II. Risks

  1. Multiparous women

III. Pathophysiology

  1. Pelvic vein varicosities with congested pelvic organs

IV. Symptoms

  1. Pelvic Pain provocative factors
    1. Premenstrual timing
    2. Fatigue
    3. Standing
    4. Intercourse
  2. Menorrhagia
  3. Urinary Frequency

V. Signs: Uterus Exam

  1. Uterus Mobile
  2. Retroverted Uterus
  3. Uterus Soft, boggy, slightly enlarged

VI. Diagnosis

  1. Dilated veins on venography

VII. Management

  1. Intravenous Vasoconstrictor
  2. Medroxyprogesterone acetate
  3. Psychotherapy in combination with above

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