Pelvic Congestion Syndrome – Causes and Treatment

Pelvic congestion syndrome or PCS is a chronic pain condition that develops when blood accumulates in the deep varicose veins of the pelvis. 30% of women with a chronic pain have Pelvic Congestion Syndrome.

Location of pain

In PCS, pain is experienced in the pelvic region but is often accompanied by pain in the legs and lower back.

Character of pain

The pain ranges from a dull ache to a sharp and throbbing pain that worsens over the day. The pain is relieved by lying down and is aggravated by long hours of sitting or standing.

Symptoms of pelvic congestion syndrome

  • Pain in pelvis
  • Pelvic or abdominal tenderness and discomfort
  • Dyspareunia; pain during intercourse
  • Pain is worse during or after pregnancy, intercourse, and menstruation.
  • Abnormal vaginal bleeding
  • Clear or watery vaginal discharge
  • Mood disorders
  • Tiredness
  • Headache
  • Bloating

Causes of pelvic congestion syndrome

Valves in deep veins of the pelvis, become incompetent and the blood starts to pool in these veins, making them swollen, engorged, and twisted. This creates a very painful condition as these bulges in veins press upon nearby nerves that result in a dull or sharp, throbbing pain. The valves can become incompetent due to several reasons, the most important of which is pregnancy.

  •  As a female’s body undergoes a lot of structural changes, these changes can affect the blood vessels too. One of these changes is incompetent valves.
  • The increase in fluid volume during pregnancy sometimes becomes too much for the veins to handle. They become engorged and the valves get damaged, resulting in varicosities.
  • The increase in estrogen levels during pregnancy also weakens the vessel walls and thus the veins become tortuous and develop varicosities.

Risk factors

The major risk factors are:

  • Two or more than two pregnancies
  • High estrogen levels due to hormonal abnormalities
  • Any sort of vasculitis
  • Family history of varicose
  • Patients with polycystic ovarian syndrome


The complications that can arise due to pelvic congestion syndrome are:

  • Chronic pain syndrome
  • Urinary incontinence
  • Irritable bowl syndrome


Pelvic congestion syndrome can be diagnosed by a detailed history of your symptoms, but a definitive diagnosis can be made by conduction a few tests, those are:

  • Ultrasound is conducted to rule out any other cause.
  • Magnetic resonance venography is a definitive test to confirm varicosities.
  • CT scan can also be done.

Treatment of pelvic congestion syndrome

Treatment is just employed to alleviate the symptoms, as there is no definitive cure for the syndrome.

Medical treatment:

  • NSAIDs can relieve pain and inflammation
  • Chronic pain medications such as gabapentin, are required for pain relief.
  • Medroxyprogesterone is given for the regulation of hormones.

Surgical treatment:

  • Pelvic vein embolization can be done for smaller veins that are problematic.
  • Radiations can also be used for the embolization of these veins.

Home remedies

  • Pain can be relieved by using a heating pad on your lower abdomen.
  • Aromatherapy can be a relaxing option.
  • Exercise and morning walks can decrease the pooling of blood in veins.
  • Avoid stress.
  • Use essential oils for gentle massage in the area to keep the blood flowing.

When to consult a doctor?

If the pain in your pelvis becomes unbearable and stronger than usual you should consult your doctor for the problem.


How does birth control help pelvic congestion syndrome?

Birth control pills can regulate hormones like estrogen and thus help in relieving the symptoms.

Does PVS cause frequent urination?

Yes, engorged pelvic veins can sometimes irritate the bladder and thus generate this frequent urge to urinate.

Does pelvic congestion syndrome get worse over time?

Yes, the symptoms worsen as the day pass by, especially in women who have long working hours.