Could Pelvic Vein Issues Be Fueling Your POTS Symptoms?
Pelvic venous insufficiency (PVI), a condition where the veins in the pelvis are unable to properly move blood back up to the heart, leading to blood pooling in the pelvis, can sneak under the radar in some people with postural orthostatic tachycardia syndrome (POTS).
Symptoms of PVI can include:
Heaviness or pressure in the pelvis worsened with prolonged standing, sitting, or exercise
Swelling in the legs or feet
Aching or throbbing in the legs
More severe or prolonged pain during menstruation
Chronic pelvic pain
Dyspareunia or painful sexual intercourse
Constipation or bloating
Pain in the lower back or hips
Problems with fertility
Varicose veins in the pelvis or legs
Increased urinary frequency, urgency, or discomfort
How is PVI diagnosed?
PVI is diagnosed through imaging such as a pelvic ultrasound or magnetic resonance venography (MRV), often by an interventional radiologist or gynecologist.
What is the treatment for PVI?
Treatment can include compression, medication, surgery, or vein embolization. Vein embolization has become the standard treatment for it.
Recent research has looked at how treating PVI may impact the quality of life of those with POTS.
Recent studies among people with POTS who have undergone iliac vein stenting for pelvic venous disease (PeVD; a broader term that encompasses conditions affecting the pelvic veins, including PVI) have shown improvement in quality of life across several domains.
More studies are underway, and this area of research could look very different in upcoming years.
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Thadani et al. (2025); Almuwaqqat et al. (2024); PMID: 36292025; PMID: 38469013; PMID: 32757696
Disclaimer: This blog post is for informational purposes only and shall not be construed as behavioral health or medical advice. It is not intended or implied to supplement or replace treatment, advice, and/or diagnosis from your own qualified healthcare provider.