Of course, there can be many other causes of abnormally heavy periods. Most of these are quite well known and include fibroids, endometriosis, pelvic inflammatory disease and other gynaecological problems.
However, although PCS is relatively common in the UK, it is often either forgotten about or ignored by general practitioners and gynaecologists.
Hence it is pleasing that one week after the BBC ran an article on pelvic congestion syndrome, The Sun newspaper has also featured PCS as a cause of heavy periods.
We do not know exactly why PCS can cause heavy periods.
At the most simple level, we know that PCS is a way of saying “pelvic varicose veins”. Just as with varicose veins in the legs, this means that blood pools in large dilated veins.
In the pelvis, blood flows through the arteries to the ovaries and uterus. Once it has given up oxygen and food, it picks up the waste products of metabolism. Now it is called venous blood and it should be taken back to the heart and away from the pelvic organs.
In PCS, the pelvic veins do not work properly, due to the valves failing in the veins. This stops blood flowing back up to the heart, allowing it to “reflux” back into the pelvic veins.
Not surprisingly, these veins dilate and the blood pools in the veins. When blood does not move much it is called “venous stasis”.
Venous stasis causes inflammation in the walls of the veins. This can cause discomfort but it is also possible the combination of high volumes of blood and inflammation in the lining of the womb could increase blood flow during a period.
However, as blood flow to the ovaries is also adversely affected by venous stasis, it is quite possible that it might be a hormonal effect due to the ovaries being inefficient.
Most patients with PCS can be cured by pelvic vein embolisation (PVE).
Platinum coils can be inserted into the pelvic varicose veins under local anaesthetic. These block the abnormal veins, whilst allowing blood to continue to flow normally up the veins that are working.
For a more in-depth understanding of PCS, please see the book “Pelvic congestion syndrome – chronic pelvic pain and pelvic venous disorders“.