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Taboo topic: Leaking Urine with Sex

Posted Aug 07 2010 6:17pm
Urinary leakage during sex is a problem that many women experience but often rarely discuss. Many women feel they are the only one with this issue. They are too embarrassed to discuss it with their medical provider or even their friends. Women's health experts tell us that about 2 % of women without problems with urinary incontinence suffer "sexual incontinence". While 12-20% of women who do have problems with incontinence also leak during sex. Women can have leakage with clitoral stimulation, vaginal penetration and orgasm. Is nothing sacred?!

As you can imagine, trying to learn more about urinary leakage during sex could be, well, interesting to say the least. Many women don't even bring the subject up with their doctors much less offer to be in "a study". Health professionals have made assumptions about why women leak during sex but there haven't been many formal investigations of this problem.

So what's happening when you leak during intercourse?

It is thought that leaking during intercourse (in the missionary position-woman on bottom) might be "mechanical problem". When there is more pressure on the abdomen and bladder, urine can be pushed out and you leak. This could be considered a type of stress incontinence (see previous blogs for more about the mechanics of stress incontinence). Also during sex, the penis could press on the bladder and cause stress incontinence.

For women who have overactive bladder or urge incontinence, it is thought that during sex the penis could stimulate an already overactive bladder causing the bladder to contract. This is quite a problem because as the bladder contracts, the urethra opens, allowing urine to escape at a very inconvenient moment.
Why women might leak with clitoral stimulation or orgasm is less clear although certainly equally annoying.

What's a girl to do?

Don't be afraid to seek help. You should talk to your health care professional about this problem. You shouldn't feel embarrassed or alone.

Some other things you can do to improve the situation are
  • Maintain good pelvic floor muscle strength-this gives you more ammunition to fight the problem and has been show to have the added benefit of helping you have better orgasm. A two for one deal!
  • Contract your pelvic floor muscles during intercourse-your partner will think you are the bomb and you may prevent both stress and urge related leaking.
  • Empty your bladder before intercourse. (You should empty your bladder after intercourse as well.)
  • Try having sex in aside-lying or on-top position as this may limit the depth of penetration and so minimize bladder irritation.
  • Make love in the shower or tub. (Now that might be fun!)
Don't let the fear of leaking stop you from having sex. (Remember sex is great exercise for your pelvic floor muscles-and what a great way to burn some calories!)
We hope this information helps you manage this delicate issue and then...problem solved.

Mary and Kathleen

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