incredible-marketing Arrow

Diagnosis / Pelvic Congestion Syndrome

Pelvic congestion syndrome (PCS) is a chronic condition caused by engorged veins in the pelvis. PCS occurs when varicose veins develop around your ovaries – similar to the varicose veins that occur in the legs. Varicose veins are veins where the valves that keep blood flowing properly have weakened, allowing the blood to backflow and pool. This pooling stretches the vein walls, resulting in thick, ropy veins that can cause pain and other symptoms. Besides being a source of pain and discomfort, varicose veins are a sign of other insufficiencies in your venous system, so it is important to seek treatment.

Many women in the United States suffer from chronic, sometimes debilitating pelvic pain. In fact, nearly ten to fifteen percent of referrals to gynecologists are because a woman is seeking answers to her long-term pelvic pain. For some women, PCS may be the root of their discomfort, however, some cases go undiagnosed because doctors aren’t familiar with the condition or don’t think to look for it.

Symptoms of Pelvic Congestion

Varicose veins in the pelvis affect up to fifteen percent of women who are of childbearing age, but many are unaware of the condition because they have no symptoms. PCS often develops during and after pregnancy, due to the increased pressure on the pelvis. Many women may not experience symptoms at all until they become pregnant, and then continue to suffer from pain following their pregnancy.

Pain is the most common and noticeable symptom of pelvic congestion syndrome, and it tends to worsen as the day goes on (after you’ve been sitting or standing for long periods of time). It may be most noticeable in your lower back, and can be a dull ache, or a sharp, throbbing sensation. The pain is most often relieved by lying down. Other symptoms of PCS include:

  • Abnormal vaginal bleeding
  • Clear or watery vaginal discharge
  • Abdominal bloating
  • Headaches
  • Fatigue
  • Mood swings
  • Increased pain after intercourse or physical activity, or before or during your period

Causes of Pelvic Congestion Syndrome

The cause of pelvic congestion syndrome is not known, although doctors theorize that hormonal changes, as well as changes in the structure of the pelvis during pregnancy may be factors. Most women who suffer from PCS are between the ages of 20 to 45, and have been pregnant at least once. Weight gain is a factor in varicose veins in the legs, so it may also contribute to developing congestion in pelvic veins as well. Estrogen, though a naturally occurring hormone, is thought to weaken vein walls, adding to the chances of a woman developing PCS.

Diagnosis and Treatment

If you are experiencing chronic pelvic pain, and a pelvic examination does not show any abnormalities, your doctor may want to test for pelvic congestion syndrome. Ultrasound is the most common diagnostic scan, though your doctor may want to confirm the diagnosis using a CT scan, MRI, or venography (an x-ray taken after dye is injected into the veins).

Treating varicose veins in the pelvis may involve one or more of the following procedures:

  • Embolization – a catheter is placed directly into the varicose veins, and tiny coils or plugs are injected to block the blood flow in the vein. The varicose vein closes off, and the blood reroutes itself into a healthy vein.
  • Sclerotherapy – Similar to embolization, sclerotherapy involves a catheter placed in the varicose vein. Sclerosant (a solution that irritates the vein walls) is injected, damaging the vein and causing it to close off. Again, once the vein is sealed, the blood reroutes itself to a healthy vein.

Most patients find that treatment of varicose veins in the pelvis results in the elimination of or a significant decrease in pelvic pain and other PCS symptoms.

If you have been diagnosed with pelvic congestion syndrome, call IVC today at 503-612-0498 to schedule an appointment with one of our team of experienced and professional interventional radiologists. You can also read our brochure on Uterine Fibroids & Pelvic Congestion.

What Our Patients Are Saying

Read More

We are announcing that Interventional and Vascular Consultants will be closing as of March 10, 2023.

We would like to thank you for the trust you have given us over the years, participating in your healthcare needs has been a privilege.

To assist in a smooth transition to a new provider, you may access your records from your MyHealth account or request a copy of medical records by clicking the link below and completing the Release of Information form.

Medical Records Release Form

Please know that we have greatly valued our relationship with you and wish you the best.


Jason Bauer, MD RVT
Michael Pfister, MD RVT

This will close in 0 seconds