Pelvic Congestion Syndrome

There are a variety of causes of chronic pelvic pain, but for some women it may be caused by varicose veins in the pelvic region, a condition known as pelvic congestion syndrome.

Varicose veins in the pelvis develop when valves in the veins become weak and don’t close properly. This allows blood to flow backwards and pool in the vein, causing bulging and pain.

Symptoms of Pelvic Congestion Syndrome

Women with pelvic congestion syndrome typically feel pain while standing but not when lying down. Other symptoms include:

• A dull, aching pain in the lower abdomen and lower back that comes after intercourse, during their menstrual cycles, after standing and during pregnancy
• Related signs include an irritable bladder, abnormal menstrual bleeding, vaginal discharge or visible varicose veins on the vulva, buttocks or thighs

Diagnosis and Treatment of Pelvic Congestion Syndrome

Doctors can diagnose pelvic congestion syndrome using the following tests:

• Pelvic Venography: Interventional radiologists perform a venogram by injecting dye into the veins of the pelvic organs to make them visible during an X-ray. Patients are examined on an incline because the veins being examined often decrease in size when a woman is lying flat.
• Magnetic Resonance Imaging (MRI): Images that provide a detailed view of specific pelvic blood vessels can be used to diagnose this condition.
• Pelvic and/or Transvaginal Ultrasound: Provides views of the pelvic cavity and veins (not effective unless the woman is standing for the test).

Treatment often consists of an outpatient procedure to close off varicose veins in the pelvic area. Although pain is reduced, the veins return to normal, and in some cases other pelvic veins may be affected and may require additional treatment.