieving the pain.
During this procedure, an interventional radiologist inserts a catheter into the jugular vein down into the faulty vein(s). Catheterization requires only a small nick in the skin for insertion and x-ray image guidance of the catheter to its target area. The catheter delivers Dacron filaments-bearing coils that clot the blood and seal the faulty vein. The use of the recently developed Sotradecol foam agent allows the radiologist to block even the smallest veins not previously accessible. The sealed off veins decompress and provide relief of pressure and painful symptoms.
The Importance of Blood Circulation
Blood circulation supplies the body with nutrients and oxygen and removes waste products. Together, the heart, arteries, and veins facilitate blood circulation. The heart pumps fresh, oxygen-rich blood throughout the body via the arteries. The veins channel oxygen-depleted blood back to the heart. Healthy veins are vital in maintaining good blood circulation in the body.
Veins and Valves
Valves inside the veins keep the blood moving back toward the heart. These valves prevent the force of gravity from pulling blood back down toward the feet.
When the veins are damaged, gravity will hinder normal blood flow causing blood to form pools in the weakened, damaged veins. The pooling blood causes these veins to enlarge. Twisted masses of veins beneath the surface of the skin, known as varicose veins, often result. Varicose veins are larger and located deeper in the leg than spider veins. Spider veins are small red, blue and purple veins on the surface near the skin.
Effect of Pregnancy on the Venous System
During pregnancy, many hormonal changes occur in the body that has a profound effect on the veins. Blood volume increases between 40% to 50%, while increased amounts of progesterone cause the vein walls to dilate and become less elastic.
The pressure of the fetal head in the pelvis can compress the iliac veins and obstruct venous outflow from the legs. As the baby grows, the uterus enlarges and applies pressure on important veins that return blood to the heart. This pressure can cause a slowing of the blood flow and valve damage, resulting in swelling, leg discomfort, and even varicose veins. A pregnant woman’s feet and legs may start to swell after sitting or standing for only a short time. In principle, this is a completely normal symptom. However, if your feet are already swollen when you get up in the morning, consult your doctor. While these symptoms may subside after delivery, with each subsequent pregnancy, they are less likely to completely disappear.
Pregnancy and Deep Vein Thrombosis (DVT)
Women who are pregnant are at a high risk for the development of a Deep Vein Thrombosis, known as DVT. One reason is due to the increased blood volume at full term.
Additionally, pregnancy causes hormonal changes that increase blood coagulability, a measure of how easily blood clots. The expanding uterus puts pressure on blood vessels, restricting blood flow from the legs and pelvis back to the heart.
Slower blood flow increases the risk of Deep Vein Thrombosis. The risk continues during the postpartum period until the woman’s hormonal levels return to their pre-pregnancy state.
Common Leg Health Problems During Pregnancy
Venous disorders and leg health problems are among the most frequent medical conditions in North America. You may experience these conditions for the first time during pregnancy. For example, swollen feet, tired aching legs and a feeling of heaviness in the legs are among everyday symptoms that pregnant women may experience.
These symptoms are especially frequent when:
- a history of varicose veins and venous disease exists in the family
- a venous condition was already present before the pregnancy
- the woman sits and stands for prolonged periods of time while pregnant
- the woman does not exercise regularly during the pregnancy, or
- the woman has had more than one pregnancy
Pregnancy plays a role in the development of varicose veins. 30% of women pregnant for the first time, and 55% of women who have had two or more full-term pregnancies develop varicose veins.
Request An Appointment Today
Metropolitan Vascular Institute is proud to provide professional vein treatment care in a friendly environment. Call our Waldorf, MD office at (301) 374-8540 to schedule your women's health visit, or click here to send us an appointment request form. Our experienced providers look forward to serving you!