Sexual Abuse and Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS)

Interstitial cystitis/painful bladder syndrome (IC/PBS) is both more common in those with a history of sexual abuse, and has a different pattern (suggestive of muscle pain with secondary central sensitization). 18-33 percent of patients with IC/PBS have a history of sexual abuse. In this study, they looked at whether the bladder symptoms manifested differently in the group with a history of abuse. They found that of 121 consecutive subjects newly diagnosed with IC/BPS, 30 (25 percent) subjects reported sexual abuse preceding the onset of bladder issues. Only 1 case of abuse had been previously documented in physicians' medical records.

Subjects with a history of sexual abuse had less daytime frequency, and less night time urination compared to those without a sexual abuse history, and more frequently demonstrated tenderness in the area above the pubic bone (which can trigger bladder spasm), vulva, vaginal wall, and rectum. These areas suggest that pelvic floor muscle and other muscle spasm (common in fibromyalgia) are common triggers for the bladder pain. As in fibromyalgia, central sensitization (amplification of pain in the brain) can then occur.

These findings help explain why addressing the fibromyalgia with our "SHINE Protocol" often helps the bladder symptoms, as well as accounting for why the medications we use (e.g., Neurontin  and Lyrica) which help decrease the pain of central sensitization can also help the bladder pain.

References

J Urol. 2008 Nov; 180(5):2029-33 10.1016/j.juro. 2008.07.053