Peeing during sex is not uncommon, nor it is anything to be embarrassed about. Also referred to as coital urinary incontinence (CI), it is known to affect women with underactive pelvic floor muscles or pre-existing urinary incontinence (UI).
For some women, CI can result in less sexual satisfaction, loss of libido, lower quality of life, or complete avoidance of intercourse, but treatment options are available and neither your sex life nor your happiness needs to suffer.
Keep reading to understand why you are peeing during sex, what causes it, and how to manage it so that not only your sex life improves, but your overall quality of life too.
Urinating During Sex: What Causes It?
When it comes to understanding why some women leak urine or pee during sex, it is helpful to comprehend that the bladder in the female body is closely located to the clitoris and vagina. It is therefore unsurprising that the female bladder might experience a certain amount of pressure or prodding from the penis, fingers, or sex toys during intercourse.
That said, not all women unintentionally urinate during sex, so why some and not others? Medical practitioners and physical therapists agree that uncontrolled or unintentional peeing during intercourse is associated with a condition called urinary incontinence (UI).
In support of that theory, the results of a recent research study revealed that approximately 60% of women with UI also report urine leakage during sex.
Urinary incontinence is not the same for every sufferer, however, so for further clarification of the causes and symptoms, medical professionals have categorized UI into three different types.
- Stress urinary incontinence
- Urgency urinary incontinence
- Mixed urinary incontinence
Stress Urinary Incontinence Explained
Despite the name, stress urinary incontinence is not connected in any way to psychological stress. It is instead caused by a weakening of the pelvic floor muscles that support the urinary system.
When the pelvic muscles and tissues are weak and no longer adequately support the bladder, urethra, or urinary sphincter, certain activities or physical movements can put ‘stress’ on the bladder, causing urine to ‘leak’.
Stress urinary incontinence is considered the most common type of incontinence that causes unintentional peeing during sex. Additional activities that put stress on the bladder include coughing, laughing, lifting heavy objects, and sneezing.
How To Treat Stress Urinary Incontinence
Once diagnosed with a urodynamic test, stress urinary incontinence is usually treated by strengthening or retraining the pelvic floor muscles with physiotherapy. In some instances, exercises may include the practice of Kegels and hip exercises.
For more effective muscle training, pelvic floor physical therapists also recommend adding Kegel weights for additional resistance to encourage the pelvic muscles to work harder and strengthen quicker.
For some people, the pelvic floor muscles may be too tight, and they may be educated in pelvic floor muscle relaxation exercises.
Urgency Urinary Incontinence
Also known as Overactive Bladder (OAB), urgency urinary incontinence is described as a sudden and frequent urge to urinate. Most common in women aged 45 and older, those with urgency urinary incontinence typically feel the need to pee many times during the day and often at night too.
In a normally functioning urinary system, the urge to urinate arises when the bladder is at least half full, however with OAB, the bladder contracts far sooner, often resulting in leakage before the bathroom is reached.
Urgency urinary incontinence is thought to be caused by several different factors including abdominal trauma, bladder infections, certain medications, nerve damage, or the overconsumption of fluids like caffeine and alcohol.
How To Treat Urgency Urinary Incontinence or Overactive Bladder
Treatment for urgency urinary incontinence is determined once a urodynamic test has been carried out to confirm the root cause of the overactive bladder.
Primary treatment options typically include eliminating triggers through certain dietary changes, bladder training, and pelvic floor strengthening with physical therapy and Kegel weights. If the preliminary treatment options produce little improvement, medications and nerve stimulation might be recommended.
Mixed Urinary Incontinence
Some women experience a mixture of the symptoms associated with stress urinary incontinence and urgency urinary incontinence. When this occurs, urine leakage can be caused by stress on the bladder from physical activity (coughing, sneezing, exercise, or sex) as well as the urgent need to pee. This condition is called mixed urinary incontinence.
Women suffering from mixed urinary incontinence can often visit the toilet with an urgent need to pee and then experience a dribble or leakage straight after.
Unintentional leaking when coughing, sneezing, exercising, dancing, lifting heavy objects, and during sex is also associated with mixed urinary incontinence, as is the need to get up during the night to urinate.
Treatment For Mixed Urinary Incontinence
Once a bladder or urodynamic test has confirmed mixed urinary treatment, your healthcare professional will determine the best type of treatment for you. Typically, with mixed urinary incontinence, one symptom will be more prominent than the others and this is the one that usually dictates the type of treatment suggested. Pelvic floor physical therapy is often recommended to address all of the issues.
Is Surgery Required to Treat Urinary Incontinence?
In the majority of cases, female urinary incontinence is treated with the help of a pelvic floor physical therapist, and by regularly practicing pelvic floor strengthening exercises at home with Kegel weights.
That said, depending on the cause of the incontinence, medication is sometimes recommended to reduce bladder spasms, and in severe cases, surgery could be required to reposition the neck of the bladder or provide extra support for the urinary tract.
Tips to Reduce Peeing During Sex
Over 40% of women over the age of 45 suffer from some form of incontinence, which can often lead to involuntary peeing during sex, but less than 17% enquire about treatment options.
If you are one of these women, don’t be embarrassed, speak with your healthcare provider or a pelvic health physical therapist about restrengthening your pelvic floor and retraining your bladder.
In addition, the following tips can help to reduce urinating during sex:
- Avoid substances that irritate the bladder before sex, like caffeine, chocolate & alcohol
- Don’t drink too many fluids before sex
- Pee before sex
- Experiment with different sexual positions that don’t put pressure on your bladder
Urinating during sex can be upsetting and embarrassing, and pelvic floor dysfunction can often lead to a reduced quality of life and even depression. The good news is, most women can cure coital incontinence with some key dietary & lifestyle changes as well as regular pelvic floor exercises known as Kegels.
If you are suffering from coital urinary incontinence, contact your healthcare provider about a bladder test to understand the cause of your incontinence and the best treatment options for you.
Urology Care Foundation - What Is Urinary Incontinence - https://www.urologyhealth.org/urology-a-z/u/urinary-incontinence
Mayo Clinic – Stress Urinary Incontinence - https://www.mayoclinic.org/diseases-conditions/stress-incontinence/symptoms-causes/syc-20355727
Cleveland Clinic – Overactive Bladder https://my.clevelandclinic.org/health/diseases/14248-overactive-bladder
Mixed Urinary Incontinence – Bladder & Bowel Community - https://www.bladderandbowel.org/bladder/bladder-conditions-and-symptoms/mixed-urinary-incontinence/
Physiopedia – Pelvic Floor Dysfunction - https://www.physio-pedia.com/Pelvic_Floor_Dysfunction
National Association for Continence – Bladder Health & Sex - https://nafc.org/bhealth-blog/bladder-health-and-sex/
National Library of Medicine - Incontinence during intercourse: myths unraveled - https://pubmed.ncbi.nlm.nih.gov/22237785/
National Library of Medicine - Stress Urinary Incontinence and Female Sexual Dysfunction: The Role of Pelvic Floor Rehabilitation - https://pubmed.ncbi.nlm.nih.gov/31703185/