Is There a Link Between Endometriosis and Overactive Bladder?

Overactive bladder (OAB), which causes urgency, frequency, and sometimes leaks, is often reported alongside endometriosis symptoms - but what exactly is the link between OAB and endometriosis?

How Does Endometriosis Affect the Bladder?

Endometriosis occurs when tissue similar to the lining of the womb grows in the body, causing inflammation, pain, and lesions. When this tissue develops near the bladder or within the pelvic cavity, it can irritate the nerves that control bladder function. This can make the bladder more sensitive, leading to urgency and frequent urination, even when there’s not much urine to pass.

Inflammation plays a huge role in this. Endometriosis triggers chronic inflammation in the pelvic area, which can directly affect the bladder lining, making it more reactive. At the same time, the condition often leads to pelvic floor dysfunction, where the muscles around the bladder become tight and overactive, further contributing to OAB symptoms.

Why We Feel the Urge to Pee During Flare-Ups

Many of us notice that bladder urgency and frequency get worse during an endometriosis flare-up. This happens for a few reasons. First, hormonal fluctuations, particularly changes in oestrogen, can affect both endometriosis symptoms and bladder sensitivity. Oestrogen influences bladder function, and when levels drop or fluctuate, the bladder can become more reactive.

Secondly, inflammation levels spike during a flare-up. This not only increases pain but can also make the bladder more sensitive to even small amounts of urine. The nerves responsible for bladder control can become overstimulated, sending signals to empty the bladder more frequently than necessary. If the endometriosis has caused adhesions or scarring near the bladder, this can also lead to feelings of pressure and discomfort, mimicking the sensation of a full bladder.

What Happens If It’s Misdiagnosed? 

Despite growing awareness of endometriosis, misdiagnosis remains a major issue, especially in those of us who are younger than 20 or older than 50. In teenagers and young adults, early signs of endometriosis are often dismissed as ‘normal period pain’, meaning bladder symptoms linked to the condition are overlooked. Instead of investigating endometriosis, some are diagnosed with urinary tract infections (UTIs) or anxiety-related bladder issues, leading to repeated rounds of antibiotics or unnecessary lifestyle restrictions.

At the other end of the spectrum, those of us over 50 who start experiencing new or worsening bladder symptoms are often told it’s simply due to menopause. While hormonal changes in perimenopause and menopause do impact bladder health, they don’t explain everything. If endometriosis was present earlier in life but undiagnosed, it can still cause bladder issues long after periods have stopped because menopause may not relieve endometriosis growth. Understanding this link is crucial in making sure the right treatment and support are given at any age.

Managing OAB Symptoms Caused by Endometriosis

Living with both endometriosis and overactive bladder can be challenging, but there are ways to manage the symptoms and improve bladder control.

Lifestyle changes can support the management of symptoms related to endometriosis, including bladder urgency or leaks. For some women, pelvic floor physiotherapy can be helpful, but working with a pelvic floor specialist is important as tight or overactive pelvic floor muscles can contribute to urgency and frequency as much as weakness in the pelvic floor muscles. Additionally, diet and hydration play a key role and identifying bladder irritants can ease urgency outside of flare-ups, too. 

Keeping a bladder diary can help identify any specific triggers and frequency of flare ups if these fall outside of your cycle.

There is presently no cure for endometriosis, but symptoms can often be managed medically through various hormone therapies, including the pill or GnRH analogues. Seeking a referral to a specialist can help you explore the right treatment options for you, and should surgery be necessary then a multi-disciplinary approach can help to treat endometriosis affecting the bladder. 

Final thoughts

While endometriosis may complicate bladder health, it doesn’t mean we have to suffer in silence. With the right support and management, we can take steps towards feeling more comfortable and in control.

While Jude's Bladder Control Supplement is not recommended for those with endometriosis, it's important to discuss other treatment with your GP, gynaecologist or endometriosis specialist to find a management plan suitable for you. Jude's Leakproof pants can be a gamechanger for those experience leaks and urgency, offer reassurance and are super comfortable to wear, too.