It is estimated that approximately 20 million Americans are affected by urinary incontinence and 85% of them are women. Among women with incontinence, about 50% suffer from coital incontinence or urine leakage during sex. The actual number of women with coital incontinence is most likely underestimated because many are too embarrassed to discuss it or believe it’s a normal part of aging. The importance of seeking care for this issue cannot be over emphasized as incontinence has a significant negative impact on quality of life and is linked to problems like depression, anxiety, and sexual abstinence.
Why I do leak urine during sex?
There are two main reasons why coital incontinence happens, first the vagina and the bladder share a wall like a duplex apartment. Not only do they share a wall, the bladder and surrounding pelvic floor structures share their support, nerves, and blood vessels with the vaginal canal. Sexual intercourse results in stimulation of the surrounding nerves and muscles of the vagina and bladder. Stimulation of the vaginal tissue triggers bladder muscle contractions which forces urine out of the bladder during sex. Alternatively, a woman may experience leakage when pressure is placed on the bladder during sex or during urethral relaxation just before orgasm.
It is not unusual that a combination of these issues causes coital incontinence in the same person. Though common, urine leakage during sex is not normal and can be treated effectively with behavioral changes, medications and at times surgical procedures.
Treating urine leakage during sex
- Empty your bladder prior to sex:Women with urinary incontinence are more likely to leak when their bladder is full so voiding prior to sex will reduce coital incontinence.
- Kegel exercises: The bladder and the urethra are supported by the pelvic floor muscles, performing Kegel exercises results in strengthening of the pelvic floor muscles and improved bladder control.
- Losing weight: Being overweight places pressure on the support structures of bladder preventing the bladder from effectively storing urine. Studies have shown that an 8% loss of body weight results in a 45% reduction in urinary incontinence, so weight loss is an important strategy for reducing urine leakage during sex.
- Medications or Botox injections: If your bladder muscles contract during sex or you leak after feeling the urge to urinate then you have a problem called urgency incontinence. Medications and Botox injections in the bladder reduce bladder muscle contractions which lead to urgency incontinence.
- Surgical procedures: Surgical procedures like minimally invasive slings are used to treat urine leakage during activities like coughing, laughing, and lifting. If your incontinence during sex is triggered by exertion, then surgery may be an effective treatment.
Overall, urine leakage during sex is a very common problem experienced by many women. Seeking care is an important first step to help you regain your sexual confidence while improving your quality of life.
I am board certified in Obsetrics and Gynecology (OBGYN) and Female Pelvic Medicine and Reconstructive Surgery (FPMRS). I currently serve as the Medical Director of Female Pelvic Medicine for the Crozer Health Medical Group in the greater Philadelphia area. I obtained my residency training in OBGYN at the Los Angeles County+ University of Southern California Medical Center and fellowship training in FPMRS at Johns Hopkins. I am passionate about the field of Women’s Health and the treatment of pelvic floor disorders like urinary incontinence and pelvic organ prolapse.