Pelvic Congestion Syndrome: the Under-Diagnosed Pain That London Clinics Are Exposing
Here at the London Pain Clinic, our world-class Pain & Vulva Doctors are extremely mindful that pelvic congestion syndrome/PCS (which is caused by venous disease), is not only a massive burden on a sufferer’s quality of life, it is also regularly undiagnosed in women with pelvic pain. However, things are changing, and now in 2025, London is leading the way by shining a light on this painful condition which is negatively impacting countless women’s lives
Did You Know?
“Pelvic congestion syndrome occurs when varicose veins develop around the ovaries, similar to varicose veins that occur in the legs. Long-term pelvic pain impacts around 15% of pre-menopausal women…” [1,2]
The aforementioned lack of diagnosis, appears to be linked to “limited awareness of this disease process by both physicians and patients, coupled with incomplete data in the literature. -This may explain why other common causes of pelvic pain and discomfort (e.g. endometriosis and fibroids), are broadly recognised, and are therefore diagnosed and treated appropriately, whereas PCS [which is classed as pelvic venous disease], is rarely included in differential diagnosis” [1]. Of note: in the UK, very few GPs have undergone the necessary additional years of training and in-house clinic practice of that of Vulva Pain Doctors.
The Smart Way to Ameliorate Pelvic Congestion Syndrome
In order to receive an accurate diagnosis and optimum treatment for PCS, the smart move is to book an online or in-person appointment with a Vulva Pain Specialist. They will review your medical history, conduct any necessary examination and tests, and then, according to your diagnosis, provide you with a Holistic Personalised Treatment Plan. This is likely to be multifaceted, and include both conventional and the latest cutting-edge treatment (including injectables such as Botox).
How You Pain Doctor Diagnoses PCS
As your Vulva Pain Consultant will explain to you, pelvic congestion syndrome is classed as a diagnosis of exclusion. To that end, other disorders such as: adhesions, pelvic inflammatory disease, uterine abnormalities (for example, arteriovenous malformations, leiomyomata, and adenomyosis), and endometriosis, are normally considered first [2].
Taking All Aspects into Account
Our highly experienced team of long-serving Vulva Pain Doctors, is always abreast of the latest research on pelvic congestion syndrome and innovative treatments. They are extremely mindful that: “other associated manifestations of PCS that are not necessarily pelvic related. This includes generalized lethargy, depression, headaches, and nausea. And although these symptoms are non-specific, they know that they should not be discounted, as they are a major cause of a decreased quality of life” [2].
Important Facets of Pelvic Congestion Syndrome (PCS)
In many instances, our Vulva Pain Doctors have seen that PCS symptoms “do not appear until a woman becomes pregnant, and then they continue after the pregnancy. The main symptom is pelvic pain. The pain typically worsens as the day goes on, especially for women who sit or stand all day, and then goes away after a night of sleep” [2].
PCS Pain Worsens in the Following Scenarios
- During sexual intercourse
- Following sexual intercourse
- At the time of menstruation
- Post-horseback riding, post-cycling, and post other physical activities [2]
So What is the Root Cause of PCS?
After varicose veins grow around the ovaries:
- The valves in the veins are not able to function normally
- This drives the blood to back up
- The result is that the veins become ‘congested’ and thus painful [2]
References
[1]. Rochon, P. J., & Spencer, E. B. (2018). “Pelvic Congestion Syndrome: Underdiagnosed, Misdiagnosed, and Undertreated…or a Misnomer?” EVT.
[2]. Stanford Medicine (2025). “Pelvic Congestion Syndrome (PCS).” https://stanfordhealthcare.org/medical-conditions/womens-health/pelvic-congestion.html
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