6 things every woman should know about bladder leaks and sex

Bladder leaks and sex?! In the realm of uncomfortable topics, this one can be pretty uncomfortable for a lot of people. And that makes sense: Leaking urine? Sex? We are often trained to avoid these topics in everyday conversation. Too often, people feel a sense of embarrassment or shame with the body and natural bodily processes.

But…the thing is, we all have the same parts. We all go to the bathroom. Sex and intimacy is a natural part of life. So, we definitely need to be talking about this! In fact, in a study of 324 sexually active women referred to a urology clinic for bladder leaks, 24% of them experienced some type of urinary incontinence during intercourse. That’s almost 1 in 4 women with this same complaint!

Here are six things every woman should know about bladder leaks and sexual intimacy to bring back that confidence in the bedroom.

1. If we have problems with one, it can lead to problems with the other

The female reproductive system and urinary system share anatomical structures. This means that the muscles, nerves, and connective tissue that play a role in urinary function also play a role in sexual function. So, if you have issues with one of the systems, it can certainly contribute to issues of the other!

2. There are two different times the bladder can leak during sex

First, to be clear, sex is different for each person and intimacy varies across the board. This is just what the research says but know that “common” does not mean “only” and “sex” does not mean “penetration”.

That being said, from a clinical research standpoint, there are two situations identified as common for bladder leaks during sexual intercourse. One is associated with vaginal penetration, and the other is during orgasm.

3. About bladder leaks and vaginal penetration…

Let’s start with the first: bladder leaks with vaginal penetration. This has been shown to be associated with stress urinary incontinence (SUI), which is the involuntary loss of urine with a pressure change that occurs in the abdominal area. For example, women with SUI may leak urine with coughing, sneezing, or jumping; these activities create increased pressure or force in the abdominal region (have your abs ever hurt from coughing a lot during a cold?). If that pressure is not well managed, then bladder leaks can occur.

Similarly, rigorous activity such as sex or vaginal penetration can cause bladder leaks too. The pelvic floor muscles assist with supporting and coordinating the function of the urethra, which is suspected to have some dysfunction when this happens. Having proper strength and coordination of these muscles, in addition to their supporting structures and surrounding muscles, is an important part of proper bladder and sexual function.

Weakness in these pelvic floor muscles is a leading cause of SUI. Various positions during intimacy can also cause an increase in abdominal pressure, and if the pelvic floor is not strong enough to hold back that pressure, leaking will happen.

Fortunately, there are some things you can do about it. You can try Flyte as an at-home treatment option that has been clinically proven in research to improve SUI in women in as little as 2 weeks. It’s an FDA cleared, clinically proven solution for bladder leaks and worth trying if you find yourself leaking urine during sexual activity.

4. About bladder leaks and orgasm …

What about bladder leaks during orgasm? These leaks can be associated with something called detrusor (the bladder muscle) overactivity: spontaneous contractions of the bladder muscle when the bladder is not emptying.

Detrusor overactivity is often seen with overactive bladder or urinary urgency, the feeling of having to run to the bathroom numerous times during the day or maybe even at night. Addressing urinary urgency during everyday life is therefore super important in ensuring the bladder functions well and does not interfere during sex.

Now, bladder leaking during sex is different from female ejaculation, also known as “squirting”. This term can be misleading because it indicates that a lot of fluid is produced during orgasm. It’s generally just a small amount and usually a combination of diluted urine and milky white fluid, produced by glands on either side of the urethra. And it’s perfectly normal.

So how do you know if it’s a true urine incontinence during sex or female ejaculate? Well, if it’s a lot of fluid, there’s a higher likelihood it’s urine. The other test? Check the smell. If it smells like urine, it probably is.

5. You don’t have to be leaking urine in the bedroom to have a problem

Maybe you aren’t experiencing issues with urine incontinence during sex. But you’re still worried that the symptoms you experience during the day will show up in the bedroom. Maybe you are nervous about the possibility of unpredictable urine loss during sex or concerned about the odor associated with urine leaking if it were to occur. This can lead to lack of fulfillment with sexual activity or avoidance of it all together.  

Bladder leaks can impact more than your sex life – they have been reported to alter self-esteem and body image in women of all ages. But the thing is, we are parts of a whole. Meaning that how we are impacted by bladder leaks on our mental health can definitely impact our sexual arousal. Female sexual arousal is highly tied into our self-esteem, body image, and connection we feel with our partners. That can certainly be affected by something as jarring as leaking urine throughout the day.

6. You don’t have to live with it. Really. You really, really don’t

If you are leaking urine with sexual activity, definitely see a qualified healthcare provider who specializes in pelvic health to fully assess you and guide you towards the best treatment moving forward. This may be a pelvic floor physical therapist, urogynecologist, or your OBgyn. These doctors can listen to your unique story and determine what lifestyle changes and treatments you need to make long-term improvement in your quality of life.

But what can you do right now?

  • Validate your feelings and recognize that leaking urine during sex can feel embarrassing and frustrating. We get that. Remind yourself that you are worthy of love and sex. Don’t let this ruin your intimate moments, get help, and get back your confidence. 
  • Try Flyte in-home pelvic floor treatment and see if that helps you. It’s clinically proven to strengthen the pelvic floor muscle and treat stress urinary incontinence. If it doesn’t work for you, it’s backed by a money back guarantee.   
  • Empty your bladder before sex and pay attention to any dietary irritants that may contribute to your urine leaking. This could be coffee, cocktails, or something else. Think about keeping a bladder log to track your intake of fluids and food for a week, noting any times you are experiencing leaking and what you may have been doing beforehand. A pelvic health specialist can help you with this too.
  • Try different sex positions. This may help you reduce the pressure being placed on your bladder and reduce leaks.

Talk about your concerns with your partner. This can help you navigate how to make the experience of sexual intimacy more pleasurable for both of you. Try talking about it with a close friend. Sometimes, keeping things close to ourselves, can make us feel a sense of shame and isolation. Find your support system in your partner, friends, family, and doctors.

Sources:

Renato L. M. (2017). Female urinary incontinence and sexuality. International Braz J Urol; 43(1): 20-28. Doi: 10.1590/S1677-5548.IBJU.2016.0102.

Hilton P. (1988). Urinary incontinence during sexual intercourse: a common, but rarely volunteered, symptom. Br J Obstet Gynaecol; 95(4): 377-81. Doi: 10.1111/j.1471-0528.1988.tb06609.x.

Moalem, S. & Reidenberg, J. S. (2009). Does female ejaculation serve an antimicrobial purpose? Med Hypotheses; 73(6): 1069-71. Doi: 10.1016/j.mehy.2009.07.024.