Pelvic Congestion Syndrome (PCS)

talking about pelvic pain

Pelvic congestion syndrome is a condition in which dilated veins in the pelvis cause chronic pain, or dilated (‘varicose’) veins the genital area or upper thighs.

Dilated pelvic veins are very common in women of childbearing age, and are often asymptomatic. They may, however, cause a chronic, dull pain in the pelvis especially after prolonged standing, and during or after sexual intercourse. Women may also see dilated veins in their upper thighs, or genital area. Symptoms may get worse during the monthly period and especially during pregnancy. Women who have had multiple pregnancies are at even higher risk of developing pelvic congestion syndrome.

The main cause of dilated pelvic veins is ‘reflux’, or blood flowing the wrong way, in the veins that drain the ovaries. This causes a backup (kind of like a traffic jam) in the veins of the pelvis which manifests as pelvic pain or dilated veins in the genital area.


PCS may be diagnosed with a trans-vaginal ultrasound, CT or MRI. All of the imaging exams contain certain pitfalls, and none are perfect in detecting dilated pelvic veins. Women who have typical symptoms of pelvic congestion syndrome are encouraged to consult with an expert, regardless of what their imaging study shows.



Certain types of birth control pills (prescribed by a gynecologist) may help alleviate the symptoms of PCS, though if relief is insufficient, invasive therapy is warranted.


In the past, surgery used to be performed to either remove the uterus, or close off the veins to the ovary. These surgeries are rarely warranted or performed nowadays.

Pelvic Vein Embolization

This is a minimally invasive procedure where a tiny catheter is inserted into the ovarian and pelvic veins. Tiny metallic coils and medication is injected through the catheter in order to close off the ovarian and pelvic veins. Patients can expect no scar, to go home the same day as their procedure, and return to their normal activities within 1-3 days. The vast majority of women who undergo this procedure experience very significant relief of their symptoms.

Our extraordinary team at The Jerusalem Vascular Anomalies Clinic is here to help you in any way we can. We will help walk you through every step of the way in navigating your pelvic congestion syndrome.

For an appointment to Dr. Farkas’s clinic, please call 02-564-5634