By: John Hogg MD, DABR, DABVLM, RPVI, RPhS, RVT, RVS
Founder and Physician at Medical Vein Clinic
You’ve been to your gynecologist. Maybe more than once. You’ve described the pain: the constant ache in your pelvis, the sharp stabs that take your breath away, the way intimacy has become something you dread instead of enjoy. You’ve been examined, tested, and told everything looks normal. “Maybe it’s stress,” they suggest. “Let’s wait and see.”
But you know something is wrong. You’ve been living with this pain for months, maybe years. It’s affecting your work, your relationships, and your ability to simply enjoy life. You’re tired of being told it’s in your head or that you just need to learn to live with it.
We hear you. We see you. We understand.
At Medical Vein Clinic, we’re treating a condition that many doctors haven’t learned about, one that could be the answer to your chronic pelvic pain.
A Condition Few Understand
Here’s a startling reality: approximately 40% of gynecological visits involve chronic pelvic pain complaints. Of those, nearly one-third are likely related to a vascular condition called Pelvic Venous Disorder (PVD), also known as Pelvic Congestion Syndrome. But less than half of these cases are ever referred to specialists who can actually help.
Studies show that between 40 and 75% of women suffering from these symptoms don’t seek medical help. They suffer in silence because they’ve been dismissed so many times.
My colleague, Thomas Gianis M.D. FACS, FSVS, DABVLM, RPVI, RVT a Board-Certified Vascular Surgeon who treats PVD at Medical Vein Clinic, sees this pattern constantly.
“These women struggle with pelvic pain that no one can explain to them. There is simply a very low awareness among medical
professionals, unfortunately, that a large number of these pelvic pain cases are caused by varicose veins deep in the pelvic region. And, this is something we can treat here at Medical Vein Clinic.”
What Is Pelvic Venous Disorder?
Think about varicose veins in the legs, those bulging, twisted, bluish-purple veins that many women develop. The same thing can happen to the veins around your ovaries and uterus. That’s Pelvic Venous Disorder.
When pelvic veins become engorged with blood, they enlarge and twist just like leg varicose veins. Here’s the big difference: they’re hidden inside your pelvis and reproductive organs, completely invisible. You can’t see them. You just feel the relentless pain they cause.
Inside your veins are tiny valves that work like one-way doors, keeping blood flowing in the right direction. When these valves weaken or fail, blood flows backward and pools in the pelvic veins. This creates varicose veins around your ovaries and pelvic organs. That pooling, that pressure, that congestion, is what’s causing your pain.
A Story That Changes Everything
Recently, I was reviewing a patient’s venous ultrasound and noticed something concerning: deep vein reflux in the legs, with superficial veins that had reopened after successful treatment the previous year. When I discussed this with the patient, she mentioned she was scheduled for pelvic surgery in October to remove mesh related to a hernia treatment, and that doctors believed was causing her pelvic pain.
Then she shared something that broke my heart: intense pain during intercourse and chronic back pain so debilitating that she struggled to stand through a full day at work.
I realized that all of her symptoms pointed to one thing: a compressed vein causing the venous blood to back up and cause Pelvic Venous Disorder. That scheduled mesh removal surgery? Possibly unnecessary, but could be answered by a specialized pelvic MRI examination. The additional invasive procedures? We might avoid them entirely.
“I saw a real opportunity to resolve her whole situation and end years of suffering. This is why specialized knowledge matters. This is why we take the time to holistically understand the full picture.”
Do You Recognize These Symptoms?
Chronic Pelvic Pain That Disrupts Your Life
The main symptom of PVD is persistent pain in your lower abdomen or pelvis. Many women tell me it feels like a constant, dull ache with occasional sharp pains that catch you off guard.
What makes PVD different is the pattern of pain.
Your pain gets worse when you:
- Stand for long periods
- Have sexual intercourse (during or afterward)
- Go through your menstrual period
- Sit for extended periods of time
- Lift heavy objects
Your pain improves when you:
- Lie down and rest
- Take pressure off your abdomen
- You might also experience lower back pain.
Here’s an important distinction: while pain from PVD may intensify during your period, it doesn’t come and go with your menstrual cycle the way endometriosis does. It’s more constant, or it fluctuates, but not in rhythm with your periods.
Pain That Started During or After Pregnancy
For many women, PVD first appears during pregnancy (usually in the third trimester) or in the months following delivery. During pregnancy, your blood volume increases dramatically, naturally causing your veins to enlarge. This extra pressure can weaken the valves in your pelvic veins, setting the stage for chronic problems.
If your pelvic pain began during or after pregnancy and never fully resolved, PVD could be the culprit.
Varicose Veins in Unexpected Places
Women with PVD often develop visible varicose veins in places you wouldn’t expect: the vagina, vulva, upper thighs, or buttocks. You’re also more likely to have varicose veins in your legs. These visible veins are warning signs pointing to what’s happening deeper inside your pelvis.
Bladder and Bowel Changes
Sometimes, PVD affects bladder and bowel function in ways you might not connect to pelvic veins.
Bladder symptoms:
- Needing to urinate frequently
- Sudden urgent bathroom trips
- Stress incontinence (leaking when you cough, sneeze, laugh, or lift)
Bowel symptoms:
- Alternating diarrhea and constipation
- Cramping abdominal pain
- General digestive discomfort
Abnormal Bleeding
Some women with PVD experience abnormal uterine bleeding: heavier periods, bleeding between cycles, or periods that arrive at unusual intervals. However, because abnormal bleeding is also common with endometriosis, polycystic ovary syndrome, and uterine fibroids, it’s important to see your gynecologist first to rule out these conditions.
The Treatment That Changes Lives
“When I look at the research and our clinical outcomes, one statistic absolutely astounds me: 80% of these women, when they are treated, find relief within two weeks.”
After years of pain, years of being dismissed, years of trying to function with chronic suffering, relief can come in just two weeks with a minimally invasive outpatient procedure.
That’s life-changing. That is our goal at Medical Vein Clinic. We want you to live a pain-free life full of possibilities and adventure.
Treatment That Actually Works
Medical Vein Clinic is the only clinic in San Antonio offering dedicated, specialized treatment for Pelvic Venous Disorder. We heard the complaints of pain, we saw the ultrasounds and evidence of the misdiagnosed and underdiagnosed disorder, and we took action.
A State-of-the-Art, Minimally-Invasive Procedure
This outpatient procedure works by inserting a catheter to stent or embolize (essentially “plugging”) the problematic veins in your pelvis that are causing your symptoms. We use the latest imaging technology to guide the catheter into the problem veins. The procedure typically takes about an hour under IV conscious sedation. You’ll be relaxed, but awake. You’ll need someone to drive you home and stay with you that day, but most women can begin resuming normal activities the next day.
No major surgery. No long recovery. Just targeted treatment that addresses the root cause of your pain.
Why Expertise and Individualization Matter
Treatment for PVD must be individualized. This isn’t a one-size-fits-all condition, which is why it requires a physician who specializes in this specific disorder and takes the time to understand your unique situation.
Dr. Gianis performs the PVD treatments at Medical Vein Clinic. Over his career, he has treated hundreds of patients with arterial and vascular problems. His specialized training and expertise have provided pain relief, enabling patients to be more active and enjoy a greater quality of life.
But more than his credentials, Dr. Gianis cares. He chose to specialize in this overlooked condition because he saw women suffering needlessly. He saw the gap in care and had to fill it.
Your Personalized Evaluation
When you come to see us, we take the time to truly understand your situation. Your workup will involve:
- A detailed history of your symptoms and how they affect your daily life
- Specific imaging such as ultrasound, MRI, and/or CT scans
- A comprehensive review to create a treatment plan tailored specifically to you
We listen. We investigate thoroughly. We design treatment around your needs, not around convenience or convention.
Insurance Coverage
Most insurance plans cover treatment for Pelvic Venous Disorder. We’ll work with you to navigate the insurance process and help you understand your coverage, so financial concerns don’t stand between you and relief.
Let our expertise help you.
Treatment procedures for Pelvic Venous Disorder at Medical Vein Clinic are performed by Thomas J. Gianis II, MD, FACS, FSVS, DABVLM, RPVI, RVT. He is focused on helping patients find relief from this debilitating and often overlooked condition.
Over the years, Dr. Gianis has worked with hundreds of patients with arterial and vascular problems. His training and expertise have given them relief from pain, and the ability to be more active and enjoy a greater quality of life.
Helping Patients Reclaim Their Lives
Since we opened Medical Vein Clinic in 2017, we’ve helped patients reclaim their lives from vascular conditions that were stealing their health and happiness. We’ve seen the transformation that happens when someone finally gets the right diagnosis and the right treatment.
You deserve relief from chronic pelvic pain. You deserve to walk without discomfort, be intimate without fear, be active with your family, and sleep through the night without pain waking you.
To set up an evaluation, contact Medical Vein Clinic at info@medicalveinclinic.com, or call 210-622-8000.
You’ve suffered long enough. Let us help you find relief.
Healthy Legs Take You Further™ Medical Vein Clinic™ is located in San Antonio, Texas, and is the only clinic in the San Antonio area offering specialized treatment for Pelvic Venous Disorder.
This article was originally published in SA Woman Magazine.