What Is Pelvic Congestion Syndrome?

Pelvic congestion syndrome is a condition that causes ongoing pain in the lower abdomen or pelvis. It happens when veins in the pelvic area become enlarged and blood does not flow properly back to the heart.

Over time, pressure can build inside these veins, leading to discomfort and other symptoms. The condition is most common in women during their childbearing years, especially after multiple pregnancies.

Pregnancy can increase the risk of pelvic congestion syndrome because pelvic veins stretch to handle increased blood flow. Hormones such as estrogen may also weaken or widen veins. Family history and multiple pregnancies may raise the risk as well.

Symptoms

The main symptom of pelvic congestion syndrome is long-lasting pelvic pain. The pain may come and go or gradually become more noticeable over time.

Symptoms may include:

• Dull, aching, or heavy pelvic pain
• Pain that worsens after standing for long periods
• Discomfort during or after sex
• Pelvic pain around menstrual periods
• Lower back pain
• A feeling of pressure or fullness in the pelvis
• Visible varicose veins around the thighs, buttocks, or vulva
• Sudden urge to urinate

How Is It Diagnosed?

Pelvic congestion syndrome can be difficult to diagnose because many conditions can cause pelvic pain. Your healthcare provider will review your symptoms, medical history, and perform a physical and pelvic exam.

Imaging tests are often used to look at blood flow and pelvic veins. These may include:

• Pelvic ultrasound
• Doppler ultrasound
• CT scan
• MRI
• Venography

Additional tests may help rule out other causes of chronic pelvic pain.

How Is It Treated?

Treatment depends on the severity of symptoms and your overall health. Providers often begin with medications to help reduce pain and manage hormone-related changes.

Other treatment options may include:

• Hormone therapy
• Vein embolization
• Sclerotherapy
• Pain management strategies
• Surgery for severe cases

Many people experience symptom relief after minimally invasive procedures that block damaged veins. Your provider will work with you to determine the treatment approach that best fits your needs.