Pelvic congestion syndrome

If you have pelvic pain, you want to know why and find treatment that’s thoughtful, comprehensive and tailored to you. As one of the few teams in the region that specialize in pelvic congestion syndrome, our experienced, compassionate experts are here to help you get the answers you need about this complex condition – and get back to being you. 

What is pelvic congestion syndrome?

Pelvic congestion syndrome, or pelvic venous congestion, is a common condition in women that causes chronic pain in the lower part of your abdomen.

Your veins are the blood vessels that carry blood back to your heart. Tiny valves in your veins open and close as the blood flows up, working against the pull of gravity. If the valves in the veins in your lower abdomen stop working well, blood can pool inside these veins. As the blood accumulates, pressure can build up, causing your veins to enlarge and change shape, like varicose veins. This can lead to chronic pain and other symptoms.

Most often, pelvic congestion syndrome happens in your childbearing years and is more common if you’ve had multiple pregnancies. It’s uncommon after menopause.

Symptoms of pelvic congestion syndrome

There are several symptoms of pelvic congestion syndrome, which can lessen as you enter menopause. You may experience:

• Abdominal and pelvic pain
• Heavy menstrual flow or other irregularities
• Painful intercourse
• Leg swelling
• Varicose veins on the legs
• Vaginal varicose veins (vulvar varicosities)
• Difficulty getting pregnant

Causes of pelvic congestion syndrome

At Advocate, our multidisciplinary team of vascular, gynecology and other specialists is continually trying to more fully understand pelvic congestion syndrome and why it happens. 

Enlarged veins in your pelvis is the most likely cause and happens when the valves in your veins don’t function as well as they should. Blood pools in your pelvic veins and pressure builds up, causing these veins to bulge and cause pain.

Certain factors also may play a role in pelvic congestion syndrome, including genetics and a family history of the condition that may involve how your pelvis is structured. Pregnancy, estrogen and other hormones may contribute to the condition, too.

Diagnosing pelvic congestion syndrome

Pelvic pain is common but complex and can have many causes. Our multidisciplinary team of specialists have the experience, expertise – and commitment – to pinpoint the reason for your pain. 

To diagnose pelvic congestion syndrome, we’ll start with a thorough exam, review your health history and ask about your symptoms. 

We may order tests for you, including:

• Lab tests such as urine and blood tests
• Imaging such as an ultrasound, CT scan or MRI to get a picture of your pelvis, blood vessels and organs, observe your blood flow and check for blood clots
• Tilt-table test where we check your blood pressure while you’re on a special table that moves you into different positions from lying down to almost standing 
• Venography, in which we inject dye in your veins and use an X-ray to look at your pelvic veins and observe the direction of your blood flow 

Find out more about our heart and vascular testing and diagnosis.

Treating pelvic congestion syndrome

We believe you deserve a tailored treatment plan, one that eases your symptoms, corrects the source of the problem and gives you peace of mind.

To treat your pelvic congestion syndrome, we provide the most comprehensive and advanced treatment options. Together, our multidisciplinary team of vascular surgeons, gynecologists and other specialists will discuss the best care plan for you. We may recommend:

• Minimally invasive procedures such as angioplasty or stent placement to repair the vein
• Surgical procedures to seal off the damaged vein