Bladder pain can signal anything from a minor infection to a serious health condition like cancer. The good news is that bladder cancer is rare, and bladder pain is usually not serious. But that doesn’t mean you should ignore it when you have pain in your pelvis or lower abdomen that may be coming from your bladder.
How do you know whether the pain is worrisome or indicates a benign condition?
Pay attention to the other symptoms you have — particularly if you have blood in your urine along with bladder pain, says Nazema Y. Siddiqui, MD, MHS, an assistant professor and director of research for urogynecology and reconstructive pelvic surgery at the Duke University School of Medicine in Durham, North Carolina.
“When women have bladder pain, they should seek evaluation,” she says. That would include looking for signs of urinary tract infections and bladder cancer, and other condition listed here:
1. Urinary Tract Infections (UTIs)
Urinary tract infections (sometimes called bladder infections) strike women more often than men, and simple anatomy is the cause. The female urethra is closer to areas that have natural bacteria (such as the anus and vagina). It’s also shorter than a man’s urethra, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
Bladder pain from UTIs can happen at any age. In young women, it is a common symptom of urinary tract infections, along with frequent and painful urination. Symptoms in older women can vary but typically include muscle aches, abdominal pain, fatigue, and weakness.
It’s important to see your doctor because treatment with antibiotics, like Cipro (ciprofloxacin) or Bactrim (trimethoprim-sulfamethoxazole), can usually clear up a urinary tract infection, the NIDDK notes. And though the infection may go away without treatment, antibiotics can speed healing and quickly eliminate uncomfortable symptoms. Drinking extra fluids and urinating frequently will also help treat the infection and your discomfort.
2. Interstitial Cystitis
More than 3 million American women live with pelvic pain related to interstitial cystitis, according to the NIDDK. “Interstitial cystitis is a severe form of bladder pain syndrome,” Dr. Siddiqui says. Ulcers or other long-term changes in the bladder wall may be to blame for the pain. Bladder discomfort from interstitial cystitis may range from tenderness to severe pain, according to the institute. Another clue that interstitial cystitis is the culprit: Menstruation tends to worsen bladder pain.
Interstitial cystitis is not caused by an infection, although the symptoms may mimic those of an infection. While the cause is not understood, one theory is that the condition may be related to inflammation, according to the NIDDK.
Treatment options for interstitial cystitis include distending or cleansing the bladder, taking oral medications, and/or using electrical nerve stimulation to alleviate pain — but there is no known cure. Sometimes surgery is an option. Treatment for the most severe cases, when the bladder is extremely scarred, may involve surgical removal of the bladder.
3. Changes in Your Reproductive System
Bladder pain in women may also be a result of thinning vaginal skin, says Karl Luber, MD, a urogynecologist in the Female Pelvic Medicine and Reconstructive Surgery Center at Kaiser Permanente San Diego Medical Center and a clinical professor at the University of California, San Diego, School of Medicine.
“This is called atrophy and it’s most common when menopause deprives the tissues surrounding the vagina of estrogen,” he explains. Oral estrogen doesn’t help, but a vaginal estrogen cream may ease symptoms.
Talking with your doctor about bladder pain and discomfort can help determine where the problem really lies, Dr. Luber says.
4. Bladder Cancer
Bladder cancer is rare, especially in women. Of the roughly 74,000 new diagnoses each year in the United States, about 18,000 are in women, according to the American Cancer Society (ACS). The most common symptom is blood in the urine; some women also experience a painful, burning sensation when urinating.
Bladder cancer treatments include surgery, chemotherapy, and radiation therapy. According to the ACS, most people need surgery to remove a tumor or tumors. All or parts of the bladder are removed in severe cases.
Get a Diagnosis, Not a Self-Diagnosis
It’s also important to consider whether the uterus and other organs of the gynecological system could be causing bladder pain, Siddiqui says, as they are close to the bladder. Pelvic floor dysfunction (such as tightness or spasms of the pelvic muscles) commonly occurs with bladder pain and may make bladder pain worse, he explains.
“If none of these conditions are present and women have ongoing bladder pain, they are typically treated for ‘bladder pain syndrome,’ which refers to painful conditions of the bladder where other causes such as UTI and cancer have been excluded,” says Siddiqui.
The bottom line for women to keep in mind: Don’t self-diagnose your bladder pain. Addressing and treating the issue can offer relief for body and mind.
Last Updated: 6/2/2015. By Diana Rodriguez. Reviewed by Pat F. Bass, III, MD, MPH
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