What Is Pelvic Congestion Syndrome (PCS)?

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Pelvic congestion syndrome (PCS) is a condition that causes pelvic or abdominal pain in women. It tends to occur in younger women who have not undergone menopause or have previously given birth.

The slow movement of blood through poorly functioning pelvic veins is what causes pain. A quick diagnosis leads to prompt and effective treatment.

This article will discuss the causes, symptoms, diagnosis, and treatment of pelvic congestion syndrome.

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What Are the Symptoms of Pelvic Congestion Syndrome?

The primary symptom of PCS is pain. The pain can occur on one side of the pelvis or both sides. It is generally a dull, achy pain but can vary from person to person.

The pain can feel worse:

  • After sexual intercourse
  • When standing for long periods
  • When sitting for long periods
  • When walking for long periods
  • When lifting heavy items

Pregnancy can also cause pain to worsen.

The symptoms tend to get better after lying down. Less commonly, the pain can occur suddenly in the lower back, hips, legs, or abdomen.

PCS and Pregnancy

Pregnancy can cause PCS pain to worsen, especially in the later stages of pregnancy as the baby grows bigger and heavier and puts more pressure on the veins in the pelvis.

What Causes Pelvic Congestion Syndrome?

The cause of PCS is pelvic venous insufficiency. This is when the veins around or near the ovaries do not function properly, causing the blood to move slowly and sometimes backward.

Slow pelvic blood flow can happen because the veins are too wide (dilated) or because the valves within the veins are not working as they should. The slow-flowing blood pools in the veins, causing pain.

What causes the veins to work improperly is not entirely understood. It may relate to the following:

  • Genetics
  • Hormones
  • Hypertension
  • Abnormal vein structure
  • Previous pregnancy

Risk Factors

There are certain factors that can increase a person's risk of pelvic congestion syndrome. They are:

How Is Pelvic Congestion Syndrome Diagnosed?

A healthcare provider will ask health history questions and perform a physical exam.

Making a firm PCS diagnosis will require special imaging:

How Is Pelvic Congestion Syndrome Treated?

There are many treatment options for pelvic congestion syndrome. When a healthcare provider has diagnosed someone, the treatment options can include:

  • Hormone medication: This decreases blood flow through the affected pelvic veins.
  • Vein embolization: A healthcare provider threads a catheter through a vein and guides it to the affected veins in the pelvis. The catheter then closes off the veins that are enlarged.
  • Compression: A study showed that wearing compression shorts decreased pelvic pain in approximately 80% of study participants. However, the compression did not resolve the condition itself.

What Is the Prognosis for Pelvic Congestion Syndrome?

Pelvic congestion syndrome can be misdiagnosed or undiagnosed. But when a person receives the proper diagnosis, the condition is treatable. In one study, the pain was completely or partially alleviated in 68% to 100% of the participants.

Can You Die From Pelvic Congestion Syndrome?

PCS is not considered a life-threatening condition.


Pelvic congestion syndrome is a condition in which veins in the pelvis do not function correctly. The blood moves slowly through the veins, causing blood to pool. This results in pelvic pain. This condition is typically diagnosed with ultrasound. Treatment varies and can include medication or venous embolization.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Bałabuszek K, Toborek M, Pietura R. Comprehensive overview of the venous disorder known as pelvic congestion syndromeAnn Med. 54(1):22-36. doi:10.1080/07853890.2021.2014556

  2. Stanford Medicine. Pelvic congestion syndrome.

  3. Stanford Medicine Health Care. Treatment of pelvic congestion syndrome (PCS).

  4. Meissner MH, Gibson K. Clinical outcome after treatment of pelvic congestion syndrome: sense and nonsensePhlebology. 2015;30(1 Suppl):73-80. doi:10.1177/0268355514568067

By Patty Weasler, RN, BSN
Patty is a registered nurse with over a decade of experience in pediatric critical care. Her passion is writing health and wellness content that anyone can understand and use.