This guide explains what to expect after ovarian vein embolization (spelt embolisation in the UK and Singapore), the procedure that closes leaky pelvic veins in pelvic congestion syndrome. Most women go home the same day and recover quickly, but the first few days can be achy, and relief from pelvic pain usually builds over weeks. Advice on exercise, sex and travel differs between centres, so use this as background and follow your own team’s instructions.
Straight after the procedure
When the tube is removed, the nurse or doctor presses on the entry point in your neck, groin or arm for a few minutes, then puts on a small plaster. No stitches are needed.
You then rest and are monitored for a few hours while the sedation wears off. If you feel well and the entry site is not bleeding, you will usually go home the same day. Some women stay overnight, for example after a general anaesthetic or a longer procedure.
Before you leave:
- Arrange a lift home. Do not drive, and avoid public transport on your own.
- Have someone with you. UK guidance suggests an adult stays with you for the first 24 hours.
- Ask for a written summary of what was done, including the number and type of coils or other materials, and a contact number.
Ovarian vein embolization recovery: day by day
Everyone is different, but a typical pattern is:
- Day 1. Rest at home. Expect a pelvic, lower back or groin ache and some tiredness. Drink normally and move around the house.
- Days 2 to 3. Light activity such as short walks is usually fine. Keep the plaster dry for two to three days, then shower normally. Do not soak in a bath until the entry site has healed.
- Days 3 to 7. The ache should be easing. Many women go back to desk work within a few days to a week.
- Weeks 1 to 6. Gradually return to your usual routine. Follow your team’s advice on heavy lifting and strenuous exercise.
- Weeks to months. Pelvic pain from the congested veins usually improves gradually as the veins shrink. It can take up to about three months to judge the result.
Post-embolisation pain and other side effects
The most common side effect is post-embolisation syndrome: an ache in the pelvis, back or flank, sometimes with a mild temperature, nausea or tiredness. It is the body’s reaction to the closed veins. It often peaks in the first two or three days and then settles. In some women it lasts longer: in one study it lasted up to about three weeks, although it settled within a month in everyone.
Other side effects and ovarian vein embolisation risks include:
- Bruising or a small lump at the entry site. This is common and fades over a week or two.
- Phlebitis. A tender, inflamed vein, more likely after foam.
- Thrombosis. A clot in a nearby pelvic vein is fairly common on scans in some studies and often causes no symptoms. A clot in a deep leg vein is uncommon.
- Coil movement. A coil moves out of place in under 2 to about 3 in 100 cases in reviews. Your team will decide whether anything needs doing.
- Contrast reaction, from a rash to, rarely, a serious allergic reaction.
- Infection at the entry site, which is rare.
Reported complication rates vary widely between studies, partly because they define complications differently. For the procedure itself, see ovarian vein embolisation.
Managing the pain at home
- Take simple painkillers as advised by your team. Some teams also prescribe an anti-inflammatory. Check with your team or pharmacist before taking anything new, especially if you take blood thinners or have kidney, stomach or asthma problems.
- Use a warm pack on your lower tummy or back if it helps.
- Rest, but keep moving. Short walks help your circulation and lower the risk of clots.
- Drink plenty of fluids.
Call your team if the pain is getting worse rather than better after a few days, or if painkillers are not controlling it.
Returning to work, exercise, sex and travel
Advice varies between centres, and the evidence for any particular timetable is limited. As a general guide:
- Work. Many women return to desk work within a few days to a week. Jobs with heavy lifting may need longer.
- Exercise. Walking can start straight away. Some centres allow normal exercise after one to two weeks, while others advise avoiding straining activities, such as weightlifting or squats, for about six weeks, to give the coils time to settle.
- Sex. There is no fixed rule. Many teams suggest waiting until the entry site has healed and the ache has settled. If sex is painful, wait longer and mention it at your follow-up. See our guide to pain during or after sex.
- Driving. Usually once you are off sedation for at least 24 hours and can move comfortably. Check your insurer’s rules.
- Flying. Ask your team, especially about long-haul flights in the first few weeks, because a recent procedure may slightly raise clot risk. If you fly, walk around, flex your ankles and drink water.
When will my symptoms improve?
Most women notice the post-procedure ache settle first, then a gradual easing of the dragging pelvic pain over the following weeks. In a 2016 review of 1,308 women, about three in four reported substantial early pain relief, and relief often grew over time. But the evidence is rated low quality, and not everyone improves.
Can pelvic congestion get worse after embolisation? A temporary flare in the first days is common. Pain that persists or returns may be due to:
- Other veins that still leak, such as the other ovarian vein or internal iliac branches
- A squeezed vein higher up, such as the left kidney or iliac vein
- Another cause of pelvic pain, such as endometriosis or a pelvic floor problem
Symptoms come back in a minority of women, with rates in different reports ranging from about 1 in 10 to as many as 4 in 10. Some women have a second procedure. A later pregnancy can also bring symptoms back.
Follow-up
Most teams arrange a review a few weeks to a few months after the procedure, sometimes with an ultrasound. This is a chance to talk about your pain, any remaining vulval or leg veins, and whether more treatment is needed. Coils stay in place permanently. Keep a note of what was used, and tell staff before any MRI scan. A Singapore vascular surgeon’s post-procedure care page gives another practical overview, and our pelvic congestion syndrome treatment guide covers other options if symptoms persist.
When to see a doctor
Contact your treating team if:
- The entry site becomes red, hot, swollen or oozing
- The ache is getting worse after the first few days, or painkillers are not helping
- You have a temperature above 38°C that lasts more than a day or two
- Your pelvic pain has not started to improve after about three months
Get urgent medical help for:
- Severe or rapidly worsening tummy, pelvic or back pain
- Heavy bleeding from the entry site that does not stop with firm pressure
- A painful, swollen, warm or red leg, which can be a sign of a deep vein clot
- Chest pain, sudden breathlessness or coughing up blood, which can be signs of a clot in the lungs
- High fever with shivering, fainting, or signs of an allergic reaction such as swelling of the face or difficulty breathing
In Singapore, call 995 in an emergency.
Frequently asked questions
What should I expect after ovarian vein embolization?
You rest for a few hours, then usually go home the same day. Expect a pelvic or back ache for a few days, mild bruising at the entry site and some tiredness. Most women are back to light activity within a day or two. Pain relief from the treatment itself usually comes gradually over weeks.
What is the ovarian vein embolization recovery time?
Most women return to normal daily activities and desk work within about a week. Heavier work and strenuous exercise may need longer, depending on your centre's advice. The full effect on your pelvic pain can take up to about three months to judge.
What are the side effects of ovarian vein embolisation?
Common side effects are a pelvic or back ache, a mild temperature for a few days, and bruising where the tube went in. Less common problems include inflammation of a vein, a clot in a pelvic vein, a coil moving out of place, a reaction to the contrast dye and infection at the entry site.
How long should I abstain from sex after pelvic vein embolization?
There is no single rule. Many teams suggest waiting until the entry site has healed and the post-procedure ache has settled, often a few days to a week or two. Ask your own team, and stop if sex is painful.
Can pelvic congestion syndrome get worse after embolization?
The ache can feel worse for the first few days as the treated veins settle. Lasting worsening is uncommon. If pain has not improved after a few months, or comes back, your specialist may check for untreated veins, compression higher up or another cause of pain.
Sources and further reading
- BSIR — Pelvic congestion syndrome and pelvic vein embolisation (patient information leaflet)
- Society of Interventional Radiology — Pelvic venous disorders (patient information)
- Daniels J et al. Effectiveness of embolization or sclerotherapy of pelvic veins for reducing chronic pelvic pain: a systematic review. J Vasc Interv Radiol 2016
- Gavrilov SG et al. Complications and adverse events of gonadal vein embolization with coils. J Pers Med 2022
- CIRSE — Pelvic congestion syndrome (patient information)
This article is general information, not personal medical advice. Please speak to a doctor about your own symptoms. How we create our content.
