She came to see me after months of feeling dismissed. She was experiencing Lyme bladder pain — pressure, burning, and urgency that felt exactly like a UTI, yet every test came back normal.

She is not the only one. Many women quietly live with bladder pain due to Lyme disease. They are often told it’s stress, hormones, or anxiety.

It wasn’t an Infection — It was a Nervous System Signaling Problem

The bladder isn’t just a storage organ — it is wired directly to the autonomic nervous system.

Urination relies on signals between the brain, pelvic nerves, sacral pathways, smooth muscle tone, and sensory feedback. Lyme disease and co-infections can disrupt these loops.

For this case, miscommunication made the bladder feel full when it wasn’t, trigger urgency without output, and cause discomfort after urinating.

That is neurogenic bladder involvement in Lyme, not imagination.

Research in IC, dysautonomia, and post-infectious syndromes shows that sensory nerve amplification can produce bladder urgency without infection — a pattern I often see in Lyme disease patients.

Her Symptoms Looked Like a UTI

She described burning, pressure, and the sensation she “had to go” but passed almost nothing. Yet her urinalyses were consistently normal.

What she was feeling was inflamed sensory nerve signaling, not bacteria.

Understanding that shifted her relationship to the symptoms — from confusion to clarity.

Her Symptoms Resembled Interstitial Cystitis

Patients with IC describe urgency, bladder pain, and pelvic sensitivity — often flaring with foods, stress, or hormonal shifts.

Lyme patients can show the same pattern.

In both conditions, sensory nerves amplify internal signals, making benign sensations feel urgent or painful.

She wasn’t exaggerating — this was Lyme bladder pain driven by neuroinflammation.

Many Lyme patients are told they have IC before anyone considers neuroinflammation. Some women I treat have an IC diagnosis before Lyme is considered. Others present with IC-like bladder sensitivity, but their symptoms resolve once nerve inflammation and infection are addressed.

This overlap is important — not every bladder pain syndrome is primary IC, and not every IC case excludes infection-related drivers.

Her Pelvic Floor Tightened to Protect Her — Then Became Part of the Problem

Chronic urgency made her pelvic floor tense reflexively. Over time, that tension stayed, circulation dropped, and discomfort worsened.

This is why some women receive pelvic floor diagnoses when Lyme-related nerve irritation was the original trigger.

Once She Knew There Was a Physiologic Basis, Her Fear Shifted to Strategy

Learning that nerve pathways — not infection — were driving her symptoms allowed her to stop questioning her body and start engaging in treatment.

That shift created space for recovery instead of fear.

So Yes — Lyme Bladder Pain and Urgency Can Occur in Women

I see this pattern most often in patients with autonomic dysfunction, neuropathy, pelvic pain syndromes, co-infections, or IC-like flare patterns.
Symptoms typically wax and wane — flaring with stress or illness, easing as inflammation resolves.

Knowing this helps women understand they are not alone — their pattern is familiar and medically coherent.

The Encouraging Part: She Improved

As we treated the underlying infection, supported autonomic balance, and released pelvic muscle tension, her symptoms gradually eased.

Urgency softened. Pressure faded. She slept through the night without mapping her day around bathrooms.

Weeks later she told me: “That phantom UTI feeling is gone. I finally feel normal down there again.”

I see this trajectory often — bladder symptoms quiet as the nervous system stabilizes.

If you’re a woman with bladder pain or urgency and Lyme disease — You Are Not Alone.

The symptom is real — even when tests are negative.

It reflects neurogenic and inflammatory signaling, not stress or oversensitivity. And with appropriate treatment and regulation, many women regain bladder comfort again.

Resources

1. International Neurourology Journal. (2013). Urinary Bladder Detrusor Dysfunction Symptoms in Lyme Disease.
2. Frontiers in Neurology. (2024) Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?
3. The Journal of Neurology (1993) Urinary dysfunction in Lyme disease.
4. Dr. Daniel Cameron: Lyme Science Blog. Can Lyme Disease Cause Bladder Pain or Urgency?
5. Dr. Daniel Cameron: Lyme Science Blog. Lyme Symptoms in Adolescents Can Be Missed