Burning sensation in the bladder or ovary region after a glass of wine, or during a very stressful moment? Pain in that area when pressure is applied?

Woman feeling burning sensation in bladder, ovarian, pelvic area.

Have you (or your clients) ever noticed an internal burning sensation in the bladder or ovary region after drinking alcohol - but your urine test came back normal?

Or pelvic discomfort during stressful times, or even pain when pressure is applied (like during sex or standing up)?

If this sounds familiar, you’re not alone. Research suggests it may not always be a UTI or Interstitial Cystitis (IC/BPS). Instead, it could be the interaction between low oestrogen, bladder sensitivity, and stress-driven nerve activation.

Low Oestrogen Driving Urinary-Pelvic Burning

• Oestrogen keeps bladder and pelvic tissues resilient.

• When levels decline in perimenopause/menopause, tissues become thinner, drier, and more fragile.

• Alcohol alone may be enough to trigger burning, while foods like citrus or coffee might not.

• Stress amplifies nerve sensitivity, so the internal burning feels more pronounced.

 Supporting research:

• NAMS Position Statement (2020): GSM = oestrogen-deficiency changes causing vaginal/urethral burning, urgency, dysuria; multiple effective therapies. Lippincott JournalsISSWSH

• NICE (2024): Visual summary-offer vaginal oestrogen for GU symptoms; serious adverse effects very rare; symptoms often return if stopped. NICE

• StatPearls (2024 update): GSM commonly presents with vaginal and urinary burning/urgency. NCBI

• Clinical trials/clinical data: Local vaginal oestrogen improves lower urinary symptoms in postmenopausal women. PubMedPMC

Stress-Related Pelvic/Bladder Nerve Sensitisation

Stress doesn’t just affect the mind - it changes how the bladder and pelvic nerves behave.

• Stress can trigger pelvic floor tension and nerve hypersensitivity.

• Alcohol + stress together may activate bladder/ovary-region nerves, causing burning without infection.

• Low oestrogen makes bladder tissues more vulnerable and mast cells more reactive.

  Supporting research:

• Review (Frontiers in Physiology, 2022): Chronic psychological stress can provoke/exacerbate LUT symptoms (OAB, IC/BPS). Frontiers

• Mechanistic study (1997): Psychological stress activates bladder mast cells - a key pathway implicated in IC/BPS pain. PubMed•

• Mechanistic paper (Scientific Reports, 2019): Dysregulation of CRH receptors in bladder; links stress signalling to bladder inflammation/neuronal changes. Nature•

• Guideline context (EAU Chronic Pelvic Pain, 2023 PDF): Addresses myofascial/pelvic floor contributors; physiotherapy interrupts the pain–spasm–pain cycle. EAU Guidelines PDF•

• Study (1995): Bladder mast cells express oestrogen receptors; oestradiol augments histamine secretion in response to substance P. PubMed•

• Study (2006): Physiological concentrations of oestradiol stimulate mast cell activation (degranulation) in human/murine cells. PMC•

• Study (2009): Oestrogen helps maintain urothelial barrier integrity; low levels increase bladder permeability. ScienceDirect•

• Review (2015): Mast cells play a central role in IC/BPS; oestrogen increases mast cell activation and migration, amplifying inflammation and nerve sensitisation. Translational Andrology & Urology

Pain in the Pelvic Area With Pressure

For some women, discomfort isn’t only about alcohol or stress - it also shows up when pressure is applied.

This may involve:

1. Low Oestrogen: fragile tissues feel bruised with pressure.

2. Pelvic Floor Dysfunction: stress + oestrogen decline = tight, overactive muscles.

3. Bladder Sensitivity: even without burning on urination, bladder walls may be hypersensitive.

The bottom line

If you’re experiencing burning after alcohol, pelvic pressure pain, or stress-related bladder symptoms, it may not be IC/BPS.

Instead, consider the bladder-hormone-stress connection. Low oestrogen, mast cell activation, and pelvic floor tension can all combine to create these sensations.

Have you (or your clients) noticed burning or pelvic discomfort without infection? What strategies have you found helpful?

🔗 If you’d like to explore this in more detail, feel free to connect.