Pelvic Pain? It Could Be Your Veins

Medically reviewed by Laura Kelsey, MD, on May 23, 2025

Discover how vein problems like pelvic congestion syndrome could be the hidden cause of your chronic discomfort—and what you can do about it.

Do you experience constant pelvic pain that feels like menstrual cramps—even when you’re not on your period? Do you suffer from bloating, low back pain, or discomfort during or after intimacy? You’re not alone—and it might not be “just in your head.”

Many women silently suffer from these symptoms for years, not realizing they could be caused by a treatable vein problem called pelvic congestion syndrome (PCS). If you’re tired of living with unexplained pain, find out how a vein doctor can diagnose and treat the real cause so that you can feel like yourself again.

To learn more, we spoke with Dr. Laura Kelsey, a board-certified vein specialist and Regional Medical Director at Center for Vein Restoration (CVR) in Grand Rapids, Michigan, and Muskegon, Michigan. Dr. Kelsey explains what causes PCS, how it’s diagnosed, and why expert vein treatment can provide relief.

✅To schedule a consultation with Dr. Kelsey in Grand Rapids, Michigan, CLICK HERE.

✅To schedule a consultation with Dr. Kelsey in Muskegon, Michigan, CLICK HERE.

✅ Don’t live near Grand Rapids or Muskegon, Michigan? Call 240-881-0546 to speak with a helpful Patient Services Representative or schedule your consultation online at one of our 110+ CVR vein clinics near you.

What Is Pelvic Congestion Syndrome?

While you may have heard of varicose or spider veins in the legs, pelvic congestion syndrome is a type of venous insufficiency in which veins in the pelvis become enlarged and twisted, similar to varicose veins in the legs. These veins don’t allow blood to flow properly, leading to pressure, swelling, and chronic pain that affects one’s quality of life.

According to Dr. Kelsey:
“Pelvic congestion feels like you’re having your period, even when you’re not. It’s a dull, achy pain often paired with bloating, abdominal discomfort, and even lower back pain. It can also cause issues like constipation or pain during and after intercourse.” – Dr.Laura Kelsey

Cedars Sinai describes pelvic congestion syndrome (PCS) as most common in women of childbearing age, especially those who’ve had multiple pregnancies, and is thought to be linked to weakened or compressed veins that cause blood to pool. This leads to dull, achy pain, often worse after standing, walking, or during intercourse.

What Causes Pelvic Congestion Syndrome?

There are two leading causes of PCS:

1. Ovarian Vein Reflux:
   Normally, blood from the ovaries drains through veins that flow upward toward the kidneys. These veins have valves to keep blood moving in the right direction. But in some women, the valves weaken or fail, causing blood to pool in the pelvis. This leads to pressure and bulging veins (aka varicose veins) in the pelvic area.
2. Vein Compression (May-Thurner Syndrome):
   Sometimes, an artery can press down on a nearby vein, blocking normal blood flow.

“Veins are flimsy, like a soft hose, while arteries are strong and muscular. When an artery presses on a vein, it can cause blood to back up, leading to pain and pelvic varicose veins. A common example is May-Thurner Syndrome, where an artery compresses a pelvic vein.” – Dr.Laura Kelsey

Why Are Women More Likely to be Affected?

PCS primarily affects women, especially those who have had multiple pregnancies. Hormonal changes and increased blood volume during pregnancy can stretch and weaken the veins, making them more likely to malfunction.

“Many women just accept pelvic pain as normal. But when it starts to affect your daily life or relationships, it’s time to look for answers.” – Dr.Laura Kelsey

How Is Pelvic Congestion Syndrome Diagnosed?

Getting a proper diagnosis is the first step to relief. Here’s how vein doctors like Dr. Kelsey evaluate PCS:

1. Start with Your Primary Doctor or Gynecologist:
   They can rule out other causes of pelvic pain, like ovarian cysts or endometriosis.
2. Ultrasound of the Legs:
   Surprisingly, the first test at a vein center is often an ultrasound of the legs. “This helps us see if any veins are escaping from the pelvis into the legs, which can be a sign of PCS,” says Dr. Kelsey.

1. Pelvic Imaging:
   Depending on the results, further imaging like a pelvic ultrasound, CT scan, or MRI may be ordered to check for swollen ovarian veins or vein compression.
2. Venogram with Intravascular Ultrasound (IVUS):
   If needed, a special procedure called a venogram can inject contrast dye into the veins to show how blood flows. IVUS, an ultrasound inside the veins, can provide detailed measurements.

How Does PCS Affect Daily Life?

PCS isn’t just uncomfortable—it can take a major toll on a woman’s life.

“I’ve had patients who couldn’t even stand long enough to make dinner,” shares Dr. Kelsey. “It’s exhausting. And the pain during intimacy can lead to relationship stress. What’s worse is that many women are told it’s all in their head.”

Chronic pelvic pain, like that caused by pelvic congestion syndrome, can take a serious toll on mental health. A Johns Hopkins study found that about 40 percent of people with chronic pain also experience depression and anxiety, especially women. This highlights the need for better screening and integrated care that addresses both the physical and emotional impact of chronic pelvic vein problems.

What Are the Treatment Options?

Once PCS is diagnosed, there are effective treatments available:

• Ovarian Vein Embolization:
  This minimally invasive procedure involves closing off the faulty ovarian vein to stop blood from pooling. “It’s similar to how we treat varicose veins in the legs,” says Dr. Kelsey.
• Vein Stenting for Compression:
  If a vein is being compressed, a tiny metal stent can be placed to hold it open and restore blood flow. These stents have shown long-term success. According to Boston Scientific, clinical studies have shown patency rates (how long the stent stays open) of over 80-90 percent at 1-5 years.
• Partnership with Specialists:
  CVR works with gynecologists and other providers to ensure that all other causes of pain are considered before moving forward with vein-specific treatments.

When Should You See a Vein Specialist?

If you’ve been struggling with unexplained pelvic pain, bloating, or varicose veins in the groin area, it may be time to visit a vein expert.

“No referral is needed in many cases,” Dr. Kelsey assures. “The worst that can happen is we rule PCS out—but the best is we give you real relief.”

Expect a thorough ultrasound and detailed discussion of your symptoms at your first visit.

“It takes about an hour and a half, but it’s worth it,” says Dr. Kelsey.

Ready to Take the First Step?

Don’t let pelvic pain control your life. Schedule a consultation with a vein doctor at Center for Vein Restoration. Our team will help you get to the root of your vein problems and develop a personalized vein treatment plan.

Call 240-965-3915 to speak with a Patient Services Representative or schedule your consultation online at a CVR near you today.