Chronic pelvic pain affects millions of women worldwide, yet many suffer in silence without a clear diagnosis. One often overlooked cause is pelvic congestion syndrome (PCS), a condition linked to varicose veins in the pelvis that can cause debilitating discomfort. At the Vascular and Interventional Centre, we are committed to shedding light on this complex condition and offering effective solutions.

What Is Pelvic Congestion Syndrome?

Pelvic congestion syndrome occurs when veins in the lower abdomen, particularly around the ovaries and uterus, become swollen and fail to return to their normal size after pregnancy or due to valve dysfunction. This leads to blood pooling and increased pressure in these veins, causing chronic pelvic pain that can last for months or even years57.

Imagine varicose veins, but instead of the legs, these are in the pelvis—hence the term congested pelvic veins. The condition primarily affects women of childbearing age, especially those who have had two or more pregnancies. It can also contribute to varicose veins in the legs and perineal area, linking pelvic vein insufficiency with symptoms beyond the pelvis itself.

Symptoms to Watch For

Symptoms of pelvic congestion syndrome vary widely but often include:

• A dull, aching pain or heaviness in the pelvic area and lower back that can worsen after prolonged standing or during menstruation
• Pain during or after sexual intercourse (post-coital pain)
• Visible varicose veins on the vulva, buttocks, or upper thighs
• Irregular and painful periods
• Lower back pain and discomfort
• Occasionally, associated hemorrhoids or bladder irritation

If you experience persistent pelvic pain that disrupts daily life, it’s crucial to consider PCS as a possible cause.

Diagnosing Pelvic Congestion Syndrome

Diagnosing PCS can be challenging because pelvic pain has many potential causes. A thorough evaluation often includes:

• Pelvic ultrasound and Doppler studies to assess blood flow
• MRI or MR venography to visualize the size and distribution of pelvic varices accurately
• Diagnostic laparoscopy to rule out other pelvic conditions

At our centre, we emphasize a multidisciplinary approach involving gynecologists, radiologists, and pain specialists to ensure an accurate diagnosis.

Treatment Options: Relief Is Within Reach

Treatment for pelvic congestion syndrome ranges from conservative to minimally invasive procedures:

• Medication: Anti-inflammatory drugs and hormonal treatments such as progestins or GnRH agonists can help alleviate symptoms temporarily.
• Alternative Therapies: Acupuncture and physical therapy may provide additional symptom relief.
• Interventional Radiology: The gold standard for many patients is percutaneous transcatheter pelvic vein embolisation. This minimally invasive procedure involves inserting a catheter through a vein in the groin to block off the problematic veins using coils and sclerosants. The result? Reduced venous pressure and significant pain relief without surgery.
• Surgical Options: In severe or refractory cases, surgical removal of affected veins or even hysterectomy may be considered, though these are less common today7.

Patients undergoing embolization report symptom improvement in up to 92% of cases, with an 80% success rate in pain reduction—truly remarkable outcomes that restore quality of life.

Why Early Intervention Matters

Ignoring pelvic congestion syndrome can lead to worsening symptoms and complications like varicose veins in the legs or chronic pelvic venous insufficiency. Early diagnosis and treatment can prevent these sequelae and improve fertility outcomes for women planning pregnancy.

Final Thoughts

If you or someone you know is struggling with unexplained pelvic pain, don’t wait. Pelvic congestion syndrome is a treatable condition once properly identified. At the Vascular and Interventional Centre, we combine cutting-edge diagnostics with expert interventional care to tackle pelvic congestion syndrome head-on.