Medical treatment for pelvic congestion syndrome with flavonoid: A pilot study

To investigate the efficacy of medical management by flavonoid in women with pelvic congestion syndrome (PCS) by comparison of the changes in venous size and quality of life (QoL) before and after treatment.

Eleven women who met the diagnostic criteria of PCS were enrolled in the study. Flavonoid 500 mg twice or 1000 mg once daily was prescribed. Objective outcome was evaluated by measurement of ovarian vein diameter via transvaginal ultrasound in each case before and after 3-6 months of the treatment. PCS related symptoms were evaluated by Pelvic Varicose Vein Questionnaire (PVVQ), and Visual Analog Scale (VAS) as subjective outcomes. Wilcoxon signed rank test was used to compare the differences pre- and post-treatment. Data analysis was performed using SPSS 22.0. Statistical significance was defined as P value < 0.05.

From January 2022 to September 2023, 11 women met the criteria and were diagnosed with pelvic congestion syndrome. The age ranged from 40 to 72 years old with mean of 57 y/o. 90.9 % of the subjects (10/11) reported significant decreases in VAS (mean = 5.9 pre-vs. 2.5 post-treatment, p = 0.005) and PVVQ (mean = 51.6 pre-vs. 30.5 post-treatment, p = 0.005). Transvaginal ultrasound also showed significant decreases in ovarian vein diameter, from 8.1 mm to 6.2 mm (p = 0.016).

Our study demonstrated that medical treatment with flavonoids significantly reduced of ovarian venous diameter in patients with pelvic congestion syndrome. Additionally, the impaired quality of life was markedly improved proven by the significant decreases of PVVQ and VAS scores following treatment. Based on these findings, we suggest that flavonoids may be considered as first-line treatment for patients with pelvic congestion syndrome in routine clinical practice.