Pain in the pelvic region is due to a number of reasons and often seen more in women than men. Similarly, for pelvic vein insufficiency, there are thought to be a number of reasons, but it has been found to be connected to the presence of ovarian as well as pelvic varicose veins.

There are veins throughout the body and within them are valves that are designed to aid in the back flow of blood when the veins are returning the blood back to the heart. When the valves do not work, the blood pools in the veins and puts pressure on them, resulting in bulging veins. When these varicose veins are found in the pelvic region, the condition is known as pelvic venous insufficiency or PVI. The disease is also known as pelvic congestion syndrome.


Symptoms of pelvic venous insufficiency

Owingto the backward flowing blood, the following signs and symptoms are observed for pelvic congestion syndrome:

  • Pain in and around the pelvis, and in the lower abdomen
  • Legs experiencing a feeling of fullness
  • Stress incontinence seeing further worsening
  • Dragging sensation in the pelvis
  • Irritable bowel syndrome symptoms also worsening further

Chronic pain for more than 6 months is observed and worsens during sexual intercourse, pregnancy, lifting things, standing for long, and when one is tired. Onset of the menstrual cycle every month also worsens the pain.

The causes of pelvic venous insufficiency are not clearly understood, but it is predominantly seen in women, especially in their 30s, and at childbearing age. Multiple pregnancies can increase the risk of PVI along with hormonal dysfunction and polycystic ovarian syndrome. The absence of valves within the veins due to abnormal development of the body can also be a cause for backward flow of blood, leading to varicose veins and thus causing pelvic venous insufficiency.


Diagnosis and treatment of pelvic venous insufficiency


One of the first things to check for is visible varicose veins and other symptoms of PVI. During pregnancy, the vulva region also shows varicose veins, which might extend to the inner thigh and run along the tendon, thus helping diagnose the disease. Ultrasound examination can also be done to diagnose the disease; and when veins are not clearly visible through this non-invasive method, a probe is placed in the vagina and then ultrasound imaging carried out to see the veins. Further examination can be done via MRI (magnetic resonance imaging) and CT (computed tomography). A proper and accurate diagnosis is done via pelvic venography.


Treatment options include drugs, such as medroxyprogesterone acetate, which provide relief to around 70 percent of patients. Another effective treatment is pelvic vein embolization using a percutaneous transcatheter. This treatment option is minimally invasive, done in a day, and has been found to be effective in patients, especially in women, where the ovarian vein is the culprit varicose vein. Surgery, both open and laparoscopic, is among other treatment options for tying the veins that are the culprits.