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Allergens or toxins in the urine are thought to cause the bladder walls to become sensitized to increased mast cells.[ref][ref][ref] Vulvodynia and mast cell activation: Vulvodynia is a chronic genital pain condition that includes an increased number of mast cells

I also think that theres a big disconnect between people writing for the medications too

Research has indicated that specific probiotics may positively influence cardiovascular health by lowering blood pressure and improving lipid profiles, which could indirectly benefit patients with ACM (213)

In specific cases, this form may protect the brain from cell damage, but more research is needed on long-term benefits for healthy individuals