What is IC/PBS?

Interstitial cystitis (IC) is a condition that results in recurring discomfort or pain in the bladder and the surrounding pelvic region. The symptoms vary from case to case and even in the same individual. People may experience mild discomfort, pressure, tenderness, or intense pain in the bladder and pelvic area. Symptoms may include an urgent need to urinate, a frequent need to urinate, or a combination of these symptoms. Pain may change in intensity as the bladder fills with urine or as it empties. Women’s symptoms often get worse during menstruation. They may sometimes experience pain during vaginal intercourse.

Because IC varies so much in symptoms and severity, most researchers believe it is not one, but several diseases. In recent years, scientists have started to use the terms bladder pain syndrome (BPS) or painful bladder syndrome (PBS) to describe cases with painful urinary symptoms that may not meet the strictest definition of IC. The term IC/PBS includes all cases of urinary pain that can’t be attributed to other causes, such as infection or urinary stones. The term interstitial cystitis, or IC, is used alone when describing cases that meet all of the IC criteria established by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). - 52k

Vulvodynia, simply put, is chronic vulvar pain without an identifiable cause. The location, constancy and severity of the pain vary among sufferers. Some women experience pain in only one area of the vulva, while others
experience pain in multiple areas. The most commonly reported symptom
is burning, but women’s descriptions of the pain vary. One woman
reported her pain felt like “acid being poured on my skin,” while
another described it as “constant knife-like pain.”

There are two main subtypes of vulvodynia, which sometimes co-exist:

Vulvar Vestibulitis Syndrome
(aka Provoked Vestibulodynia)

As shown in the diagram on the right, vulvar vestibulitis syndrome (VVS) is characterized by pain limited to the vestibule, the area surrounding
the opening of the vagina. It occurs during or after pressure is
applied to the vestibule, e.g., with sexual intercourse, tampon
insertion, a gynecologic examination, prolonged sitting and/or wearing
fitted pants.

VVS is further classified as Primary or Secondary. Women with Primary VVS have experienced vestibular pain since the first attempt at vaginal penetration. Women with Secondary VVS have experienced pain-free sexual intercourse prior to the development of pain.

Generalized Vulvodynia

For women with generalized vulvodynia (GV), pain occurs spontaneously and is relatively constant, but there can be some periods of symptom
relief. Activities that apply pressure to the vulva, such as prolonged
sitting or simply wearing pants, typically exacerbate symptoms.

Some women experience pain in a specific area, e.g., only in the left
labia or near the clitoris, while others experience pain in multiple
areas, e.g., in the labia, vestibule, and clitoris. In the latter
group, pain may also occur in the perineum and inner thighs, as
demonstrated in the diagram on the right.

About Vulvodynia
What Causes Vulvodynia?

Vulvodynia is not caused by an active infection or a sexually transmitted disease. Through continued research efforts, we move closer to uncovering the
underlying cause(s) of vulvodynia. Researchers speculate that one or
more of the following may cause, or contribute to, vulvodynia:


An injury to, or irritation of, the nerves that transmit pain and other sensations from the vulva

An increase in nerve fiber density in the vulvar vestibule

Elevated levels of inflammatory substances in the vulvar tissue

An abnormal response of different types of vulvar cells to environmental factors such as infection or trauma

Altered hormone receptor expression in the vulvar tissue

Genetic susceptibility to chronic vestibular inflammation

Genetic susceptibility to chronic widespread pain

Genetic factors associated with an inability to combat vulvovaginal infection

A localized hypersensitivity to Candida (yeast) or other vulvovaginal organism

Pelvic floor muscle weakness or spasm


What is pelvic floor dysfunction?

The pelvic floor muscles line the bottom, front, sides, and back of the pelvis and provide a hammock-like structure that supports the pelvic
organs such as the bladder, prostate, uterus, and rectum (see diagram).
Besides providing support, they're responsible for the complex relaxing
and contracting that enables us to urinate and defecate properly and
even enjoy sexual intercourse. These muscles are always interacting
with the pelvic organs. For example, urination involves relaxation of
these muscles while the bladder contracts. Sometimes, these muscles
either spasm or simply don't interact as they should with the pelvic
organs. We call this "pelvic floor dysfunction" (PFD).


Pelvic floor dysfunction can give rise to lots of uncomfortable sensations and even frank pain. To make matters more complicated, PFD can exist along with problems such as interstitial cystitis, irritable
bowel syndrome, prostatitis. fibromyalgia, and others. Pelvic floor
dysfunction has lots of other names in the medical literature such as
proctalgia fugax, coccygodynia, levator ani syndrome, Hinman's
syndrome, tension myalgia of the pelvic floor, and
non-neurogenic-neurogenic bladder.

The symptoms of PFD may vary greatly depending upon what part of the muscle complex is affected. These may include:

* Difficulty initiating the urine stream
* Straining with urination
* Pain with urination
* Starting and stopping of the urine stream
* Sensation of incomplete bladder emptying or the sensation of needing to urinate almost immediately after urinating
* Pelvic pressure or pain
* Frequent daytime voiding
* Constipation
* Pain with orgasm
* Pain with vaginal penetration (superficial and/or deep)
* Increased discomfort when sitting for long intervals