About
About
- Chronic condition associated with painful varicose veins in the abdomen, thighs, buttock region or genital area
- Also known as Pelvic Venous Insufficiency (PVI)
- Can be the source of pain in up to 30% of women who have chronic pelvic pain
Potential Causes
Potential Causes
Multiple pregnancies increase the chance as a result of pelvic structural and hormonal changes
- Rise in estrogen levels during pregnancy can weaken the blood vessel walls
Symptoms
Symptoms
- Dull pain and ache that can increase:
- When standing for a period of time
- During/after sexual intercourse
- In the evenings
- Days prior to menstruation
- In the late stages of pregnancy
- Painful menstruation (dysmenorrhea)
- Abnormal bleeding during menstruation
- Backache
- Depression
- Fatigue
- Varicose veins around the vulva, buttocks and legs
- Abnormal vaginal discharge
- Swelling of the vulva/vagina
- Abdominal tenderness
- Increased urination
- Irritable bowel symptoms
Diagnosis
Diagnosis
- Abdominal/Pelvic Ultrasound: Can help eliminate other common causes of chronic pelvic pain
- CT/MRI scan: To visualize any abnormal veins within the pelvis
- Venogram: Can identify the abnormal varicose veins and the reversal of blood flow within the affected veins
Treatment
Treatment
- Oral Medications
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Chronic pain medications (gabapentin, amitriptyline)
- Pelvic Vein Embolization (PVE): Minimally invasive surgical procedure that blocks off certain varicose veins that are believed to be the source of pain
- Small coils/plugs are placed to block blood flow into the ovarian vein, which reduces the pressure within the enlarged pelvic veins



