Symptoms of nutcracker syndrome that you may notice include: Blood in your pee (hematuria). This is the most common symptom. Feeling dizzy when you stand up (caused by orthostatic hypotension). Flank pain on your left side. Symptoms can also vary based on your sex. Men and people assigned male at birth (AMAB) may experience swollen veins in their scrotum (varicocele). Women and people assigned female at birth (AFAB) may experience symptoms of pelvic congestion syndrome. These include: Pain during sex (dyspareunia). Pain when you pee (dysuria). Pelvic pain. There are also signs your healthcare provider can see through testing. You can’t see these signs on your own. Clinical signs of nutcracker syndrome include: Low levels of red blood cells (anemia). Microscopic amounts of blood in your pee (microhematuria). Too much protein in your pee (proteinuria).