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Chronic pain is never a pleasant experience, but the causes of chronic pain are many and varied. If you are one of the 33% of women that experience chronic pelvic pain, it could be due to Pelvic Congestion Syndrome (PCS).

PCS is often connected to varicose veins located in the ovaries or pelvic region. It is often overlooked during checkups because when a woman lies flat, it relieves the pressure on the bulging veins and they do not appear to bulge as much. There are several risk factors that increase the likelihood of PCS, but there are also treatment options available.

Risks, Causes, and Factors

  • Multiple pregnancies and increases in hormonal activity
  • Hormonal dysfunction
  • Polycystic Ovaries
  • Women under 45 in childbearing years
  • Previous pregnancies


  • Dull, aching pain in the lower abdomen or back. Pain may increase after intercourse, during menstruation, toward the end of the day (especially while standing), or during pregnancy.
  • Irritable bladder issues.
  • Abnormal menstruation cycles.
  • Varicose veins in the pelvic region, buttocks, or thighs.


  • MRI – A non-invasive method to detect venous abnormalities. There is a specific method for detection by MRI that differs from standard MRI procedures.
  • Pelvic Ultrasound – Unlike typical ultrasounds, the patient needs to stand for this detection method to be effective. It is more commonly used to rule out other pelvic pain causes.
  • Transvaginal Ultrasound – Like the pelvic ultrasound, this test needs to be conducted while standing. It is also used to rule out other causes.
  • Pelvic Venography – This method is the most accurate for detection and involves injecting a contract dye into the pelvic veins. This dye shows up well on subsequent x-rays and allows medical staff to find the hidden varicose veins.


  • Embolization – Embolization is a minimally invasive procedure that uses radiologic imaging to locate and repair damaged veins. It is an outpatient procedure that involves inserting a spaghetti strand sized catheter into the femoral or jugular vein in the groin. Using x-ray imaging for guidance, the catheter is moved to the affected vein. Upon reaching its destination, a radiologist inserts tiny metal coils and a sclerosing agent, which causes the vein to close itself. Once the vein is closed, blood will flow through other, healthy veins and the affected vein will shrink.
  • Hormonal – Birth control pills can decrease hormonal levels and adjust menstrual cycles, which may alleviate the pain.
  • Surgery – A hysterectomy may be performed, depending on the severity of issues. This involves removing the ovaries, and tying off or removing the affected veins.

Over 95% of cases where embolization is used are successful in alleviating symptoms, but they may return or require further treatments. Consult a vein specialist if you think you may be experiencing symptoms of Pelvic Congestions Syndrome so that a proper evaluation can be performed.