Vascular Conditions

Pelvic Congestion Syndrome

A common problem in the United States, chronic pelvic pain accounts for 10 to 15 percent of referrals to pain clinics and gynecologists. For some women, this pain stems from a condition known as pelvic congestion syndrome, or PCS, which unfortunately often goes undiagnosed.


Pelvic pain is the main symptom of PVS and often does not appear until a woman becomes pregnant. The pain continues after pregnancy and typically worsens as the day goes on, especially in women who sit or stand for much of the day. In addition, pain can worsen during or after intercourse, around menstrual cycles, and after certain activities such as horseback riding or bicycling.

Symptoms will subside after long periods of rest, like a long night’s sleep, for instance.


Pelvic congestion syndrome is a condition that occurs when varicose veins develop around the ovaries, similar to the varicose veins that form in legs. When this happens, the valves in the veins no longer function normally, causing blood to back up and the vein to become engorged or “congested.” This can result in a great deal of pain.


When women have pelvic pain but a pelvic examination does not reveal any abnormalities or swelling, pelvic congestion syndrome may be diagnosed. If suspected, ultrasonography can help identify the condition. However, other imaging tests or procedures may be needed to confirm the diagnosis. These include:

  • Venography (x-rays taken after dye is injected into a vein in the groin)
  • Computed tomography (CT)
  • Magnetic resonance imaging (MRI)
  • Magnetic resonance venography

If pain is chronic or severe, and the cause cannot be identified, laparoscopy is typically performed. This procedure entails a small incision made just below the navel and a viewing tube inserted to directly view the pelvic structures.


Fortunately, there are ways to treat PCS, including hormonal medications, and embolization, which is a minimally invasive procedure that uses a catheter to “plug” the varicose vein.