Many women would rather keep their experiences with coital incontinence "under the covers", yet it is a common problem that needs to be discussed, as it can impact on sexual health.
Urinary incontinence is a taboo subject for many women and they find it difficult to talk about at the best of times. Coital incontinence, the leakage of urine during sex, is even more challenging to discuss. It can occur in women with any type of incontinence, and a 2016 study showed that 40% of women who have issues with incontinence leaked urine during sex – so it really isn’t that uncommon.
It is understandable that some women will break off intimacy when that “oops” moment happens, or even abstain from sex altogether for fear that it might happen. Fear can knock your libido on the head and can end up having a very negative impact on your sex life.
During penetration or orgasm?
There are many things that can cause a woman to leak urine during sex, and the most common thing to exclude is a bladder infection (UTI). It might also only happen in certain sexual positions. Other possible causes to consider could include pelvic floor damage; weak muscles because of childbirth; numerous pregnancies; certain medical conditions such as diabetes; multiple sclerosis (MS); as well as some neurological problems.
Many foods and drinks can irritate the bladder, and of course being overweight won’t help as it puts more pressure on the bladder.
Then you need to consider if it’s happening during penetration or during orgasm. If it's on penetration, it might mean that you have stress incontinence and that the pelvic floor muscles aren’t strong enough to prevent leakage. If it happens during orgasm, it could likewise be stress incontinence, but could also be because the bladder experiences spasms, which is a symptom of urge incontinence.
So, what can you do?
As always, having a frank discussion with your HealthCare provider is the best way to find out why you are having these issues, and for them to give you the help that you need. They should take a thorough history and may do a physical examination.
If that isn’t an option, for whatever reason, then these are some points to consider:
1. Communicate with your partner
The first thing you should do after a discussion with your HealthCare provider is to communicate openly and honestly with your partner regarding your condition and how it may affect your sex life. Working through the situation together can lead to improved sexual health and a more satisfying sex life for both of you.
Try different positions – missionary style can often exacerbate the symptom. Woman on top, side by side, and rear entry can improve the situation. Also, make the situation more manageable by being prepared, putting down a towel, having a bathroom close by, and using incontinence/hygiene products as needed.
2. Empty your bladder
Make sure your bladder is empty before sex; if it’s less full then there will tend to be less leakage. You may want to consider how much and what you are drinking an hour or so beforehand as well. This should however not keep you from staying well hydrated throughout the day.
3. Avoid bladder irritants
You may enjoy a couple of glasses of wine, but alcohol along with caffeine, juices, fruits, acidic foods, spicy foods, artificial sweeteners and chocolate can cause your bladder to spasm and subsequently leak during sex.
4. Lose weight
If you are overweight, losing a few pounds may help. Losing about 10% of your body weight can improve your symptoms as it helps to decrease the pressure in your abdomen.
5. Pelvic Floor Muscle Exercises (Kegels)
Exercise your vagina and make it stronger. The stronger your pelvic floor muscles are, the less you will leak. You can do pelvic floor muscle exercises before, during, and after sex, but remember it is important to make sure you are doing them correctly so take advice from a HealthCare professional.
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