Pelvic Congestive Syndrome is similar to varicose veins that occur in the legs.  In both cases, the valves in the veins that help return blood to the heart against gravity become weakened and don’t close properly.  This causes blood to flow backwards and pool in the pelvis causing pressure and bulging internal veins.

Risk Factors

  • Two or more pregnancies – the veins supplying the uterus and ovaries increase in size related to previous pregnancies.
  • Women with PCS are typically less than 45 years old and in theiry child-bearing years.
  • Hormonal abnormalities
  • Retroverted uterus
  • Polycystic ovaries


  • Chronic pain which may worsen: after standing for prolonged period, at the end of the day, during or after intercourse, during pregnancy, during menstruation
  • Swelling of vulva or vagina
  • Labial fullness
  • Abnormal menstrual bleeding


Since most women lie down during pelvic exams, pressure may be temporarily relieved from ovarian veins, temporarily relieving pressure and making diagnosis more difficult. PCS can be diagnosed through several minimally invasive methods including:

  • MRI
  • Ultrasound
  • Pelvic Venography


  • Embolization – a minimally invasive outpatient procedure using a thin catheter to inject coils with a sclerosing agent. This seals the vein with the faulty valves, relieving pressure on those veins.
  • Anti-inflammatory drugs