Pelvic pain 11 months after giving birth.

I had my baby 11 months ago and I'm still in pain. I think it's pelvic congestion syndrome. I want to get better but I don't know what to do. What are some steps I can take to improve?

Answers from doctors (3)


Mercy Imaging Centers

Published on Nov 26, 2016

First step is to rule in or rule out pelvic congestion syndrome, because there are many alternative disorders that cause pelvic pain.

The key question is: when is the pain at its worst? PCS pain very characteristically occurs after being upright (standing or sitting) for hours and increases with each continuous hour of upright posture. So, it should be at its worst at the end of a day after being upright for many consecutive hours.

Further, PCS pain should improve after laying flat for an hour or so, and NEVER occur first thing in the morning after being flat while sleeping for several hours.

If the pain strikes unrelated to whether you are flat or upright (for example, occurs at night waking you from sleep, or if sometimes getting up and walking around makes it better) then PCS is pretty much off the table. However, if staying up makes it worse and laying down makes it better, then PCS could be present and an imaging study would be the next step to see if you can be treated.

The problem is that standard pelvic imaging exams can miss the diagnosis because they are done flat and the engorged veins can vanish and go undetected. If the history is right, you need a consultation with an interventional Radiologist to make sure the imaging is done properly. The two options are upright transvaginal ultrasound and semiupright catheter venography.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/1561_1427402862.jpg
Answered by Mercy Imaging Centers

First step is to rule in or rule out pelvic congestion syndrome, because there are many alternative disorders that cause pelvic pain.

The key question is: when is the pain at its worst? PCS pain very characteristically occurs after being upright (standing or sitting) for hours and increases with each continuous hour of upright posture. So, it should be at its worst at the end of a day after being upright for many consecutive hours.

Further, PCS pain should improve after laying flat for an hour or so, and NEVER occur first thing in the morning after being flat while sleeping for several hours.

If the pain strikes unrelated to whether you are flat or upright (for example, occurs at night waking you from sleep, or if sometimes getting up and walking around makes it better) then PCS is pretty much off the table. However, if staying up makes it worse and laying down makes it better, then PCS could be present and an imaging study would be the next step to see if you can be treated.

The problem is that standard pelvic imaging exams can miss the diagnosis because they are done flat and the engorged veins can vanish and go undetected. If the history is right, you need a consultation with an interventional Radiologist to make sure the imaging is done properly. The two options are upright transvaginal ultrasound and semiupright catheter venography.

Published on Jul 11, 2012


Hratch Karamanoukian, MD, FACS, RVT, RPVI, RPhS

Published on Nov 21, 2016

A pelic Doppler ultrasound by an accredited vascular lab is a good way to start. This can be followed by a CT venogram, MRV (MRI variant with venography) and finally tilt table venography (if necessary). The latter is classified as an invasive study.

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/7743_1538076833.jpg
Answered by Hratch Karamanoukian, MD, FACS, RVT, RPVI, RPhS

A pelic Doppler ultrasound by an accredited vascular lab is a good way to start. This can be followed by a CT venogram, MRV (MRI variant with venography) and finally tilt table venography (if necessary). The latter is classified as an invasive study.

Published on Jul 11, 2012


VeinCare Centers of Tennessee

Published on Jan 10, 2012

See your OB for an exam and ask for an evaluation for pelvic congestion syndrome and pelvic varicose veins. This usually will require referral to a vascular surgeon or interventional radiologist experienced in treating PCS.

Stephen F. Daugherty, MD, FACS, RVT, RPhS

//imgs-origin.edoctors.com/imageresizer/image/user_uploads/58x58_85-1/doctors/755_1499906765.jpg
Answered by VeinCare Centers of Tennessee

See your OB for an exam and ask for an evaluation for pelvic congestion syndrome and pelvic varicose veins. This usually will require referral to a vascular surgeon or interventional radiologist experienced in treating PCS.

Stephen F. Daugherty, MD, FACS, RVT, RPhS

Published on Jul 11, 2012


Related Questions for Pelvic Congestion Syndrome Treatment

Pelvic Congestion Syndrome Treatment -2 answers
Is Pelvic Congestion Symdrome life threatening if left untreated?
See More
Pelvic Congestion Syndrome Treatment -3 answers
I am 60 years of age and have had prominent veins in the buttocks for some years but they are just beginning to trouble me. I've had a pelvic ultrasound scan which showed that I also have prominent veins in the uterus and small fibroids.
See More
Pelvic Congestion Syndrome Treatment -4 answers
Or are there other treatments?
See More
Pelvic Congestion Syndrome Treatment -4 answers
I have low and mid back pain along with nausea. Can this be attributed to Pelvic Congestion Syndrome?
See More
Pelvic Congestion Syndrome Treatment -4 answers
My radiologist put coils on the main left ovarian vein. He said the procedure was a success and that was the only varicose vein. I felt great after the procedure but then two weeks later the pain is worse. Why do you think that is?
See More
Pelvic Congestion Syndrome Treatment -1 answer
I have had a ct scan that showed I had PCS several years ago and have a hysterectony 3 years ago is it possible to have PCS after the hysterectomy? I am now starting with dull aching pain in the lower abdomen and upper legs.
See More
Pelvic Congestion Syndrome Treatment -2 answers
Can you still get pregnant with pelvic congestion syndrome?
See More
Pelvic Congestion Syndrome Treatment -1 answer
Can PCS have symptoms like abdominal bloating or palpitations?
See More
Pelvic Congestion Syndrome Treatment -5 answers
I was recently diagnosed with PCS. Its very painful, almost all the time. My doctor put me on birth control for treatment. Is this an effective treatment? And would the surgical procedure work for the veins in my legs if they just embolize the stomach veins?
See More
Get answers from our experienced doctors.
How it works
Pelvic Congestion Syndrome Treatment -3 answers
What is your recommended treatment of PCS and do you recommend an OBGYN? Is weight gain typically associated with PCS?
See More
Pelvic Congestion Syndrome Treatment -2 answers
My MD said it was varicose vein, gyn said nothing can be done and dismissed it. I have pain, pressure, skin burning especially with standing or sitting too long. Should I see a vein specialist or "live with it" as gyn said. affects quality of life.
See More
Pelvic Congestion Syndrome Treatment -2 answers
I was recently dx with PCS from an ultrasound and very obvious enlarged vessels. While I'm seeking additional testing, what should I avoid? Can I run, bend or lift normally? Is there a risk for blood clot?
See More
Pelvic Congestion Syndrome Treatment -2 answers
See More
Pelvic Congestion Syndrome Treatment -2 answers
I am really worried, can Pelvic Congestion Syndrome make women infertile? Are their infertility options for women with PCS?
See More
Pelvic Congestion Syndrome Treatment -3 answers
I still want to have children, but now that I have been diagnosed with PCS I'm not sure if it's possible. Will this syndrome affect my ability to get pregnant? What about delivery a baby?
See More
Pelvic Congestion Syndrome Treatment -3 answers
I have pelvic congestion syndrome. Is discharge one of the symptoms? What are the typical symptoms of Pelvic Congestion Syndrome apart from pain?
See More
Pelvic Congestion Syndrome Treatment -1 answer
They sound kind of the same.
See More
Pelvic Congestion Syndrome Treatment -5 answers
The only thing that relieves it is rolling up a towel and placing it under by left buttock and sitting. It then feels like things are circulating better and the pain goes away. Have you ever heard of this and why does it happen?
See More
Pelvic Congestion Syndrome Treatment -1 answer
I was wondering what treatments were available for PCS. Pros? Cons?
See More
Get answers from our experienced doctors.
How it works

Related Articles

Have specific questions?
ASK A DOCTOR