Do you have pain in the back of your legs during menstruation? Painful intercourse or varicose veins around the pelvic area? If so you may have pelvic congestion syndrome.


Pelvic congestion syndrome is long-lasting (chronic) pain in the lowest part of the torso (pelvis) caused by accumulation of blood in veins of the pelvis, which have widened (dilated) and become convoluted.

Pelvic congestion syndrome seems to be a common cause of chronic pelvic pain (pain lasting more than 6 months). Pain occurs because blood accumulates in veins of the pelvis, which have dilated and become convoluted (called varicose veins). The resulting pain is sometimes debilitating. Estrogen may contribute to the development of these veins. Up to 30% of women of childbearing age have varicose veins in their pelvis, but not all of them have symptoms. Sometimes pain that occurs before or during menstrual periods results from pelvic congestion syndrome.




Typically, the pain is a dull ache, but it may be sharp or throbbing. It is worse at the end of the day (after women have been sitting or standing a long time) and is relieved by lying down. The pain is also worse during or after sexual intercourse. It is often accompanied by low back pain, aches in the legs, and abnormal vaginal bleeding. Some women occasionally have a clear or watery discharge from the vagina. Other symptoms may include fatigue, mood swings, headaches, and abdominal bloating.




Doctors may suspect pelvic congestion syndrome when women have pelvic pain but a pelvic examination does not detect inflammation or another abnormality. 

Ultrasonography can help doctors confirm the diagnosis. Other imaging studies can be performed including MRV, CTA or venagram. Sometimes, particularly if doctors are considering other possible causes of pelvic pain, laparoscopy is done.