Pelvic Congestion Syndrome (PCS) is a medical condition that afflicts women. It is caused by venous insufficiency of veins located in the pelvis such as the ovarian veins and internal iliac veins and its branches. The symptoms include a dull, aching pain with discomfort in the lower pelvis, back and abdomen. The discomfort can worsen with intercourse, bowel movements, irritable bladder and menstrual cycles.  Long periods of standing can exacerbate the pain. Often, visibly enlarged veins in the labia and upper inner thigh can be present.  This condition is hard to detect is often missed during pelvic exams due to the veins deflating once the patient lays down on the examination table. Pelvic congestion syndrome is most common in women who have had multiple pregnancies and fibroids.  Pelvic venous ultrasound and venography is often needed to diagnose and treat this condition.