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Pelvic Venous Congestion (PVCS)

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Most people know varicose veins mostly affect the feet and legs

But varicose veins can also occur in the pelvis causing chronic pelvic pain in women; this condition is known as Pelvic Venous Congestion Syndrome (PVCs) or ovarian vein reflux. Herein is a look at the condition, the risk factors, causes, symptoms, and treatment options. Read on to find out more.

Facts About Pelvic Venous Congestion

What is pelvic venous congestion syndrome (PVCs)? Pelvic Venous congestion is the enlargement of blood vessels in the pelvis due to faulty vein valves in the lower abdomen. See, veins have valves to guide blood flow towards the heart. However, these valves become faulty in some cases due to damage or other problems causing blood to flow backward. When this happens in the lower abdomen, blood builds up in the area, causing the veins to enlarge and change shape.

Therefore, PVCs are varicose veins in your pelvis. This engorgement or congestion of blood vessels in the lower abdomen can cause chronic, unbearable pain. It affects at least 1 in three women at some point during their lifetime. Chronic PVCs last more than six months. It is not associated with period pain at all. PVCs are common among women who’ve given birth more than once.


Chronic PVCs last longer than half a year. PVCs are commonly experienced for the first time during or following pregnancy. It is characterized by a heavy aching feeling that may get worse as pregnancy progresses. In most cases, you feel the pain on the left side only. But at other times, you may feel the pain on both the left and right sides. PVCs pain is usually worse during the evenings.

Certain factors also aggravate PVCs pain; these include:

  • When you change posture
  • Sex
  • Standing for extended periods
  • Walking
  • Menstrual period

Apart from pelvis pain, other PVCs symptoms include:

  • Pain during or after intercourse
  • Sudden urge to urinate
  • Lower back pain
  • Irritable bowel syndrome (diarrhea and constant abdominal pain accompanied with constipation)
  • Deep dyspareunia – pain during intercourse
  • Feeling one’s legs fuller
  • Engorged and distorted veins around the vagina, vulva, inner thigh, buttocks, and sometimes down the legs

Causes of Pelvic Venous Congestion Syndrome

  • Enlarged veins are indeed the major cause of pelvic congestion and pain. However, some women have enlarged veins without the symptoms. Therefore, scientists are still trying to understand the causes of the syndrome. In most cases, factors such as pregnancies and polycystic ovaries enlarge blood vessels and cause symptoms.
  • Still, in other cases, hormones may play a role in developing pelvic venous congestion syndrome (PVCs). For example, estrogen is well-known to cause dilation of veins. This may be why the condition affects women between ages 20 and 45 mostly; because, after menopause, estrogen levels decrease.
  • Weight, too, and pelvic structural changes during pregnancy may contribute to the development of the syndrome. For example, weight exerts excess pressure within the lower abdomen veins, weakening their walls and enlarging.

Risk Factors

Who is at risk of pelvic venous congestion? Women are predisposed to PVCs because of the estrogen hormone. Stats show that women between ages 20 and 45 are most likely to be affected. Factors that commonly cause the condition include:

  • More than one pregnancy
  • Retroverted or tipped uterus
  • Polycystic ovaries
  • Fuller leg veins
  • Increase in estrogen levels

How is Pelvic Congestion Syndrome Diagnosed?

There are various ways to diagnose pelvic congestion with Pedes Orange County state-of-art diagnostic and testing. These include CTs and MRI scans, pelvic venography, and ultrasounds. However, it’s not easy to diagnose the syndrome because while many women experience pelvic pain, not all are due to congestion of blood vessels. Indeed, some pelvic pains have psychological origins, others are caused by issues within the reproductive, gastrointestinal, and urinary system, and still, others are caused by bones or muscles.

Therefore, your doctor will consider all the above and ask for urine and blood samples, consider your health history, etc. However, X-rays, MRIs, CTS, and Ultrasound are the surest ways of detecting pelvic congestion.

Congestions in the pelvis and lower abdomen can be diagnosed using ultrasound techniques. It’s a technique that helps visualize backflow in the veins in the ovary and identify enlarged veins. If you want to get a pelvic or abdominal ultrasound, consult with Pedes Orange County.

Abdominal and pelvic ultrasounds help visualize backflow in ovarian veins. But it doesn’t provide enough information, and therefore, CTs and MRIs may be used to take further images. CTS and MRIs help evaluate the pelvis

In some situations, ultrasound alone may not provide all the necessary information, and your physician may want to obtain additional imaging. For example, CT and MRI are used to take detailed pictures.

Pelvic venography uses X-rays to take images of veins in the pelvis. It’s the most definitive pelvic screening technique for checking congestion. It’s a minimally invasive technique that involves the use of a catheter. The tube is inserted into the venous system via the neck or groin and then guided into the veins in the ovary using X-rays. Then, using an iodine-based dye, the medical specialist obtains images of the pelvic structure on a fluoroscopy machine.

After obtaining the images, the catheter is removed. The doctor will then apply slight pressure on the puncture area to stop bleeding. You will be discharged 1 to 4 hours later. Pelvic venography may also be used as a treatment when it’s combined with pelvic embolization.

When Should I Contact My Doctor?

Some women have enlarged veins with no symptoms; others have enlarged veins that cause pains and aches. In most cases, these don’t require a medical emergency. The symptoms should reduce as you head into menopause. However, in case of chronic, unbearable pain, nothing is stopping you from seeking medical help. In fact, see your healthcare giver right away for help.

To get the most out of the consultation, here’s what to do:

  • Know the purpose of the visit and what you want to get from it
  • Before visiting the doctor, put down questions you need them to answer.
  • Bring company along to help ask questions and note down points from the doctor.
  • Please write down the name of the diagnosis, its tests, and treatment options explained by the doctor. Also, take notes of any new instructions during each visit.
  • Know the reasons for new medication prescriptions, their benefits, and their risks.
  • Inquire whether it’s possible to treat your condition another way
  • Know why and what the results of a test procedure mean
  • Ask what will happen if you don’t undergo testing or take medication.
  • Ask whether a follow-up appointment is available and note down the visit’s time, date, and reason.
  • Ask the doctor for their contacts in case you need a further chat.

What are the Pros and Cons of Pelvic Vein/Ovarian Embolization?


Of the ovarian vein or pelvic vein has already been demonstrated to be a safe procedure for relieving pain sensations and improving varicose vein appearance.

  • Embolization helps shut off affected veins, easing pressure from them, so they reduce in size.
  • It’s a minimally invasive technique requiring only a tiny incision in the skin. You won’t even need stitches.
  • Fewer complications than traditional surgery. You also lose less blood, and the incision mark is not even visible. You won’t also need to stay in the hospital for long.
  • 85% of women who undergo the procedure report feeling much better within 14 days of the operation
  • You may be allergic to the iodine-based dye and a contrast agent used to take detailed images.
  • A small number of women develop infections after embolization.
  • Since the procedure involves placing a tube inside blood vessels, it may damage them or cause bruising and bleeding at the point of incision.
  • If an embolic agent migrates to the wrong place, it may cut off the oxygen supply to the tissue, i.e., non-target embolism
  • There’s a 10 % chance that the varices may develop in the veins again.
  • It exposes the ovaries to radiation. However, studies have not found any links between the procedure and infertility or abnormal periods.

How is Pelvic Congestion Syndrome Diagnosed?

What are the treatment options for pelvic venous congestion (PVCs)? Available treatment options for PVCs include pain-relieving progestin hormone drugs, ovarian function-blocking Gonadotropin-releasing hormones, pelvic venous embolization

Pelvic & Labial Varicose Veins

Concerned About Vulvar Varicosities? Make an Appointment

What are Labia Varicosities (Vulvar Varicosities)?

Vulvar varicosities, also commonly referred to as labia varicosities, are a condition when the veins in the labia minora or majora become dilated.

Like any other part of the human body, the vulva is interconnected through an extensive reach of large and small blood vessels. During pregnancy, the increase in weight and pressure may reduce blood flow to the lower body and genitals. This will then cascade into the condition known as Labia varicosities.

While no one is fully exempt from developing vulvar varicose veins, the condition is more apparent in pregnant women. Moreover, pregnant women are more susceptible to developing pelvic varicosities due to the pressure and weight exerted by the baby.

However, in most cases, the condition does go away after giving birth. Ideally, you should start feeling better within six to eight weeks from the delivery time. Unfortunately, in some women, the dilated veins do not recover independently and need medical intervention to help fix the condition and get you back to your normal self.

Most people understand that varicose veins can be found in the legs and feet. And while this is mostly true, they can also manifest in the vulva. This is generally why most women who develop from vulvar varicosities don’t notice it until the condition begins to worsen.

There are numerous veins supplying blood to and from the vulva. And since they all differ in size, there’s no sure way to tell if you’re developing pelvic varicosities. The impact may leave them moderately swollen from the varying size of the veins, especially in the smaller veins. Larger veins may get twisted and become painful over time. This further goes to assert the importance of consulting a healthcare professional if you’re uncertain.

Signs and Symptoms of Pelvic Varicosities

As highlighted above, pelvic congestion syndrome can manifest in varying ways. As a result, there’s no one standard sign or symptom associated with the condition.

However, many women suffering from pelvic varicosities report a dull but recurring pain. While the pain may come and go, certain factors and situations can worsen the pain. Some of the situations that could lead to chronic pain include;

  • Standing up for extended periods of time
  • Sitting for long or remaining inactive
  • The period leading to menstruation
  • In the evenings
  • In the mid or late stages of a pregnancy
  • During or after sexual intercourse

While pain is the most recorded symptom associated with labia varicosities, some women also note a different combination of recurring symptoms. These are likely influenced by the severity and advancement of the condition. Other pelvic congestion syndrome symptoms include;

  • Experiencing overly painful menstruation (commonly called dysmenorrhea)
  • Excessive or abnormal bleeding during menstruation
  • Swelling of the vulva or vagina
  • Irritable bowel syndromes
  • Backache
  • Fatigue
  • Increased urination
  • Depression
  • Hip pain
  • Change in the vaginal discharge
  • The appearance of varicose veins around the legs, buttocks, and vulva
  • Abdominal tenderness

Whether alone or part of a combination, you should consult a doctor if you notice these symptoms. This will help rule out any conditions, and if it is indeed a pelvic congestion disorder, they can begin the treatment process.

What Causes Vulvar Varicosities?

  • There is ongoing research concerning the causes and risk factors associated with pelvic congestion syndrome. However, the most commonly known cause of vulvar varicosities is pregnancy.
  • Blood vessels such as veins contain valves whose task is to prevent blood from flowing back. Veins in the abdominal and lower parts of the body have to work against factors such as gravity to ensure smooth and uninterrupted blood flow.
    However, pregnancy can lead to the dilation of veins.
  • Consequently, this means the valves have to work even harder to keep blood flowing in the proper direction. This dilation can go unnoticed in the initial stages, making pelvic congestion syndrome hard to detect in the early days.
  • Other factors, such as the pregnancy’s pressure on the lower body and the increased blood flow to the genitalia, can alter valves’ normal working and efficiency, which then results in the development of varicose veins.
  • Recent research also shows that pelvic congestion syndrome runs in the family. So, if a relative or someone genetically close to you has encountered a case of vulvar varicosities, you too may be at risk. To combat this situation, you can schedule regular checkups with your physician to ensure no signs of pelvic congestion syndrome.
  • Pelvic tumors have also been identified as a causative and accelerant agent to labia varicose veins. If you’re worried you may have a pelvic tumor – or any other previously undiagnosed tumor, you should seek professional medical services immediately.

How are Pelvic Varicose Veins Diagnosed?


From the list shared above regarding the common signs and symptoms associated with pelvic congestion syndrome, you can tell most are either common or can be easily misdiagnosed. For example, if you’re having recurring back pain, you could easily get some pain relievers thinking that to be the problem.

Medically, doctors may need to run a number of tests before diagnosing the condition. This is a result of the various associative symptoms. Moreover, since there’s such a vast array of symptoms, healthcare providers need to rule out other possible underlying causes for the symptoms.

Some of the procedures you can expect when getting vulvar varicose veins include;

  • A laparoscopy. This is a relatively small and minimally invasive surgical procedure where the doctor inserts a small camera inside the pelvis for a clearer and objective look.
  • A computed tomography (CT) scan
  • A Magnetic Resonance Imaging (MRI) scan
  • An ultrasound tests
  • A venogram exam

In most ideal cases, the healthcare provider will opt for the ultrasound examination. Besides being simple, non-intrusive, and quick, an ultrasound exam can detect varicosities and assess the blood flow.

Seeing a doctor can prove beneficial, even when you’re exhibiting some or none of the apparent symptoms. This is largely because some women with developing labia varicosities show little-to-no symptoms other than swollen veins.

The other importance of seeing a doctor whenever you start exhibiting these signs is to get ahead of any underlying health conditions. Pelvic congestion syndrome is often the sign of other health issues, especially regarding the body’s circulatory system. For instance, through an examination, pelvic varicose veins could help identify varicose veins in other parts of the body.

Pelvic congestion syndrome is rarely a permanent condition. Most of the symptoms will likely disappear within six to eight weeks of giving birth.

However, if you have previously developed labial varicosities during a previous pregnancy, chances are high the condition will come back during the next pregnancy. In these cases, the recurring pelvic congestion syndrome will be more painful with every subsequent pregnancy.

Even when the varicosities disappear on their own, it’s still vital to speak with your doctor. This will help kick in preventative measures to ensure the condition doesn’t recur.

So, you’ve noticed a few worrying signs, gone to the doctor, had tests run, and the results are out; you have pelvic congestion syndrome. What next?

Well, the treatment approach largely depends on whether you’re pregnant or not. If you are pregnant, the best cause of action is alleviating the pain and discomfort and eliminating the symptoms.

This treatment option for pregnant women is aimed at alleviating any pain and accompanying symptoms. To achieve this, the healthcare provider may use various medications, including;

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Chronic pain relief medication such as gabapentin and amitriptyline

In other cases, the faulty veins can be targeted, isolated, then closed off through minimally invasive procedures. Once these nonfunctional veins are closed, the body will naturally redirect venous blood to the healthier veins. Subsequently, the pelvic venous drainage will improve over time, taking away most, if not all, of the symptoms.

However, before these procedures are performed, your doctor may put you in an observation period lasting between six to twelve months. Since most varicosities disappear after eight weeks, the doctors may choose to give your body a chance to repair itself. Fortunately, you can still receive pain medication to alleviate any pain during this observation window.

You can also use various anecdotally proven methods to keep the situation from getting any worse. These anecdotal remedies include;

  • Avoid standing or sitting for too long
  • Avoid wearing uncomfortable shoes, such as high heels, which put more pressure on your lower body and back
  • Change positions regularly
  • Drink a lot of water
  • Elevate your legs periodically to improve blood circulation
  • Applying heat or ice on the painful areas
  • Wearing supportive underwear when pregnant –such as compression and support stockings while labial varicose veins are not usually dangerous, may lead to poor circulation in the lower parts of your body. This could then lead to blood pooling, which can cause deep vein thrombosis.

When these blood clots are in the deeper veins, they can break loose and move to other parts of the body. These cases, while rare, can lead to life-threatening complications.

Some of the signs of blood clots development include increased pain in the affected region, redness, swelling, and hardening. If you experience any of these, you should notify your healthcare provider as soon as possible.

As highlighted before, there are numerous symptoms that could warn against labial varicose veins. To be certain of what these symptoms could mean, you should see a doctor. The doctor will help you understand more about the condition and examine you for possible varicosities. If there’s a problem or complication, early detection is your best chance of getting effective treatment options.

Moreover, if you start experiencing the symptoms synonymous with deep vein thrombosis and blood clots, you should notify your healthcare provider. DVT cases can turn fatal when not meticulously handled.

Ultimately, labial varicosity is a condition that affects about 15 % of women. And while the symptoms will likely disappear in less than two months, it’s always important to consult a healthcare professional.

Seeing a doctor will help keep your mind at ease. Moreover, if there is a severe underlying condition, the healthcare professionals will identify and take the necessary actions. Seeing a doctor can also help you fight symptoms like chronic pain, which can significantly impact the quality of life.

Labial Varicose Veins (Labia Varicosities)

Unlike varicose veins, spider veins are harmless. Most people seek treatment for cosmetic reasons. However, treatment will also alleviate the mild yet persistent discomfort labia varicosities sometimes causes.

Our Vascular Disease Physicians

The physicians at Pedes Orange County devote their lives to saving limbs and minimizing pain. Our conveniently located, state-of-the-art facility is designed for your comfort and utilizes cutting-edge technology to provide minimally invasive treatments. Our vascular surgeons and vascular specialists are board-certified and some of the best in Southern California. Personable staff members make every visit a positive experience, with short wait times and an efficient, streamlined process that ensures you leave feeling educated and confident that you are in good hands.

J. Joseph Hewett, M.D.

Vascular Specialist

Neil K. Goldstein, M.D.

Vascular Specialist

Derrick Tran, MD

Vascular Specialist

Mohammad Jaber, M.D.

Vascular Surgeon

What to Expect from Your Visit to Pedes


Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.


Once we review the results of your diagnostic tests, our physicians will help you develop a plan to provide you with the best treatment for your disease.


Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.

Follow up

Your treatment will begin with an ultrasound examination of your veins, arteries, or both, in your legs to diagnose the presence and extent of the disease. Your test results will be immediately available to review with the doctor.

Treatment Options

Learn more about our treatment options

What to Expect

Learn more about our what to expect

Vascular Disease

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