Endometriosis and interstitial cystitis (IC) have similar symptoms, making it easy for one to be mistaken for the other. In fact, sometimes women who have endometriosis and undergo a hysterectomy mistaken the pain they experience in their pelvic region following the procedure as a return of their endometriosis, when in actuality it could be caused by interstitial cystitis.

What is interstitial cystitis? Interstitial cystitis (pronounced "In-ter-stish-ul sis-ty-tis"), also known as Painful Bladder Syndrome, is a chronic medical condition that is characterized by inflammation of the bladder. This inflammation is believed to occur when the mucous layer inside the bladder is damaged. The damaged mucous layer lets irritating substances, especially urine, come in direct contact with the bladder wall. These substances aggravate the bladder, resulting in inflammation and pain.

It is obvious by the above characteristics of IC that endometriosis and interstitial cystitis are clearly not the same condition, and, therefore, require different treatment. Unfortunately, diagnosis isn't as easy as one would think because the symptoms of IC closely mirror endometriosis, as the following will illustrate:

Endometriosis symptoms-

•Pelvic pain
•Pain in lower back
•Painful menses - pain before and/or during and/or after menstruation
•Severe menstrual cramping
•Pain during intercourse
•Pain during orgasm
•Heavy menses
•Irregular menses
•Painful bowel movements usually accompanied by an alteration between constipation and diarrhea
•Gastrointestinal upset including bloating, nausea and vomiting
•Bladder pain
•Frequent need to urinate
•Fatigue

Interstitial cystitis symptoms -

•Pelvic pain
•Pain in lower back
•Pain during intercourse
•Pain after intercourse
•Painful menses
•Heavy menses
•Painful bowel movement during menses
•Slight discomfort, tenderness, pressure or pain in the bladder or pelvic area
•Urgent need to urinate
•Frequent need to urinate
•Fatigue

The above symptoms that have been italicised for endometriosis and interstitial cystitis are the same. Although some symptoms differ, you can see how many symptoms are similar between the two. Thus is why IC has been nicknamed endometriosis "evil twin".

To make matters even worse for some women, it isn't uncommon for a woman to suffer from both endometriosis and IC. In fact, one study involving 60 women found that more than 79% of these women had both interstitial cystitis and endometriosis at the same time. In some cases, this is often why women still experience pain after they have endometrial tissue removed or why some find their endometriosis hard to treat. The pain they are experiencing is similar to endometriosis but is actually caused by IC.

Therefore, if you have endometriosis and continue to have pain despite the treatments you've tried, perhaps it's time to ask your doctor to further investigate your pain to find out if endometriosis is actually the cause of your problem, or if it's something else like interstitial cystitis.

If you suspect your may have endometriosis and interstitial cystitis you need to tell your doctor about your suspicions. However, before you jump to conclusions, and before you attend your appointment, it's a good idea to make a record of the symptoms you are experiencing. Write down the symptoms you experience in one week and present these symptoms to your doctor so he/she can help provide you with better tests for a more effective diagnosis and treatment course.

Keep in mind, if you suspect you have IC the symptoms you need to focus on include:

•Urgency and frequency of urination
•Fluctuation of pain as the bladder empties or fills
•Pelvic or bladder pain that intensifies during menstruation

In addition, if you want an accurate IC diagnosis you may want to request that your doctor refer you to a gynaecologist or urologist. Finally, remember that while both endometriosis and interstitial cystitis are chronic conditions, they are treatable when effectively diagnosed.