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Dear Alice,
Is pelvic congestion a real and serious problem or just an easy answer for doctors who can't find another answer?
Dear Reader,
"Pelvic congestion" is not an easy answer for health care providers, since so many have different opinions concerning it.
When women are sexually aroused, they experience some degree of pelvic congestion caused by an increase of blood flow to the vagina and vulva. This congestion, which is normal and temporary, is usually relieved by orgasm. If a woman does not orgasm, the congestion subsides, but more slowly.
Pelvic congestion can also be associated with unexplained pelvic symptoms that are uncomfortable, and even painful. Pelvic congestion, primarily affecting premenopausal women, is not considered a disease, but a medical condition that describes a transient state related to the phase before menstruation occurs. Pelvic congestion syndrome is a collection of symptoms, including chronic pelvic discomfort or pain and pelvic congestion itself.
While some women with pelvic congestion are symptom-free, others feel mild discomfort to debilitating pain within all of the structures in the pelvis, including the pelvic muscles and ligaments, uterus, ovaries, and/or vulva. Pelvic congestion can be marked by consistent lower abdominal pain that worsens during menstruation, lower back pain, and/or other symptoms often associated with PMS (premenstrual syndrome). The pain can be chronic, occurring while standing or menstruating, or it can occur during or after vaginal penetration, making sexual activity problematic, unpleasant, or impossible.
The term "pelvic congestion" is sometimes misused as a universal explanation for unexplained pelvic symptoms, when more serious gynecological problems are the cause and are thereby undiagnosed. A diagnosis of pelvic congestion is considered after other gynecological conditions, such as endometriosis, pelvic inflammatory disease, or ovarian or uterine abnormalities, are ruled out. However, diagnosing pelvic congestion by means of exclusion can be frustrating for women, as you mention in your query. That's why it's a good idea to get a second opinion, after a thorough evaluation, from a gynecologist or a women's health care nurse practitioner.
If pelvic congestion appears to be the most likely explanation for chronic pelvic discomfort or pain, the most basic and recommended treatment is to take over-the-counter naproxen sodium or ibuprofren to alleviate the symptoms. If pelvic congestion symptoms are still problematic, other treatment options can be explored with a health care provider or gynecologist.
Yes, unexplained intermittent or chronic discomfort or pain in the pelvic area is unpleasant and/or frustrating. If a health care provider is unable to identify the cause, or if the diagnosis doesn't seem right, it's important to get a second opinion. The provider needs to evaluate the symptoms to make sure that something more serious is not to blame. Seeking the care and expertise of a health care provider who is knowledgeable and supportive can be reassuring and helpful at remedying the matter.
