For women who have issues with incontinence, the fear of a urine leak during intimate moments is a valid one – up to 24% of women who have pelvic floor disorders experience leaks during sex (and there’s a very good likelihood that it’s underreported). Anxiety over the possibility of an “accident” can lower sexual enjoyment or even completely kill your libido. According to the American Foundation for Urologic Disease (AFUD), 1/3 of women with stress incontinence avoid sexual intimacy because they fear leakage. However, there is no reason to just live with the strain of incontinence in your daily life, and there are things you can start doing right now to stop incontinence from sabotaging your love life.
Understand the Problem
First it’s important to understand what’s causing you to pee during sex. Coital incontinence can be split into 2 different categories – urination with penetration and urination with orgasm – which are caused by two different types of incontinence in women.
Urination with penetration happens when something is inserted into your vagina and puts pressure on your bladder or urethra (the tube that urine flows out of). This is a form of stress incontinence – the pelvic floor muscles are not strong enough to keep that tube closed if there’s increased pressure on the bladder – like coughing, sneezing, or sex.
Urination with orgasm can occur because the muscles of the bladder spasm uncontrollably – this is called urge incontinence or over active bladder (OAB). But recent studies have found that weakness of the pelvic floor also contributes to leaks during orgasm.
Treating Urinary Incontinence
Talk to Your Healthcare Provider
Studies have found that only 3% of women take the initiative to talk to their doctors about problems with leaks during sex. Don’t let embarrassment stop you from having a great sex life! You doctor can only help you fully if they know exactly what your symptoms are and how often you’re experiencing these leaks. Your doctor might want to try different treatments depending on what type of incontinence you have.
Urination with orgasm sometimes responds well to certain OAB medication – but if you don’t tell your doctor about your issues then you might not get the most effective treatment plan. Your doctor may even refer you to a urogynecologist who specializes in dealing with urinary tract issues in women.
Kegel, Kegel, Kegel!
Kegel exercises, the contraction and release of your pelvic floor muscles, are the number one doctor recommended treatment for pelvic floor disorders and studies show that women who complete Kegel exercise routine on a regular basis have fewer leaks during intimacy. Be sure to get the right Kegel technique, you can also ask your gynecologist to help you practice or use a Kegel weight to help you isolate those muscles.
Work towards Your Ideal Weight
Being overweight increases the likelihood of leaks because that weight can strain your pelvic floor and put pressure on your bladder. Even a 7% weight loss can improve your incontinence. Discuss your weight loss plan – including diet and exercise – with your doctor.
Managing Incontinence During Sex
Talk to Your Partner
Incontinence can be an embarrassing topic, especially when it’s affecting your sex life. While more than half of women with incontinence report feeling concerned about leaks during sex being a problem in their relationships the majority of their partners did not. Communicating about the leaks with your partner is extremely important to maintaining a healthy sex life while you’re treating your incontinence. Being open about the issue can bring you closer together – your partner wants to know why you’ve been avoiding sex and they should also want to make intimacy comfortable for you. So telling them could also give you even more support and motivation towards your treatment goals.
Limit Fluid Intake Before Sex
Try not to drink anything, particularly if it can irritate the bladder, in the hour before you have sex. However you should stay hydrated throughout the rest of the day – since dehydration can also irritate the bladder and make leaks worse.
Go Before You Have Sex
Use the toilet just before you get started to lessen the likelihood of leaks. Try the “double voiding” method: urinate, then relax your bladder fully (some women also stand up for a few seconds), and try to urinate again to make sure you get as much out as you can.
Try New Positions
Certain positions, like missionary, put more pressure on your bladder, so take this as an opportunity to switch things up. As an added benefit, you both might discover a new favorite way to make love and add a little spice to the bedroom. Being on top gives you more control of your pelvic muscles and how much stress is placed on your bladder (not to mention a better chance of hitting your G-spot). Penetration from behind can put less stress on your bladder and urethra. Just experiment a bit to find something you both like.
Take a Bathroom Break
Don’t be embarrassed to take a break during sex – between foreplay and intercourse, between intercourse and cuddling. Sex doesn’t have to be a sprint, you should both take as much time as you want and enjoy the intimacy of just being together.
Try it in the Shower
Or, if you’re adventurous, try a little fun in the shower – a little leak won’t matter so much when the water’s already running and you’re both enjoying getting slippery together.
Incontinence during sex is a common problem for women of all ages – but it isn’t something you just have to live with. A little bit of planning, some Kegels, and help from your doctor can get you back in the sack and enjoying your sexuality again. Just don’t be embarrassed to get the help you need.
Please note that advice offered by Intimina may not be relevant to your individual case. For specific concerns regarding your health, always consult your physician or other licensed medical practitioners.
Lane Baumeister is an internationally-based Canadian writer with several years’ experience creating educational and entertaining articles that discuss intimate health and sexual well-being. When not waxing profound about menstruation, she devotes herself to enjoying extremely good food and equally bad movies.