Corrine Jones was tucking her two young children into bed one Sunday evening when she was suddenly struck by excruciating stabbing pains in her lower abdomen.
The heavy, dull ache that had plagued her on and off for more than six months had now turned into severe shooting sensations that left her bent over double and vomiting.
‘I was so scared and had no idea what was happening,’ says the former surfer and model, who runs a production company with her husband Ben, 37.
‘I’d always managed the dull ache before with rest, paracetamol and a hot water bottle, but this was different – the sharp pain was totally unbearable,’ says the mother of two, from Newquay, Cornwall.
A ‘very worried’ Ben called 111.
The operator suspected appendicitis and urged Corrine to go A&E.
‘The NHS was wonderful, I can’t fault them,’ says Corrine, 36, who was rushed to hospital by her mother, while Ben stayed at home to look after their sons, Albee, now six, and Ozzie, three.
Corrine Jones had the typical symptoms of pelvic congestion syndrome (PCS) – which affects 1.5million women – caused by varicose veins around her ovaries
‘I was admitted overnight and examined for an ovarian cyst and anything else that could be going on in that area.’
But blood tests and internal and external ultrasound scans were clear.
‘The nurse said this sometimes happens where women come in with these symptoms, and they don’t ever really find out why they’re in pain,’ says Corrine.
She was sent home the following day and told to take normal pain relief and rest.
‘I was also put on a waiting list to see the gynaecology team.’
By now, the intense, sharp pain had subsided.
Yet, Corrine still suffered with the ongoing dragging feeling in her pelvic region. ‘It was really upsetting because I knew something was wrong, but a cause hadn’t been found.
‘I forced myself to carry on with life as normal but was so lethargic. The pain was particularly debilitating after long days on my feet running around after the children.
‘All I could do was go to bed and rest.’
In fact Corrine had the typical symptoms of pelvic congestion syndrome (PCS), caused by varicose veins around her ovaries.
Also known as ovarian vein reflux, it occurs as a result of faulty valves in the veins – so blood that should be pumped out of the pelvis and back to the heart instead pools in the pelvic and ovarian veins, stretching and dilating them.
Over time the enlarged, sagging veins are pushed onto the bladder, bowel, vagina and pelvic floor, causing extreme discomfort. Some women complain of pain after sexual intercourse, the need to use the loo more urgently (because of pressure on the bladder and bowel), hip and back pain.
Common signs include pelvic pain that worsens as the day goes on, especially after prolonged periods of standing, and during menstruation.
Varicose veins at the top of the inner thigh are another clue.
Up to 1.5 million adult women in the UK are believed to be affected by hidden pelvic varicose veins. While it affects both sexes, it’s less common in men, with bulging veins in the scrotum a possible sign.
Typically if it is diagnosed, this is in women under 40 who’ve had more than one pregnancy – pressure from the womb, a growing baby and increased blood flow can sometimes cause valves to stop working properly.
But despite affecting so many people, the condition is not well known, say experts.
Corrine had never heard of it until she stumbled across an Instagram post in April 2023, three months after her hospital admission: it was a lightbulb moment.
Like her mother and grandmother, Corrine first developed varicose veins in her legs in her mid-20s. ‘I’d taken a lot of long-haul flights, but my legs would still swell and feel like they were filled with concrete.
‘I went to the doctor multiple times because of my family history of varicose veins but was told they weren’t severe enough to be looked at as they weren’t ulcerated.’
During her first pregnancy, in 2018, the bulging veins in Corrine’s legs worsened, and after giving birth to her second child in 2021, the pelvic discomfort really ramped up.
‘I had what felt like period pains all the time,’ Corrine says.
Treatment options for PCS include anti-inflammatory drugs, the Pill (which relieves pain by reducing bleeding) and keyhole surgery to tie off veins.
Common signs include pelvic pain that worsens as the day goes on, especially after prolonged periods of standing, and during menstruation
However, Robert Morgan, a professor of interventional radiology and clinical director for diagnostics at St George’s University Hospitals NHS Foundation Trust, London, says the preferred method is PVE (pelvic vein embolisation), a minimally invasive procedure which stops blood flow in the congested veins and causes them to shrink.
First, an internal ultrasound is used to identify the troublesome veins: tiny catheters are then inserted into the vein (via a vein in the neck or groin), and when in situ, special platinum coils – which cluster together to stop blood flow – are released with a special foam that contains a chemical to destroy veins.
Once blocked, the faulty veins are reabsorbed into the body by the immune system over many months, and the competent veins can work more efficiently.
‘[PVE] is relatively safe, takes 30 to 60 minutes, has low complications and patients are discharged from hospital the same day,’ explains Professor Morgan, whose team of 13 interventional radiologists perform approximately 40-60 procedures at St George’s annually.
However, the procedure is only available on the NHS in some centres.
Corrine contacted The Whiteley Clinic, a private practice that specialises in vascular procedures, as ‘I knew the NHS wouldn’t treat me as they had already told me my veins weren’t bad enough’.
Professor Mark Whiteley warns one in three women attending gynaecology outpatients with chronic pelvic pain (CPP) have hidden varicose veins
An internal scan revealed that Corrine had pelvic congestion in the ovarian vein on her left side and on both sides in the internal iliac veins – these are a group of veins that return blood from the pelvic organs to the heart.
These veins are the problem ‘in 97 per cent of PCS cases, but most doctors only treat the ovarian veins as they are easier to treat’, says Professor Mark Whiteley, a consultant venous surgeon who set up The Whiteley Clinic.
‘It was eye-opening to realise this was what I’d been dealing with since my 20s,’ Corrine says. ‘On the scan, I could see the blood pooling in the pelvic veins and not flowing properly.’
Corrine travelled to London for the 90-minute day case procedure (PVE treatment starts from £4,400).
She returned to Newquay the same day.
It took a month for the internal inflammation to settle, but Corrine began carrying out her daily activities, including going to the gym, with no discomfort.
‘It was amazing. Sadly, I think a lot of women are probably living with hidden varicose veins and just trying to manage the discomfort because it’s not picked up or talked about.
‘Looking back, it’s surprising, given how common it is, that no one mentioned it or suggested it when I had my tests in the hospital.’
One in three women attending gynaecology outpatients with chronic pelvic pain (CPP) have hidden varicose veins, according to Professor Whiteley.
‘Unfortunately, these conditions are not recognised by most gynaecologists, let alone other health professionals and these patients are frequently told they have endometriosis or that there is ‘nothing wrong with them’.
‘Many gynaecologists see the dilated veins on scans – but are not trained to know that these are the cause of the problems, so they ignore them.’
Professor Whiteley warns it is only an effective treatment if the right veins are located using a transvaginal duplex ultrasound scan, which is performed with the patient half sitting and half lying with their back at a 45-degree angle to spot faulty blood flow.
‘Although many doctors like to use MRI, CT or venography [an X-ray using a contrast dye], these have been shown to be less accurate as they do not give information about the blood flow in the veins,’ he says.
‘Unfortunately, we do see patients [who’ve had PVE elsewhere] but don’t get improvement because the wrong veins were identified or the coils were left too high in the vein. This can be due to inexperienced doctors performing the embolisation, or a groin approach being used rather than in the neck, meaning that the catheter is not passed all the way to the bottom of the affected vein.’
Earlier this month, the House of Commons Women and Equalities Committee warned that women with conditions including heavy periods, endometriosis and adenomyosis were being dismissed and suggested there was a lack of medical research, treatment options and specialists.
Arguably, more research is needed on pelvic congestion syndrome, too.
Professor Morgan, who is currently president of the British Society of Interventional Radiology, suggests awareness about the condition is improving – he’s seen a rise in PCS procedure referrals, a result of increasing media reporting, patient knowledge and greater education.
Corrine, who received her treatment free in exchange for sharing her story, says she’s been ‘inundated with messages [on social media] saying ‘I think I have this’.
‘I want women to know that the pain of PCS isn’t something they have to put up with for ever.’
