Pelvic Venous Insufficiency: What You Need To Know


Pelvic venous insufficiency or PVI is a condition that produces symptoms such as chronic pelvic pain and leg swelling. PVI develops when veins in the pelvic region can’t circulate blood properly. Instead of blood flowing back toward the heart, blood pools or builds up in the pelvis.

If you have symptoms of PVI or suspect you have the condition, you should schedule an appointment with your vascular doctor.

A medical evaluation and a series of tests can determine if you have PVI. Should your test results indicate PVI, you’ll work with your doctor, nurse practitioner, or physician assistant to design an appropriate treatment plan.

But for now, it helps to review everything you need to know about pelvic venous insufficiency. Below is an overview of the disease and what increases your risk of developing it. Common symptoms and treatment protocols are also discussed. Let’s get started!

Pelvic Venous Insufficiency Explained

As you’re probably aware, your body has many veins. These veins form a venous system that allows blood from your body’s different organs and parts to return to your heart. In a well-functioning venous system, blood flows directly back to the heart with little interruption, so it doesn’t get “stuck” in those parts.

But sometimes specific veins stop working properly and don’t send blood back to the heart. As a result, the blood pools in the veins and weakens the walls because there’s more pressure on them.

Sometimes those veins visibly swell or take on a knotty appearance underneath the skin. Known as varicose veins, they often require surgery or therapy to correct the flow of blood.

With PVI, these veins are present in the body’s pelvic region. Consequently, swelling within the veins can lead to excess pressure on nearby organs like ovaries and the uterus.

However, people may also feel this pressure or pain in the lower back and upper legs. PVI’s symptoms may be progressive or fluctuate.

Symptoms of PVI

To be clear, PVI is a condition that typically impacts females. Its symptoms range in severity, and not everyone with pelvic venous insufficiency will experience the same signs each day, week, or month. That said, there are some common symptoms to watch out for.

  • Dull or sharp pain in the pelvic area that comes and goes.
  • Chronic dull aches in the pelvis or upper legs.
  • Swelling or a feeling of heaviness in the pelvis.
  • Heavy leg syndrome or leg swelling and aches.
  • Pain during menstruation or sexual activity.
  • Swollen feet.
  • Feeling bloated with excess gas.
  • Problems with getting pregnant.
  • Issues with urinary incontinence.
  • Constipation and lower backaches.
  • Visible varicose veins in the pelvic region and legs.

Granted, some of these symptoms can be indicators of other conditions and diseases. This is why it’s important to make a list of the signs of PVI you’re experiencing. It also helps to write down your perceptions of severity and how often each symptom occurs.

You might also want to log whether certain activities like sitting and standing aggravate or bring on your symptoms. All this data will help a doctor determine which tests to order and how to approach your medical evaluation.

Remember that some people with PVI have mild to no symptoms. So getting regular checkups and bloodwork can be just as important.

How Do Doctors Diagnose PVI?

A visual check for varicose veins in the pelvic region and the legs can lead doctors to a PVI diagnosis. However, imaging in the form of ultrasounds, CT scans, and MRIs usually confirms the condition exists. Imaging lets doctors see veins that aren’t visible to the naked eye.

Also, sometimes a varicose vein isn’t obvious beneath the skin. An ultrasound or scan brings veins into clear view and shows whether they’re functioning incorrectly.

A medical practitioner can sometimes determine the extent and severity of the problem with images and ultrasounds. Similar to other conditions, symptom severity does not always equal the condition’s progression.

Treatment Options for Pelvic Venous Insufficiency

Your treatment options will depend on your symptoms and what your doctor discovers during your evaluation. Generally speaking, your doctor will recommend less invasive treatment options if your symptoms are mild or infrequent.

They may also recommend these options if the severity of the condition is mild or moderate.

Here is what your doctor may ask you to do:

  • Wear compression stockings or leggings to increase circulation and reduce leg pressure.
  • Wear compression garments that fit over your pelvic region to regulate pressure and circulation.
  • Avoid activities where you must sit or stand for extended periods. Alternatively, you may be asked to alternate your activities to avoid excessive sitting or standing.
  • Elevate your legs for short periods throughout the day or at night during rest.
  • Engage in more physical activity and exercise to promote circulation and weight loss.
  • Change your dietary habits to help with weight loss.

However, more serious or extensive cases of PVI often require medications and even minimally-invasive surgery and embolization procedure to remove varicose veins.

Risk Factors

While risk factors do not mean you’ll develop PVI, they increase your chances. Things that can heighten your risk include being overweight, being pregnant, having a genetic history of varicose veins, and not getting enough exercise.

Other risks include a personal or family history of blood clots and entering perimenopause or menopause.


Pelvic venous insufficiency isn’t necessarily a life-threatening condition. However, PVI can become more severe and extensive over time and lead to blood clots. Patients seek further options and procedure when symptoms are difficult to bear or want to improve their quality of life. 

PVI is a condition that impacts women who are usually in their childbearing years. Symptoms range from leg swelling and aching to infertility, chronic pelvic pain, and even back pain.

If you have signs of PVI, it’s imperative to get a formal evaluation and diagnosis from a doctor. Together you can discuss your treatment options to get relief from your symptoms and control or correct the condition. 


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