Interstitial Cystitis: The Cortisol Connection

Interstitial cystitis (IC) is overwhelmingly more common in women than in men, with an epidemiologic incidence that is estimated to be as high as 510 per 100,000 women. The condition is characterized by urinary frequency, urgency, and pelvic pain. Not always localized to the pelvis and bladder, pain may occur in the lower back, vagina and lower abdomen and is often aggravated at the onset of menstruation as well as after intercourse.

Principally a diagnosis of exclusion, IC may have a profound impact on an afflicted individual's quality of life and may be associated with psychological disorders including depression and/or anxiety. IC is a poorly understood, chronic condition and its cause is unclear. The goal of treatment is generally to reduce pain and urinary frequency, and treatments may include multiple weeks of bladder instillations, stress management, anti-inflammatories, nerve stimulation, antidepressants, anticholinergic-antispasmodic agents and even surgery. Many individuals suffering from interstitial cystitis seek complimentary and alternative care including acupuncture, pelvic floor therapy and diet modification and hormone balancing.

You can support your  suffering from IC by addressing adrenal health and diurnal cortisol levels. Cortisol, our body's own natural anti-inflammatory agent, is produced endogenously by the adrenal cortex and secreted in highest amounts in the morning with a gradual tapering of levels throughout the day.

Cortisol's anti-inflammatory nature assists in keeping chronic inflammation and pain at bay. Unfortunately alterations of this diurnal cortisol pattern, as seen in individuals with phase 1, 2 or 3 adrenal fatigue, may alter the body's ability to control inflammation, allowing chronic inflammatory conditions such as IC to ensue.

Research has demonstrated just how important optimal cortisol levels may be in controlling the symptoms associated with IC and findings indicate that diurnal cortisol patterns in IC patients may have significant treatment implications. IC patients with sub-optimal morning salivary cortisol levels less than 12.5 nmol/l were found to be over 12 times more likely to report urinary urgency than those patients with levels above 12.5 nmol/l! Patients with higher total daily free cortisol levels reported decreased overall symptomatology.


This information indicates that diurnal salivary cortisol testing can help you in developing a treatment plan for your IC.  Boosting  cortisol levels when necessary through nutritional, glandular or herbal support or with cortisol replacement therapy can help you gain long term relief from symptoms and lead to a pain-free and symptom-free life. Test now and treat right.



  1. Susan K Lutgendorf, et.al. Diurnal Cortisol Variations and Symptoms in Patients with Interstitial Cystitis. The Journal of Urology. Vol 167, 1338-1334 March 2002

  2. Joseph E Scherger, MD, MPH et al., Interstitial Cystitis 2007. via www.MDConsult.com


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The Canary Club is an educational advisory group with a team of medical advisors headed by Richard Shames, M.D.