High Rates of Overactive Bladder Found in Women With Fibromyalgia

Overactive bladder is highly prevalent in women with fibromyalgia, a new study reported. More than half of the sample had an overactive bladder.1

“These findings support the argument that [overactive bladder] may exist only as an extension of the central sensitization process seen in fibromyalgia and not an isolated urological co-morbidity,” wrote study investigator Duygu Kurtulus, from the Ümraniye Training & Research Hospital in Turkey, and colleagues. 1“Physicians should consider routine screening for [overactive bladder] symptoms in [fibromyalgia] patients, and treatment considerations include focusing on integrated strategies where musculoskeletal and visceral symptoms are addressed together.”

Patients with fibromyalgia often experience lower urinary tract symptoms. Previous research has identified a high burden of genitourinary symptoms in fibromyalgia, but most of these studies depended on severity-oriented checklists or self-reported symptoms and did not incorporate validated, gold-standard diagnostic evaluations.2 Thus, the prevalence of urinary tract symptoms in fibromyalgia was not well-defined.

In this cross-sectional analysis, investigators evaluated how common overactive bladder is in women with fibromyalgia and compared their clinical characteristics with non-fibromyalgia controls who presented with similar urinary symptoms.1 The study included 232 women aged 18 – 65 years, with 192 diagnosed with fibromyalgia and 40 age- and symptom-matched controls.

Overactive bladder was diagnosed based on International Continence Society criteria using the Overactive Bladder Awareness Tool Version 8 (OAB-V8; cut-off ≥ 8) and a 3-day bladder diary. Fibromyalgia burden was determined via the Widespread Pain Index (WPI), Symptom Severity Scale (SSS), and the General Symptom Score (GSS). The study also recorded psychiatric comorbidities and irritable bowel syndrome (IBS).

The study identified overactive bladder in 62% of patients with fibromyalgia and 28.6% of controls (P <.001).1

“This discrepancy provides rigorous evidence of a substantial association between [fibromyalgia] and [overactive bladder] and indicates that urinary symptoms in [fibromyalgia] could be more than a product of random overlap between [fibromyalgia] and [overactive bladder]; they could represent a true expression of the underlying fibromyalgia-related pathophysiology,” investigators wrote.1

Patients with fibromyalgia who had overactive bladder were significantly older and had longer disease duration than the controls who had overactive bladder (P <.001). These patients also had significantly greater WPI, SSS, and GSS scores than those with fibromyalgia but no overactive bladder and controls with overactive bladder (P <.0001).1

Investigators observed moderate correlations between overactive bladder and fibromyalgia symptom severity (P =.33 – P =.42; P <.01).1

Although the primary objective of this study was to assess overactive bladder prevalence in fibromyalgia, the findings also highlighted a heightened rate of co-occurring conditions among patients with fibromyalgia who experience OAB, including IBS, migraine, anxiety, depression, and obesity. The investigators noted that these comorbidities likely intensify symptom perception, contribute to shared neurochemical dysregulation, and further complicate both diagnosis and management.

The team wrote that the overlap between overactive bladder and fibromyalgia likely stems from shared neurobiological pathways, as central sensitization in fibromyalgia affects circuits involved in both pain processing and bladder sensation. Autonomic dysfunction and neurogenic inflammation further support a biological basis for their co-occurrence.

“There remains a need for a more complete understanding of the central and peripheral mechanisms by which [fibromyalgia] and [overactive bladder] are linked, and further, neuroimaging studies could provide evidence for overlap of pain and bladder circuits and autonomic profiling,” the team concluded. 1“Randomized controlled trials assessing different intervention recommendations, including pharmacological and nonpharmacological, will be integral to developing clinical treatment strategies for this complex group of patients.”

References

1. Kurtulus D, Arkan K, Suceken FY, Akgol S, Can B. Assessment of Overactive Bladder in Women With Fibromyalgia Presenting With Lower Urinary Tract Symptoms: A Controlled Clinical Study. Neurourol Urodyn. Published online December 3, 2025. doi:10.1002/nau.70206

2. Puri BK, Lee GS. Overactive Bladder Symptoms in Patients with Fibromyalgia: A Systematic Case-Controlled Study. Rev Recent Clin Trials. 2021;16(2):202-205. doi:10.2174/1574887115999201006201328