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What Causes Pelvic Congestion Syndrome?

Do your legs ache after sitting or standing for an extended period of time? Do you often feel pain in your hips or lower back? Is your period heavy or abnormal? If these symptoms describe you, there is a chance you may be suffering from pelvic congestion syndrome (PCS). PCS affects a huge number of women each year and accounts for as much as 10-15% of all referrals to the gynecologist. With such painful symptoms and so many diagnoses, you may be curious as to what causes pelvic congestion syndrome in the first place.


Simply stated, pelvic congestion syndrome is a medical condition that causes chronic pelvic pain due to varicose veins in the pelvis. In an unaffected individual’s body, blood flows unobstructed through the pelvic area, carrying nutrients and oxygen to the area. For someone suffering from PCS, however, blood pools in the ovarian veins and causes them to become enlarged, dilated, and even twisted in a manner similar to varicose veins in the legs. To learn more about varicose veins, see Alate Vein Center’s informational page.


Unfortunately, doctors are still struggling to figure out exactly what causes pelvic congestion syndrome to manifest. However, there are risk factors that may influence whether or not a woman will suffer from PCS:

Multiple pregnancies – women who have conceived several children are at the highest risk for PCS due to the expansion of pelvic veins during pregnancy and childbirth. Only in very rare circumstances do women who have never carried a child suffer from the disease.
Women of childbearing age under 45 years old
Presence of varicose veins on the vulva, buttocks, or thighs
Thickness of leg veins
Hormone deficiencies
Presence of fibroids or other ovarian cysts


As briefly mentioned at the beginning of this post, the symptoms of PCS can range from mildly inconvenient to extremely painful. While several of the signs for PCS overlap with other diseases, the combination of these ailments warrant seeing a vein specialist for a potential diagnosis:


The main issue many regular physicians run into when considering a PCS diagnosis is that many of the symptoms of PCS are applicable across several different diseases. Many doctors who don’t specialize in vein treatment may hesitate to give you the proper diagnosis due to ambiguity to the untrained eye. If they suspect that you could have PCS, your physician will most likely confirm your diagnosis using one of multiple tests. These include, but are not limited to MRIs, CAT scans, ultrasounds and laparoscopies.

At Alate Vein Center, however, we are experts in vein disease and varicose veins. Our interventional radiologists utilize the venogram diagnosis test as well as a pelvic sonography to be certain that you receive the care you need. Contrast dyes are injected into the veins and x-ray imaging is used to view blood flow. If the blood appears to be flowing naturally through the pelvic region, then PCS is not the issue. However, if the dye pools or begins flowing backwards, it is very likely that there are varicose veins in the pelvis.


Treatment for the chronic pain of PCS goes beyond taking pain medications to temporarily numb the discomfort. Our team offers patients long-term solutions that give them a chance at a happier, pain-free life. Using a minimally invasive procedure known as vein embolization, our specialists insert small catheters into varicose veins and stop the backward flow of blood in order to prevent pooling and eliminate pain. Unlike surgery, which up until recently had been the only option for those wanting a more permanent solution for their PCS, patients undergoing embolization therapy recover quickly. They are able to go home on the same day as the surgery, with significant relief within the next two to four weeks. For more information on how you can benefit from embolization therapy or any of our other vein services, see our page on treatment options.

Just over 39% of women will suffer from pelvic congestion syndrome at some point during their lives. Come talk to us and learn how we can help. If you would like more information regarding pelvic congestion syndrome, take a look at this earlier post on our blog titled “Heaviness & Aching? It Could Be Pelvic Congestion Syndrome.” With our experienced staff and state-of-the-art facilities, we work hard to give you the comfortable and fulfilling life you deserve.

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