Interstitial Cystitis
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Endometriosis may overlap with interstitial cystitis/bladder pain syndrome (IC/BPS). Discover symptoms, diagnostic pathways, and evidence-based treatments and self-care to reduce flares, protect bladder health, and ease pelvic pain.
Overview
Interstitial cystitis/bladder pain syndrome (IC/BPS) causes bladder‑centered pain, pressure, or burning with urinary frequency and urgency, typically with sterile urine cultures. Symptoms often worsen with bladder filling and ease after voiding, and can flare with stress, sex, certain foods, or around menstruation. IC/BPS commonly coexists with endometriosis through shared pain mechanisms and pelvic floor hypertonicity, making evaluation of Pelvic Floor Dysfunction important. It differs from structural disease in Bladder Endometriosis, which may cause cyclical hematuria or visible lesions; both can occur together and need tailored care.
Learn how clinicians confirm IC/BPS using history, bladder diaries, pelvic exam, and selective testing to rule out infection, stones, or malignancy; cystoscopy is reserved for red flags or to identify Hunner lesions. Explore stepwise care that starts with bladder training, individualized nutrition strategies, stress regulation, and Pelvic Floor PT, then progresses to medications and intravesical therapies when needed. Guidance also covers flare planning, sex and exercise modifications, and how findings from Diagnostics & Imaging inform care when endometriosis is present.
How is IC/BPS diagnosed—do I need cystoscopy?
IC/BPS is a clinical diagnosis based on bladder‑focused pain with frequency/urgency for at least six weeks and negative urine cultures, after excluding other causes. Cystoscopy isn’t always required, but is recommended if there’s blood in the urine, cancer risk factors, or to look for Hunner lesions that can change treatment options.
How can I tell IC/BPS from Bladder Endometriosis?
IC/BPS pain typically builds with bladder filling and improves after voiding, and urine tests remain negative. Bladder Endometriosis is more likely to cause period‑linked pain, visible lesions on imaging or at surgery, and sometimes hematuria; coordinated evaluation through Diagnostics & Imaging helps when both are suspected.
What treatments relieve IC/BPS symptoms?
Care is stepwise: education, bladder training, trigger reduction, stress regulation, and Pelvic Floor PT help many people. If symptoms persist, options include oral medicines such as amitriptyline or hydroxyzine, intravesical therapies like lidocaine or DMSO, and in refractory cases neuromodulation, combined with individualized Medical Management and Pain Relief strategies.
Should I take antibiotics for ongoing urinary symptoms?
Repeated antibiotics are not helpful for IC/BPS when urine cultures are negative and can cause side effects and antibiotic resistance. Work with your clinician to document sterile cultures, rule out recurrent UTI, and pivot to bladder‑directed treatments instead.
Do diet and hormones affect flares?
Many report flares from acidic foods, caffeine, alcohol, or artificial sweeteners, and symptoms often worsen premenstrually due to hormonal and inflammatory shifts. A personalized elimination‑and‑rechallenge plan alongside cycle‑aware pacing can help; for structured support, see Nutrition and At-Home Remedies.
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