An international team of researchers has identified five gynecologic conditions that commonly coexist with interstitial cystitis/bladder pain syndrome, highlighting the need for thorough evaluation and multidisciplinary care among patients with chronic pelvic pain.

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a chronic condition characterized by pelvic discomfort or bladder pain lasting more than six weeks without infection or other identifiable causes. It predominantly affects individuals assigned female at birth and is frequently underdiagnosed due to overlapping symptoms with other pelvic disorders.

The researchers developed their consensus through a structured, multi-phase process, including an extensive literature review and analysis of clinical studies and diagnostic guidelines. They identified five gynecologic conditions frequently associated with IC/BPS: endometriosis, adenomyosis, vulvodynia, female sexual dysfunction, and overactive pelvic floor muscles.

Endometriosis and Adenomyosis

Endometriosis involves the growth of endometrial-like tissue outside the uterus and is strongly linked to both pelvic and bladder pain. It coexists with IC/BPS in approximately 65 percent of cases and shares common inflammatory and genetic mechanisms. Adenomyosis, which is characterized by endometrial tissue grows into the uterine muscle, may worsen bladder-related symptoms by contributing to heightened pain sensitivity and systemic inflammation.

Vulvodynia and Sexual Dysfunction

Vulvodynia, a chronic vulvar pain condition without a clear cause, frequently overlaps with IC/BPS. Discomfort may be triggered by sexual activity, tampon use, or light touch. The shared embryologic origin of pelvic organs may explain the concurrent pain in the bladder and vulva.

Sexual dysfunction is also prevalent in patients with IC/BPS. Many report pain during intercourse, low sexual desire, and fear of intimacy due to anticipated pain. One study cited by the panel found that over 80 percent of women with IC/BPS experienced at least one form of sexual dysfunction.

Overactive Pelvic Floor Muscles

Overactive pelvic floor muscles are found in up to 85 percent of patients with IC/BPS. This dysfunction can lead to urinary symptoms and pelvic pain and is often linked to involuntary muscle tension triggered by chronic pain, anxiety, or trauma.

Hormonal Influences

Hormonal fluctuations related to menstruation, pregnancy, menopause, or hormone therapy can influence the severity of IC/BPS symptoms. Some patients report increased pain before menstruation, while others benefit from hormone-based treatments, even before menopause.

Call for Multidisciplinary Care

The researchers recommend a comprehensive, trauma-informed approach to assessment and management. This includes a detailed medical history, pelvic examination, and collaboration among urologists, gynecologists, physical therapists, and mental health professionals.

The consensus underscores that IC/BPS is not solely a urologic condition. Addressing its gynecologic comorbidities through multidisciplinary care may improve symptom management and patient quality of life.

The authors reported no conflicts of interest.

Source: Neurourology and Urodynamics