Could Interstitial Cystitis Be Linked to PCOS?

If you have PCOS and also experience symptoms like bladder pain, frequent urination, or pelvic pressure, especially when your urine is clear, it’s easy to feel confused or dismissed. You might have been told it’s “just a UTI” or been given antibiotics without much relief. But if these symptoms are recurring or long-lasting, it’s worth considering whether interstitial cystitis (IC) could be part of the picture.

IC is a chronic bladder condition often described as “painful bladder syndrome”. It’s not officially linked to PCOS in diagnostic criteria, but research and clinical experience suggest there may be shared underlying factors, particularly chronic inflammation, hormone disruption, and gut imbalance.

What Is Interstitial Cystitis (IC)?

Interstitial cystitis, or IC, is a chronic condition that causes:

• Frequent urination (even during the night)

• Bladder pain or pressure

• A constant urge to urinate without infection

• Discomfort during or after sex

• Flare-ups linked to certain foods or stress

Unlike a typical urinary tract infection (UTI), IC doesn’t show up on standard tests. That’s one reason why it’s often misdiagnosed, especially in women with overlapping PCOS symptoms like bloating, pain, and inflammation.

Why It Might Affect Women with PCOS

While IC isn’t exclusive to women with PCOS, several root causes overlap:

1. 

Chronic Inflammation

PCOS is often associated with low-grade systemic inflammation, which may affect the lining of the bladder in some women. Inflammation can make the bladder wall more sensitive and reactive, triggering symptoms without infection.

2. 

Oestrogen Imbalance

Many women with PCOS experience either oestrogen dominance or fluctuations in oestrogen levels, especially when cycles are irregular. Oestrogen plays a role in maintaining the integrity of the bladder and vaginal tissue. Low or imbalanced oestrogen may contribute to increased sensitivity or recurrent irritation.

3. 

Gut Health and the Bladder Microbiome

Emerging research suggests that gut dysbiosis, a common issue in PCOS, can impact the bladder through immune and microbial pathways. The bladder has its own microbiome, and imbalances in gut flora may influence bladder health via the gut-bladder axis. This might help explain why some women experience both IBS-like symptoms and IC.

4. 

Histamine Sensitivity

Women with PCOS are more likely to experience histamine intolerance or mast cell activation issues, especially around ovulation or when oestrogen is high. Histamine can increase bladder irritation and urgency, contributing to IC-like symptoms. If your bladder symptoms worsen after certain foods or around your cycle, histamine could be a missing piece.

What You Might Notice

You may not have a formal diagnosis of IC, but you might relate to symptoms like:

• Needing to urinate frequently but passing only small amounts

• A feeling of pressure or burning even when tests are clear

• Symptoms worsening after certain foods (spicy, citrus, alcohol, caffeine)

• More intense symptoms around ovulation or just before your period

• A sense that your bladder or pelvic area is inflamed or oversensitive

How a Functional Nutrition Approach Can Help

While there’s no one-size-fits-all protocol for IC or PCOS, identifying and working on the root causes behind your symptoms can be a valuable part of managing them.

In my practice, we may explore options such as:

• Anti-inflammatory nutrition tailored to your symptom triggers

• Identifying histamine-reactive foods and supporting histamine clearance

• Gut testing if IBS, bloating, or antibiotic history is relevant

• Vaginal and bladder microbiome support (if appropriate)

• Cycle tracking to understand symptom patterns and hormone fluctuations

• Nervous system support to reduce bladder sensitivity and pain signals

The goal isn’t to treat or cure IC, but to better understand what’s driving your symptoms, so you can feel less at the mercy of your body and more in control.

You’re Not Imagining It

Many women with PCOS feel dismissed when they bring up symptoms like bladder pain, pelvic discomfort, or frequent urination, especially when standard tests come back clear.

But if you’ve noticed a pattern in your symptoms, or you’re constantly being told “everything looks normal,” that doesn’t mean nothing’s wrong. It simply means your body may be asking for a deeper look.

Next Steps

If you’re dealing with PCOS and also navigating unexplained bladder or pelvic symptoms, you’re in the right place. You may benefit from a more personalised approach that connects the dots, between your hormones, gut health, and inflammation.

I offer 1:1 online support with optional functional testing, so we can explore what’s really going on and give you practical, realistic steps to move forward.

Related Resources:

• 7-Day PCOS Blood Sugar Reset

• Free Discovery Call

• 12-Week Programmes

Updated in June 2025 to reflect new PCOS research and nutrition strategies.

Disclaimer: This blog is for informational purposes only and is not intended to diagnose or treat any medical condition. If you are experiencing severe or persistent symptoms, please speak to your GP or a healthcare professional.