Pain is often associated with infections and for women experiencing bladder pain, this often is the assumed reason. While an infection in the bladder can cause pain, an infection is not the sole cause of bladder pain in women.
Understanding the female bladder
Before we discuss causes of bladder pain in women, it’s important to understand this organ in regards to women.
The bladder is a hollow, muscular organ that holds urine until you get the sensation of needing to void this fluid from the body. When voiding, the pelvic floor muscles relax and the bladder muscle will contract, squeezing urine through the urethra, the tube that carries urine from the bladder to the outside to be dispelled. As the bladder muscle contracts, the muscle that holds the urethra shut during storage (called the spincter), relaxes to allow urine to pass through. This whole system is supported by the muscles of the pelvic floor that runs from the tip of the tailbone through to the pubic bone.
The bladder in men and women has some similarities and some differences. One similarity is the capacity of urine storage – it’s the same in both sexes. But the location is different – the bladder in women is located in front of the vagina and below the uterus while a man’s bladder sits in front of the rectum and above the prostate gland.
The urethra is another structural difference between men and women. Women’s urethra is shorter than a man’s and women use their urethra only for urinating. Men use their urethra for both urination and ejaculation. The male urethra is also longer than a woman’s since it has to pass through the penis as well.
Causes of bladder pain in women
Know that you have a better understanding of a woman’s bladder, here are four conditions that can contribute to bladder pain in women:
1. Urinary tract infections
Urinary tract infections (UTIs), sometimes called bladder infections, are more common in women than men. Because women’s urethra is shorter than a man’s urethra and is located to areas prone to bacteria – the anus and vagina – this sets the stage for UTIs to occur. Young women with a UTI may have frequent and painful urination while older women with a UTI are more likely to have muscle aches, abdominal pain, fatigue and weakness.
UTIs need to be diagnosed by a doctor and then treated with an antibiotic. It’s important to take the full course of the antibiotic to completely kill the bacteria that caused the UTI, clearing the infection. Women should be advised to drink plenty of water each day, urinate frequently, and to always wipe from front to back after bowel movements.
2. Interstitial cystitis
Interstitial cystitis (IC) is a bacterial infection of the bladder usually caused by a urine infection that affects primarily women. Of the more than 700,000 Americans who have interstitial cystitis, as many as 90% are women. For women, the intense pelvic pain as well as the urge to urinate frequently will justify a trip to the doctor to get it treated as soon as possible.
Bladder discomfort from interstitial cystitis may range from mild tenderness to severe pain. Interstitial cystitis is not caused by a UTI, although the symptoms may worsen if a woman has both a UTI and IC at the same time. While the cause is not completely understood, certain factors seem to trigger flares such as stress, changes in diet, allergies, and taking certain drugs.
The goal of treatment is to relive pain and reduce inflammation. The approaches for this can include use oral medications such as an antibiotic to prevent the infection from spreading to the kidneys and bladder instillations – drugs that are introduced into the bladder by a catheter and held for 15 minutes. If a woman is experiencing burning pain, she may also be prescribed medication to relieve that symptom.
Other options for treatment might include stress reduction, exercise, biofeedback, or warm tub baths to help improve symptoms. Bladder training – learning to urinate only at specific times despite the urge to go – can help reduce urinary frequency.
Advice to drink plenty of water will be given as well as drinking cranberry juice to help decrease the concentration of bacteria in the urine.
3. Genitourinary syndrome of menopause (GSM)
Women who have gone through menopause may experience thinning vaginal skin that has atrophied known as GSM. Vaginal atrophy is thinning, drying, and inflammation of the vaginal walls that may occur when a woman’s body makes less estrogen and typically occurs after menopause.
Not only does vaginal atrophy cause painful intercourse but also leads to distressing urinary symptoms such as burning and urgency of urination and recurrent UTIs. Any woman experiencing these symptoms should make an appointment with their doctor to discuss treatment.
One way to possibly prevent GSM is regular sexual activity, either with or without a partner. Sexual activity increases blood flow to the vagina which keeps vaginal tissues healthy.
4. Bladder cancer
Even though men are far more likely to develop bladder cancer, women should still be aware of the symptoms of this disease. The most common symptom is blood in the urine (hematuria). Other symptoms may include UTI-like symptoms, unexplained pain in the flank area, abdomen, or pelvis, reduced appetite, and postmenopausal bleeding which is similar to blood in the urine but is easy to overlook.
Bladder cancer treatments include surgery, chemotherapy, and radiation therapy. Any woman who is having any of the symptoms associated with bladder cancer, needs to talk to her healthcare provider right away to get it diagnosed and properly treated.
Bladder cancer may be overlooked in women because it’s easy to chalk up symptoms to a stubborn UTI or normal vaginal spotting. Unfortunately, this means women are often diagnosed after the cancer has spread and becomes harder to treat. Women should call their doctor to determine if it’s a minor infection or something more serious. Bladder cancer is more easily treated when caught and diagnosed early.
Dr. David Samadi is the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, available online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncolo gy and prostate cancer 911.