A Patient Was Told Her Pelvic Pain Was “Normal” for Years. It Wasn’t.

Unfortunately, stories of dismissal remain common. Dr. Famularo recalls hearing from patients who discovered psychiatric referrals in their medical records after being told no physical cause for their symptoms could be identified.

Experiences like these can leave patients feeling unheard and can delay appropriate diagnosis and management. But Dr. Famularo encourages women to continue seeking help when they know something is wrong.

PeVD Hasn’t Always Been Recognized

The challenges patients face today reflect a complicated recent history. When Dr. Famularo was training as a vascular surgeon, PeVD was still viewed skeptically. Although some physicians recognized its impact, “it was still not seen as a real diagnosis at the time,” she said.

She credits one of her mentors in vascular surgery, Dr. Joseph Lombardi, for helping advance awareness of the condition. “He was really the first one who said, this affects a lot of women and it’s really important.”

While awareness has grown substantially in recent years, Dr. Famularo believes continued research and education are needed to help more patients reach the right diagnosis sooner. “We need to have more data. And the data that we need to have needs to be better,” said Dr. Famularo.

That need for research is why Weill Medical College of Cornell University launched the EMBOLIZE trial with support from the Society of Interventional Radiology (SIR) Foundation, The VIVA Foundation, and Penumbra Inc. The EMBOLIZE trial is a first-of-its-kind prospective, randomized controlled trial studying the effects of ovarian vein embolization in reducing pain and improving quality of life in women experiencing chronic pain due to PeVD.

Finding the Right Diagnosis

Diagnosing PeVD is rarely straightforward. Chronic pelvic pain can have multiple causes, and many patients have more than one condition contributing to chronic pelvic pain, including endometriosis, pelvic floor dysfunction, and venous disease.^1,2

That complexity is why careful evaluation is so important. “We go through a lot of trouble trying to figure out who the right person is to get the procedure.”

At Lehigh Valley Health Network, where Dr. Famularo practices, patients are evaluated through a unique multidisciplinary chronic pelvic pain program that brings together gynecologists, vascular specialists, pelvic floor physical therapists, and other providers.

The goal is not simply to identify who may benefit from embolization, but to understand the full picture behind a patient’s symptoms.

Considering Care Options

For patients diagnosed with PeVD, embolization may offer a minimally invasive option, she says. In appropriately selected patients, embolization works by closing off the malfunctioning vein, reducing the pressure that may be contributing to symptoms.

Chronic pain is complex, and outcomes can vary. However, Dr. Famularo notes that the procedure is generally associated with a favorable safety profile and can offer many patients relief from their chronic pelvic pain. “In the right patient, this can significantly improve quality of life ” said Dr. Famularo.

Some of Dr. Famularo’s patients improved enough after embolization to avoid more invasive procedures. “I had a few patients that had excellent outcomes and were able to cancel other planned surgeries.” She notes, however, that embolization is not the right solution for everyone, and conditions such as endometriosis may require other treatments.

The key, she says, is ensuring that patients are evaluated by specialists who can work together to determine the most appropriate course of care.

What Success Looks Like

For Dr. Famularo, success is reflected in the patients who regain the ability to work, attend school, care for their families, and participate in activities that chronic pain had stolen from them.

It is also reflected in the community that forms to help other women. “What happens is they refer their sister and their friends and their friends’ sisters.” Those referrals represent something powerful: patients who finally found answers wanting others to find them too.

Although awareness of PeVD is growing, many women still live with unexplained symptoms. Their experiences highlight the need to take chronic pelvic pain seriously, investigating it thoughtfully and listening closely to what patients are experiencing –– and foremost, not dismissing their pain as “normal.”

Learn more about the Embolize Trial.

^{1. Kaufman, C.S. et al. The Society of Interventional Radiology Practice Guidance Document on Venous-Origin Chronic Pelvic Pain in Women. J Vasc Interv Radiol. 2026 June;37(6);107954.}

^{2. Ni T, Friedman I, Smith J, Liu B, Melchior M, Brown AD. Pelvic venous disorders in women: Diagnosis and management for gynecologists. Int J Gynecol Obstet. 2026; 174: 1267-1276. doi:10.1002/ijgo.70955.}

^{3. Meissner, MH et al. Clinical outcome after treatment of pelvic congestion syndrome: Sense and nonsense. Phlebology. 2015 February; 30(1_Suppl); 73-80.}