It is estimated that nearly a third of all women experience chronic pelvic pain during their lifetime. Chronic pelvic pain is defined as pain lasting greater than six months. The condition is notoriously difficult to diagnose because of the absence of any visible abnormalities on routine tests. In the most common situation, a woman experiencing symptoms consistent with pelvic congestion syndrome will have seen several specialists before arriving at a diagnosis. Clearly, a complete evaluation by a gynecologist is primary. Some general clues include chronic pelvic pain that is worse when sitting or standing (similar to varicose veins), relieved with lying down, and the presence of vulvar varicose veins.