Chronic Pelvic Pain in Women: When Veins Are the Overlooked Cause
Chronic pelvic pain in women: the many possible causes, from endometriosis to bladder, bowel and muscle problems, and the clues that point to veins.
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Understanding Pelvic Vein Conditions
Clear explanations of pelvic congestion syndrome and related pelvic vein disorders, including vulval varicose veins, nutcracker syndrome and May-Thurner syndrome, how they feel and when they need a doctor.
Articles in Understanding Pelvic Vein Conditions
May-Thurner Syndrome (Iliac Vein Compression): Causes, Risks and Outlook
May-Thurner syndrome is when an artery squeezes the left iliac vein. Who it affects, the link with leg swelling, DVT and pelvic veins, and when to treat it.
Nutcracker Syndrome: What It Is, Why It Happens and How Rare It Is
Nutcracker syndrome explained: how the left kidney vein gets squeezed between two arteries, its symptoms, how rare it is, and why scans can overdiagnose it.
What Causes Pelvic Congestion Syndrome? Ovarian Vein Reflux, Pregnancy and Hormones
What causes pelvic congestion syndrome: faulty ovarian vein valves, pregnancy, oestrogen and squeezed veins higher up, plus who is at risk.
Pelvic Congestion Syndrome Symptoms: The Dragging Ache That Worsens When You Stand
Typical pelvic congestion syndrome symptoms: a dull, heavy ache that builds when you stand, pain with sex, visible veins, and back, hip or leg aching.
Pelvic Congestion Syndrome: What It Is, Who Gets It and Why It's Missed
What pelvic congestion syndrome is, how widened and refluxing pelvic veins cause a dull, heavy pelvic ache, who gets it, why it is often missed, and how it is diagnosed and treated.
Vulvar Varicose Veins (Vulvar Varicosities): Causes, Symptoms and When They Point to Pelvic Reflux
Vulvar varicosities explained: what they look like, why they appear outside pregnancy, the link to pelvic vein reflux, risks and treatment options.
How pelvic veins work
Veins carry blood back to the heart. In the pelvis, blood from the uterus, ovaries, bladder and bowel drains into a web of veins on each side of the uterus. These drain upwards through the ovarian veins (one on each side, running up to the kidney area) and sideways into the internal iliac veins. Like leg veins, many of these veins have one-way valves.
If the valves stop working, or a vein further up is squeezed, blood flows the wrong way and pools. The pelvic veins widen and become twisted, much like varicose veins in the legs. In some people this causes no symptoms. In others it causes a dull, heavy pelvic ache that is worse after standing, which doctors call pelvic congestion syndrome.
The conditions we cover
- Pelvic congestion syndrome (PCS): long-term pelvic pain linked to widened, refluxing pelvic veins.
- Vulval and vaginal varicose veins: visible veins around the vulva, often in pregnancy and sometimes from pelvic vein reflux.
- Leg varicose veins from the pelvis: varicose veins on the buttocks, back of the thigh or upper inner thigh that are fed from pelvic veins.
- Nutcracker syndrome: the left kidney vein squeezed between two arteries.
- May-Thurner syndrome: the left iliac vein squeezed by the right iliac artery.
- Varicocele: the male equivalent, widened veins around the testicle (see our men’s health section).
When to see a doctor
Pelvic pain that lasts six months or more, pain during or after sex, or new visible veins around the vulva or upper thighs are worth discussing with a doctor. Our pelvic symptom check can help you think through your symptoms first. Sudden severe pain, heavy bleeding or fever needs urgent care.
Explore the other sections
Diagnosis and Tests
How doctors confirm pelvic vein problems and rule out other causes.
Treatment Options
Embolisation, stenting, medicines and other options, explained.
Recovery and Living Well
What to expect after treatment, and day-to-day self-care.
Pregnancy, Sex and Women's Health
Pregnancy, fertility, periods, menopause and pain during sex.
Men's Pelvic Vein Health
Varicocele, its symptoms, treatment and effect on fertility.
Questions and Costs
Is it serious? Who treats it? What does it cost?