Background: A 31-year-old mother of two came to our clinic because her varicose veins had returned, even after having vein treatments years ago. She noticed a large, bulging vein on the front of her right thigh and another vein in the left groin area.

She also had ongoing pain. This included pain in her lower back, buttocks, and down the backs of her thighs and knees. She felt heaviness and achiness in both legs. She also had painful periods and intercourse.

Clinical Evaluation: To find out what was going on, we did a special ultrasound of her pelvis and veins. The test showed that a major vein in her left pelvis was being squeezed by an artery. This is called May-Thurner syndrome. The scan also found a lot of swollen veins in her pelvis.

On her physical exam, we saw the large vein on her right thigh and the vein near her private area on the left.

Diagnosis and Treatment: She had pelvic venous disease, which means the veins in her pelvis weren’t working well. The May-Thurner syndrome made it worse. She also had classic symptoms of pelvic congestion syndrome – painful periods, painful intercourse and pain in her lower body.

We treated the big vein on her right thigh first, using vein ablation and microphlebectomy to close it off and remove it. Next, we planned to treat the vein in her left groin area. We also wanted to use intravascular ultrasound (IVUS) to get a better look at where the squeezing was happening in her pelvis. Depending on what we found, we might insert a small tube (stent) to open up the vein and keep it working properly.

Why This Matters: This case shows how pelvic vein problems can cause recurring varicose veins and ongoing pain. It’s important to check for vein squeezes or blockages when these symptoms keep coming back.

Using advanced imaging and different treatments can help get rid of pain and stop the problem from returning.

Contact Vein Specialists for more information about endovenous ablation or to schedule a consultation with Dr. Joseph Magnant and his team, Southwest Florida’s leading vein specialists.