The Complexities of IC/BPS

IC/BPS is defined as a chronic condition of bladder-centric pain that has been present for at least six weeks. It is often referred to as the “great mimicker”, as symptoms can feel like a urinary tract infection (UTI) or be similar to endometriosis pain in women and chronic prostatitis (CP) in men. Many patients with IC/BPS are treated for UTIs multiple times before it is discovered that the pain is due to IC/BPS, and there is no infection.

IC/BPS is not only difficult to diagnose, but it is also difficult to treat. This is largely due to the fact that the etiology, or cause, of IC/BPS remains unknown. Different theories include a weak or “leaky” bladder lining, an inflammatory or allergic type process, and bladder-centric pain that is part of another pain syndrome in the body, such as fibromyalgia.

There are prescription treatments for IC/BPS, including oral medications, bladder instillations (inserting a solution into the bladder with a small catheter), nerve stimulators, and bladder injections (steroids or botulinum toxin). While these treatments help some, others do not find relief, or they simply prefer more natural remedies (including dietary changes and taking supplements) over medication.

We have firsthand experience with the frustrations of patients and doctors when trying to manage IC/BPS. Collectively, we have 50 years of combined experience treating IC/BPS and other pelvic pain conditions. As urogynecologists, we respect and appreciate that patients are looking to alternative treatments for their symptoms. That’s why we created Femetry.

We see many women (and occasionally men) with IC/BPS in our clinics every week. By the time they get to us, they’ve nearly lost all hope. Some of their frustrations include being misdiagnosed for too long, being ignored by doctors, or being made to feel their symptoms were in their heads. Often, people have received too many treatments that not only didn’t work, but also had undesirable side effects.

Evidence-based treatment options for patients with IC/BPS are limited. In the American Urological Association Guideline for IC/BPS, pelvic health physical therapy is the only treatment option that has the highest level of evidence. A “Grade A” means that physical therapy is a treatment option that has been studied in randomized controlled trials or is backed by exceptionally strong observational studies. These guidelines state that manual physical therapy techniques should be offered for pelvic floor tenderness and strengthening exercises should be avoided for patients with IC/BPS.

With the goal of improving the quality of care for IC/BPS patients, we conducted our own research. We believe that understanding IC/BPS begins by asking questions, such as:

• What can we learn from online discussions amongst IC/BPS patients?
• Are patients with IC/BPS being treated with medications according to guidelines?
• Are patients with IC/BPS using supplements?
• Do all patients with IC/BPS have food sensitivities?
• How are IC/BPS patients with Hunner’s bladder ulcers different from those who don’t have them?
• How often are patients misdiagnosed?
• What are the reasons for misdiagnosis?

Our research has been fascinating and rewarding. It has helped improve the way we (and hopefully other doctors) understand and care for patients with IC/BPS. With Femetry, we had the opportunity to actually create a better support system for IC/BPS patients with ingredients that have little to no side effects.

Over the next several years, we met for numerous brainstorming sessions. We researched IC/BPS and the impact of supplements, taking into consideration how different supplements affected the symptoms of our patients. We discussed how to create the best supplements possible based on science and clinical experience.

In collaboration with LifeSeasons, we were essentially able to choose all of the ingredients for the formulas based on published research studies and our combined 50+ years of clinical experience. The LifeSeasons chemists determined the optimal combinations for effectiveness.

Here’s a snapshot of some of the Femetry ingredients:

• Aloe for supporting relief from pain and inflammation
• Quercetin (rutin) and turmeric also provide support for inflammation, and each have antioxidant properties
• Calcium glycerophosphate and sodium bicarbonate help neutralize acids. A clinical study showed that when taken together, they could reduce sensitivity when triggering foods are consumed
• Hyaluronic acid, glucosamine, and chondroitin sulfate all have molecules that can support the glycosaminoglycan (GAG) layer of the bladder, which is often insufficient in IC/BPS patients
• Ashwagandha is an adaptogen that helps modulate the stress response. Many people report that stress contributes to IC/BPS flares

Keep in mind that while these bladder health supplements can be useful for IC/BPS, they are most effective when used consistently over time and in combination with a healthy lifestyle, stress management and dietary changes.

While there’s still no cure for IC/BPS, we’re optimistic about improving the quality of life for our patients. We’ve been listening. We understand that out of all the frustrations this condition comes with, the most harrowing is suffering in silence.

To learn more about our supplements, visit the Femetry web site. 

Enter code PHS for 15% off!

Research conducted by Drs. Jennifer Anger, Karyn Eilber, and Victoria Scott:

Dallas, K., Bresee, C., Hoedt, A. D., Senechal, J., Barbour, K., Kim, J., Freedland, S., & Anger, J. (2020). MP31-13 Reasons for misdiagnosis of interstitial cystitis/bladder pain syndrome in a national cohort of VA patients. The Journal of Urology, 203. https:// doi.org/10.1097/ju.0000000000000875.013

Gonzalez, G., Vaculik, K., Khalil, C., Zektser, Y., Arnold, C. W., Almario, C. V., Spiegel, B. M., & Anger, J. T. (2023). Experiences of women with interstitial cystitis/bladder pain syndrome: What can we learn from women’s online discussions? Journal of Urology, 209(1), 208–215. https://doi.org/10.1097/ ju.0000000000002955

Jarman, A., Janes, J. L., Shorter, B., Moldwin, R., De Hoedt, A. M., Barbour, K. E., Kim, J., Freedland, S. J., & Anger, J. T. (2023). Food sensitivities in a diverse nationwide cohort of veterans with interstitial cystitis/bladder pain syndrome. Journal of Urology, 209(1), 216–224. https://doi.org/10.1097/ ju.0000000000002938

Kuhlmann, P., Chen, A., Dallas, K., Castaneda, P., Scott, V., Anger, J., & Eilber, K. (2021).
PD01-08 use of supplements in the interstitial cystitis/bladder pain syndrome community: Patient-reported utilization patterns and perceptions. Journal of Urology, 206(Supplement 3). https://doi. org/10.1097/ju.0000000000001965.08

Skove, S. L., Howard, L. E., Senechal, J., De Hoedt, A., Bresee, C., Kim, J., Freedland, S., & Anger, J. (2018). MP39-17 The misdiagnosis of interstitial cystitis/ painful bladder syndrome. Journal of Urology, 199(4S). https://doi.org/10.1016/j.juro.2018.02.1264

Tholemeier, L. N., Bresee, C., De Hoedt, A. M., Barbour, K. E., Kim, J., Freedland, S. J., & Anger, J. T. (2022). Do medication prescription patterns follow guidelines in a cohort of women with interstitial cystitis/bladder pain syndrome? Neurourology and Urodynamics, 41(5), 1121–1126. https://doi. org/10.1002/nau.24923