Pelvic Congestion Syndrome (PCS) is a common but often overlooked cause of chronic pelvic pain in women, affecting those who experience persistent discomfort that worsens with standing or prolonged activity. This condition results from enlarged, dysfunctional veins in the pelvis, which create pressure, pain, and circulation issues. PCS is frequently misdiagnosed, leaving many women struggling with undiagnosed pain, heavy menstrual cycles, and lower abdominal discomfort for years.
At Vascular Surgery Associates, our top vascular specialists in Los Angeles and Santa Monica provide advanced diagnostic imaging and minimally invasive treatments to relieve pain and restore normal blood flow, helping women regain comfort and quality of life.
Understanding Pelvic Congestion Syndrome – A Hidden Cause of Chronic Pain
Pelvic Congestion Syndrome occurs when veins in the pelvis become enlarged and fail to circulate blood efficiently, leading to pain, pressure, and swelling in the lower abdomen, lower back, and pelvic region. These veins–known as pelvic varicose veins–function similarly to varicose veins in the legs, with weakened vein walls that cause blood to pool instead of flowing normally back to the heart.
Studies show that PCS accounts for nearly 30% of all chronic pelvic pain cases in women and is most commonly diagnosed in those between the ages of 20 and 45. Many women suffer for years before receiving an accurate diagnosis, as symptoms are often confused with gynecological or musculoskeletal disorders.
Signs & Symptoms of Pelvic Congestion Syndrome – When to Seek Treatment
PCS symptoms can vary in severity, with many women noticing worsening discomfort after long periods of standing or sitting. The most common signs include:
- Chronic pelvic pain lasting more than six months
- Dull, aching pain that worsens at the end of the day or after prolonged activity
- Pain that intensifies during menstruation, intercourse, or pregnancy
- Visible varicose veins in the buttocks, thighs, or vaginal area
- Lower back pain and leg heaviness associated with standing for long periods
- Frequent urination or increased bladder pressure
Women with PCS often experience relief when lying down, as this reduces venous pressure in the pelvic region. If these symptoms sound familiar, a vascular evaluation is essential to determine the underlying cause.
What Causes Pelvic Congestion Syndrome?
Several factors contribute to the development of Pelvic Congestion Syndrome, including hormonal influences, pregnancy, and vein dysfunction. Common causes and risk factors include:
Pregnancy and Childbirth
Increased blood flow, weight gain, and hormonal changes during pregnancy weaken vein walls and valves, leading to chronic venous insufficiency in the pelvis
Hormonal Changes
Estrogen causes veins to dilate, making women more prone to PCS symptoms
Family History of Varicose Veins
Women with a history of leg varicose veins or venous disorders are more likely to develop pelvic vein insufficiency
Polycystic Ovary Syndrome (PCOS)
Hormonal imbalances and enlarged ovaries may contribute to pelvic vein congestion
Multiple Pregnancies
The more pregnancies a woman has, the higher her risk of developing weakened or enlarged pelvic veins
Understanding these underlying causes allows for earlier detection and treatment, preventing long-term discomfort.
How is Pelvic Congestion Syndrome Diagnosed?
Because PCS symptoms mimic other conditions, proper diagnosis is essential to rule out gynecological, urological, and musculoskeletal disorders. At Vascular Surgery Associates, our specialists use advanced imaging techniques to assess pelvic vein function and confirm the presence of enlarged or dysfunctional veins.
Pelvic Ultrasound
Detects abnormally enlarged pelvic veins and evaluates blood flow patterns
CT or MR Venography
Provides detailed imaging of the pelvic veins, identifying areas of congestion and insufficiency
Doppler Ultrasound
Measures blood flow velocity and identifies venous reflux (backward flow of blood)
Intravascular Ultrasound (IVUS)
A catheter-based technique that allows real-time assessment of pelvic veins from inside the vessels
An accurate diagnosis is the first step in relieving chronic pelvic pain and restoring proper circulation.
Advanced Treatment Options for Pelvic Congestion Syndrome
At Vascular Surgery Associates, we offer minimally invasive, highly effective treatments to eliminate pelvic vein congestion and restore normal blood flow, relieving chronic pelvic pain and discomfort.
Pelvic Vein Embolization – A Permanent Solution for PCS
Pelvic Vein Embolization (PVE) is the gold standard for treating Pelvic Congestion Syndrome. This minimally invasive, outpatient procedure effectively closes off abnormal veins, redirecting blood flow to healthy, functional veins.
- A catheter is inserted into the affected pelvic vein through a small puncture
- A specialized embolic agent (such as coils or sclerosing foam) is delivered to block the abnormal vein
- Blood flow is rerouted, reducing venous pressure and relieving pain
- Patients can return home the same day with minimal downtime
Clinical studies show that 80-95% of women experience long-term symptom relief after pelvic vein embolization, making it an effective and safe alternative to surgery.
Lifestyle Modifications and Supportive Therapies
In addition to medical procedures, certain lifestyle changes can help manage symptoms and improve overall vein health. These include:
- Regular exercise to promote circulation and reduce venous pressure
- Compression garments for support and symptom relief
- Avoiding prolonged sitting or standing to prevent blood pooling in the pelvic region
- Maintaining a healthy weight to reduce pressure on the pelvic veins
With a combination of medical treatment and lifestyle adjustments, most women experience significant improvements in daily comfort and quality of life.
Frequently Asked Questions About Pelvic Congestion Syndrome
PCS is not life-threatening, but it can significantly impact quality of life and daily comfort. Without treatment, pain and venous dysfunction may worsen over time.
Most women return to normal activities within a few days, with full recovery typically within two weeks.
Pelvic vein embolization provides long-lasting relief, but follow-up care is essential to monitor vein health. In rare cases, additional treatment may be needed.
There is no strong evidence linking PCS to infertility, but some women experience increased discomfort during pregnancy due to pelvic vein congestion.
If you have chronic pelvic pain lasting more than six months, leg heaviness, or visible varicose veins in the pelvic area, an evaluation by a vascular specialist is recommended.
Dedicated to Excellence in Vascular Care Since 1963
Vascular Surgery Associates (VSA) has established itself as a cornerstone of vascular health in Southern California, combining decades of experience with cutting-edge treatment methods. Founded by visionary surgeons in 1963, our practice has grown from pioneering beginnings into one of the busiest and most respected vascular surgery groups in the Western United States.
Expert PCS Treatment in Los Angeles & Santa Monica – Get Lasting Relief Today
Pelvic Congestion Syndrome is often misdiagnosed, leaving many women suffering for years without answers. At Vascular Surgery Associates, our team of top vascular specialists in Los Angeles and Santa Monica offers expert evaluation, advanced imaging, and minimally invasive treatment options to eliminate pelvic vein congestion and restore pain-free living.
Contact us today to schedule a consultation and start your journey toward lasting relief from chronic pelvic pain.