Varicose veins around the ovaries and in the pelvic cavity often are related to pelvic pain. These varicose veins are due to the result of valves that do not work correctly. The blood then increases in pressure and causes the veins to bulge much like in the legs. These veins cause pelvic insufficiency often referred to as pelvic congestion syndrome.
Some studies show that 30% of patients with chronic pelvic pain have pelvic venous insufficiency. Risk factors for developing pelvic insufficiency include multiple pregnancies, polycystic ovarian disease, fullness of the leg veins, and hormonal dysfunction.
Women with PVI usually complain of a dull aching and heaviness in the pelvis that increases when standing, during pregnancy, and during menstruation. Sometimes this pain may be experienced in the lower back. There may be visible varicose veins in the groin area, buttocks, or upper thigh and pressure behind the knee during menstruation.
The cause of the varicosed ovarian or pelvic veins is poorly understood. Pelvic congestion syndrome most commonly occurs in young women , and usually in women who have had at least 2-3 children. During pregnancy the ovarian vein can be compressed by womb increasing pressure on the veins. This is thought to affect the valves in the vein causing them to stop working and allowing the blood to flow backwards.
There may be other causes of obstruction to the ovarian and pelvic veins leading to pelvic congestion syndrome, which are much less common, and are the result of vein obstruction. There is an association with polycystic ovaries. The absence of the vein valves due to abnormal development may be a contributing factor to all varicose veins.