Pelvic Congestion Syndrome (PCS)

At Sun Vein & Vascular, we offer effective, personalized care for women with Pelvic Congestion Syndrome. Chronic pelvic pain is a very common problem in the United States. It accounts for 10 to 15 percent of referrals to gynecologists and pain clinics. For some women, the cause of their pelvic pain is a condition known as Pelvic Congestion Syndrome (PCS). It may go undiagnosed simply because physicians are often unfamiliar with it or fail to look for it.

Many times, symptoms don't appear until a woman becomes pregnant, and then they continue after the pregnancy. The main symptom of PCS is pelvic pain. The pain typically worsens as the day goes on, especially for women who sit or stand all day, and then goes away after a night of sleep. Pelvic congestion syndrome occurs when varicose veins develop around the ovaries, similar to varicose veins that occur in the legs. Then:

  1. The valves in the veins no longer function normally,
  2. This causes blood to back up; and
  3. The veins become engorged or “congested,” which can be very painful.

The pain can also worsen:

  • During or following intercourse
  • Around menstrual periods
  • After certain physical activities, such as bicycling or horseback riding


The cause of PCS is unclear. However, the possibility of anatomic or hormonal abnormalities or dysfunction can contribute to the development of PCS. The majority of women who are affected are between the ages of 20 and 45 and with multiple previous pregnancies. One theory is that hormonal changes and weight gain along with anatomic changes in the pelvic structure during pregnancy can cause an increase of pressure within the ovarian veins. This may weaken the vein wall leading to dilatation. Estrogen also can weaken the vein walls, predisposing women to PCS.

What we do know is that in normal veins, blood flows from the pelvis up toward the heart in the ovarian vein and is prevented from flowing backward by valves within the vein. When the ovarian vein dilates, the valves do not close properly. This results in a backward flow of blood, also known as “reflux.” When this occurs, there is pooling of blood within the pelvis. This, in turn, leads to pelvic varicose veins and clinical symptoms of heaviness and pain.

Risk Factors

Most women with pelvic congestion syndrome are younger than age 45 and in their childbearing years. Certain factors can put a woman at higher risk for the condition, including:

  • Multiple(2 or more) pregnancies
  • Presence of a "tipped" (retroverted) uterus
  • Fullness of the leg veins
  • Polycystic ovaries
  • Hormonal increases or dysfunction

Treatment Options For Pelvic Congestion Syndrome (PCS)

There are several treatment options for pelvic congestion syndrome. Hormonal medications, prescribed by your gynecologist, can reduce blood flow and congestion of the varicose veins. If these are ineffective, then minimally invasive therapies may be considered such as nonsurgical embolization of the varicose veins. This is an outpatient procedure, in which a vascular surgeon inserts a small catheter (plastic tube) into a central vein in the upper arm, shoulder, or thigh and guides it to the problem area using imaging guidance. No incisions or stitches are required and there is no sensation inside while this is happening. Intravenous medications are all that is required for comfort and relaxation. The varicose veins are permanently sealed off from the inside. Patients typically return to work and light activities the following day, and to full activities in a week.

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Wednesday: 7:30am - 4:30pm
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