22 January 2019

5 tips on managing urinary incontinence during sex

Incontinence can be an embarrassing issue, especially when it comes to intimacy. Here’s what you should know.

Urinary incontinence is a condition that can affect your self-esteem, especially when it comes to sex. 

It can be difficult to talk about your condition with your partner and this may lead to anxiety and lack of sexual intercourse.

According to a study published in 2018 in BJU International, urinary incontinence is one of the main causes of a decline in sexual activity in older people. High levels of depression and anxiety were also linked to urinary incontinence, leading to lower self-esteem, anxiety, embarrassment and social withdrawal.

The International Society for Sexual Medicine (ISSM) elaborates on how urinary incontinence can severely affect your sex life. The fear of constant leaking during intercourse is tied to anxiety. As a result, one can start feeling undesirable and unattractive. One may also rush through sex and fail to achieve orgasm.

Anxiety can also cause the body to tense up, which may cause painful intercourse.

And besides the physical aspects, someone who is trying to hide urinary incontinence from their partner or fails to talk about their condition may also become emotionally withdrawn, which can lead to a lack of communication and less intimacy in general. According to ISSM, those who experience urinary incontinence often refuse to talk about it, as they fear that it might make their partner find them less desirable.

When you manage your urinary incontinence and maintain healthy communication with your partner, there is no reason why your sex life should suffer.

Here’s what you can do:

1. Communicate clearly

Don’t hide urinary incontinence from your partner. Talk openly about your condition and that you are scared that you might leak during sexual intercourse. A loving partner will understand and support you.

Older couple talking

2. Try another position 

Certain positions are more likely to trigger urinary incontinence than others. Choose a position that places less pressure on the pelvic area and urethra. 

Couple in bed

3. Try pelvic floor exercises

If you haven’t already started doing pelvic floor exercises to help manage urinary incontinence, now is the time. Not only do studies show efficacy and improvement in those with urinary incontinence who do pelvic strength exercises, but strengthening the Kegel muscle can also improve the intensity of one's orgasms.

If you are unable to incorporate these exercises, a physiotherapist may be able to help you.

woman doing exercises

4. Limit your fluids beforehand

Nothing anticipates a night of rewarding sex more than wining and dining, but limit your alcohol intake beforehand if you know that you will be having sex and are worried about leaking, as alcohol can irritate the bladder.

water and wine on table

5. Consult your doctor or a medical professional

If you have trouble managing your urinary incontinence and it’s severely affecting your lifestyle and intimacy, it’s time to see your doctor or a urologist who might be able to help you in terms of treatment options, whether it’s medication or other methods. In the event of urinary incontinence, it's important to see a doctor, as urinary incontinence should never be accepted as "normal". Don't hesitate to seek professional help for other issues that may occur because of urinary incontinence. If your relationship is affected, consult a therapist. 

Woman talking to her female doctor

Image credit: iStock


Ask the Expert

Incontinence Expert

Dr Prenevin Govender completed his MBChB at the University of Cape Town in 2001. He obtained his Fellowship of the College of Urologists in 2009 and graduated with distinction for a Masters in Medicine from the University of Cape Town in 2010. His special interests include laparoscopic, pelvic organ prolapse and urinary incontinence surgery. He consults full-time at Life Kingsbury Hospital in Claremont.

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