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Incontinence, Orgasm, sex

Leaking urine during sex…what’s up with that?

You are in the throngs of great sex when all of a sudden there is a new sensation. It takes your brain, very occupied with other things, a few seconds to switch gears and process. And then you realize that you have inadvertently emptied your bladder.

This is a real medical problem called coital incontinence. The exact number of women who have this condition is unknown as many are reluctant to talk about it. However, urinary incontinence affects 20% of women. Women with incontinence at other times are more likely to have coital incontinence, but women who never, ever leak a drop otherwise can still develop problems during sex.

There are two major mechanisms of incontinence. The first is an overactive bladder, meaning you have the urge to go more often (and if you don’t find a bathroom you might leak) or you may even find your bladder triggered to empty for what seems like no good reason. The other kind is stress incontinence, which is an anatomical problem involving support of the bladder neck. Women with stress incontinence typically leak with coughing or sneezing.

Some people think that leaking urine on penetration is more likely stress incontinence and leaking during orgasm is overactive bladder, but the truth is the condition is so poorly studied that we really don’t know.

So what should/can you do?

Don’t panic! Urine is sterile, so put it in perspective (the vagina is most definitely not sterile). You won’t give anyone “anything” by leaking some urine. I’m not saying it shouldn’t be treated, but if it isn’t bothering you or your partner, it doesn’t have to be treated.

Regardless if you want it treated or not, get tested for a bladder infection, because infections irritate the bladder and can lead to leaking.

Let your doctor know this is happening. While it is not likely to be a sign of anything more sinister, only someone who knows your whole history can tell you that.

Empty your bladder before sex and skip common bladder irritants (they can make overactive bladder much worse) such as coffee, tea, chocolate, artificial sweeteners, soda, juice, and alcohol. Some women with overactive bladder can become dry by eliminating irritants alone.

If you are overweight, work towards your ideal weight. Even taking off 7% of your weight can make a difference. The more overweight you are, the more pressure on your bladder. Talk with your doctor about the safest weight loss strategy for you.

Talk with your doctor about your treatment options. What they recommend will depend on knowing all your symptoms and performing a physical exam. The first line treatment is typically pelvic floor physical therapy, which helps to retrain and strengthen the muscles that support the bladder. The upside of physical therapy is that it is very effective for incontinence and there are no medication side effects. Your doctor may also talk with you about trying medications for overactive bladder. If the problem turns out to be stress incontinence, surgery might be the answer.

If your GYNO doesn’t know what to offer (or even where to start) ask for a referral to a urogynecologist (a GYNO who has done extra training in the bladder and pelvic muscles). They will be able to discuss the appropriate investigations, rule out any other health concerns, and get you started on the best therapy for you.

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Discussion

16 thoughts on “Leaking urine during sex…what’s up with that?

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    Posted by http://tinyurl.com/worllunt42203 | January 16, 2013, 10:57 am
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    Posted by tinyurl.com | March 2, 2013, 5:11 am
  3. Sorry for these folk.

    Posted by Hashmi Dawakhana | September 8, 2014, 9:12 am
  4. Uhmmm this is bullshit. Its called female ejaculation. You cant pee during sex. Your body cant use both muscles at the same time

    Posted by Christina | October 26, 2014, 9:41 pm
    • No it’s not. You can leak urine during intercourse. There are several mechanisms. Levator ani contractions during orgasm do not prevent the bladder from emptying.

      Posted by Dr. Jen Gunter | October 27, 2014, 8:02 am
      • There is such a thing as female ejaculation, though. It tastes sweet and is a clear and/or milky color, it’s odorless, and does not stain the sheets like pee. In India it’s called rasa, nectar.

        Posted by J | December 7, 2015, 8:03 am
    • I definitely pee sometimes when I have a clitoral orgasm. It’s not ejaculation; I can tell the difference.

      Posted by Carolina | February 18, 2016, 6:12 am
      • I haven’t had sex in 7 years because my husband died from cancer, and I got a dildo and once I got it in pee started coming out and I wasn’t peeing on my self. I don’t understand it.

        Posted by susie | July 24, 2016, 4:23 pm
  5. Its happening to me.. I just had a baby 6 months ago and ever since have had a horrible time with leaking.. I cough I leak I have sex and sometimes I’ll leak but other times I won’t I don’t understand what’s going on.. my mom had a prolapse and had to have a full hysterectomy.. is it genetic???

    Posted by Laura | March 30, 2015, 12:25 am
    • Leaking for up to 1 year after a baby is pretty normal.

      Posted by Dr. Jen Gunter | March 30, 2015, 1:53 am
      • I’ve had 3 babies since 2010 But my leaking during sex didn’t start till I had my last baby in July of 2013. It Feels like an orgasm but when I just let it go thinking that’s what it is….it a small or sometimes large gush of fluid. Sometimes it has no smell and other times it has a faint smell of urine. Please help me out with some info??!!

        Posted by kaycee | May 4, 2015, 12:23 am
  6. I have a problem urine during sex I want it to stop I never had this problem before it started last year

    Posted by martha | August 1, 2015, 6:28 am
  7. What’s the issue of a man urination, during sex.

    Posted by Ellusive Lady | December 9, 2015, 6:59 am

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  1. Pingback: “Squirting” during sex is urine – new study | Dr. Jen Gunter - January 10, 2015

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