Pelvic Congestive Syndrome or PCS Could be the Cause of Your Pelvic Pain

Chronic Pelvic Pain PCS

If you have experienced chronic pelvic pain, you’re not suffering alone. One-third of U.S. women have pelvic pain, and 30% of those with chronic pain have pelvic congestive syndrome (PCS). Although it’s not a well-understood condition outside the medical community, the word is spreading about PCS. This painful – and treatable – health issue doesn’t have to limit your enjoyment of life. Let’s take a closer look at the causes of and treatments for PCS.

Defining Pelvic Congestive Syndrome

Called Pelvic Congestive Syndrome or PCS. Some specialists refer to Pelvic Venous Insufficiency to describe the same condition. PCS describes long-lasting (chronic) pain in the pelvis which can often be attributed to compressed or dilated veins. Long-lasting is defined as a period of 6 months or more where the pain is severe and interferes with day-to-day life.
Did you know that varicose veins can happen in the pelvis? It might seem strange, but about 15% of women of childbearing age have varicose pelvic veins, meaning the veins have widened and may be bulging. However, not all women who have this condition feel pain.
The pain of PCS can feel like a throbbing or a dull ache. At times, the pain may feel like a sharp, stabbing poke in the pelvis. For some women, PCS pain worsens prior to and during menstruation – but again, the sensation varies. Some women don’t report that it’s tied to their period at all. In many cases, women report increased pelvic pain during sexual intercourse.
Typically the pain is worse when standing for long periods and lessens when lying down.
PCS is a widely misunderstood syndrome that may go undiagnosed or misdiagnosed by your doctor. If you think you might have it, bring it up by name with your doctor for a deeper discussion.

What Causes Pelvic Congestive Syndrome?

Researchers are still struggling to identify the exact cause of PCS. Varicose veins in the pelvis are a contributor, but what leads to those in the first place?
So far, here’s what’s been discovered about the causes of PCS:

  • Varicose veins are a factor, but not all women with pelvic varicose veins have pain or any symptoms at all.
  • Pregnancy may increase your risk of PCS due to the strain on the body systems it causes.
  • Circulatory system problems are likely a contributor, but not all women with PCS otherwise have circulatory issues.
  • Hormones are a likely culprit because estrogen is known to dilate veins. It’s also interesting to note that PCS is not commonly diagnosed after menopause when estrogen levels drop.
  • Researchers are still exploring the connections between hormones, underlying circulatory problems, pain, and PCS. A multi-specialty approach is vital to a proper diagnosis.

Am I a Candidate for Pelvic Congestive Syndrome?

Here are a few things to consider about PCS as it relates to your lifestyle and medical history. These are all factors your providers will want to weigh when evaluating you for a PCS diagnosis.

  • Women of childbearing age are at the highest risk.
  • Pregnancy, including miscarriages and abortions, may contribute to PCS, so make sure you mention them to your doctor.
  • Being sexually active is a contributor, in that it may be related to pelvic pain.
  • Standing for long periods is a known contributor to varicose veins, so it may also contribute to PCS.
  • Walking for long periods may make your PCS pain better or worse.
  • Extreme menstrual pain can be related to PCS.
  • Urgency to urinate is often seen in women with PCS.
  • Irritable bowels, including diarrhea and/or constipation, is common too.
  • Visible veins on the thighs, buttocks, or vulva are also often found in women with PCS.
  • Vaginal discharge that doesn’t seem normal could be related to PCS.
  • Excessive bloating is also something to mention to your doctor.

Is it Pelvic Congestive Syndrome or Something Else?


Not Pelvic Congestive Syndrome, but have similar symptoms:

  • Urinary system problems
  • Ovarian or uterine disease
  • Gastrointestinal issues
  • Muscle or bone damage or disease
  • Pregnancy
  • Sexually transmitted diseases
  • Anemia
  • Blockages, cysts, or masses of many types

Medical Evaluation of PCS

Because so many other conditions can masquerade as PCS, it’s essential to get a full gynecological workup before being evaluated by a vascular specialist. While vascular specialists use specific diagnostic and laboratory tools, the combination of your Primary Care Provider, Gynecologist or vascular surgeon may include selected tests from the list below.

  • Blood tests
  • STD tests
  • Pelvic ultrasound
  • Doppler ultrasound
  • Venography, or an x-ray of veins
  • Computed tomography, also known as a CT scan
  • Magnetic resonance imaging, also known as an MRI
  • Magnetic resonance venography
  • Laparoscopic tests
  • A visual examination
  • A medical history, including questions from the doctor

What are the Treatment Options for Pelvic Congestive Syndrome?

PCS is treatable, and there are many noninvasive, non-surgical options available. Once other causes are ruled out, choosing a vascular specialist offers the best options for treatment.
You can likely have PCS-related procedures in an outpatient environment where you’re home the same day. Only more complex surgery must be handled in the hospital.

Pelvic Congestive Syndrome treatment options include but not limited to:

  • Nonsteroidal anti-inflammatory drugs
  • “Unblocking” the vein with an endovascular procedure
  • Sclerotherapy or embolization to shut off veins that are already damaged

By taking medication, having outpatient procedures, and improving the blood flow, PCS patients can often find relief they’ve desired for years. In fact, ending chronic pain can be a transformative experience that drastically improves the quality of your life.
If you are experiencing pelvic pain with unknown or unconfirmed diagnoses, let the specialists at Maryland Vascular Specialists evaluate your condition.  You many be just steps away from resolving this painful condition. Just click below to get started.
Talk to a PCS expert!

  • Posted in PCS