Pillow Talk: Be Open About Bladder Issues - Large

It’s a common problem for women with urinary incontinence: Do you bring up with your partner that you might have some urine leakage during sex? Or do you say nothing and hope he doesn’t notice?

“A lot of patients talk to me about their embarrassment with leaking urine during intercourse,” says William Rush, MD, female pelvic medicine specialist with Lifestages-Samaritan Centers for Women, in Dayton, Ohio. “Incontinence is very common and can inhibit your sex life. Although many women avoid sex because they fear leaking, I’ve never heard anyone say her partner won’t have sex because of it.”

He continues, “My advice is that if you have a physical relationship with someone, discuss the issue openly, and your partner is likely to be sympathetic. It’s much better to let your partner know the truth. You can work through it together rather than having your significant other wondering if there are other problems in the relationship that are making you avoid sex.”

How to Deal with Urine Leakage during Sex

As you discuss bladder issues with your partner, these suggestions may make you feel more comfortable:Pillow Talk: Be Open About Bladder Issues - Content

  • If possible, limit fluid intake about an hour before having sex, and try to empty your bladder just before sexual activity. (That doesn’t mean you can’t have a glass of wine or other beverage if you are dining out or relaxing at home.)
  • Be reassured that although urine isn’t completely sterile, it’s not harmful to a sexual partner.
  • If urine leakage is more than a few drops during intercourse, have a towel or pads available to protect your bedding.
  • Try different sexual positions to reduce pressure on the bladder. Being on top may give you better bladder control. Entry from behind means less pressure on the bladder and urethra. Side intercourse also can be less strenuous on the bladder.

Talk to your partner candidly about your bladder issues, but also consider visiting a urogynecologist. This specialist in treating urinary incontinence can offer a variety of solutions. Depending on the cause of urine leakage, 80 to 95 percent of urinary incontinence can be improved  with treatment.

Urge incontinence (overactive bladder due to nerve or muscle damage) can be treated with physical therapy or medicines, and stress incontinence (from weakened pelvic floor muscles) can be corrected with a procedure or physical therapy.

Coping with Prolapse during Sexual Activity

Sometimes, a prolapse occurs in the pelvic organs — a weakening of muscles and dropping down of the bladder, uterus, rectum or top of the vagina — so that it may feel during sex that there is something solid inside your vagina.

Although many women avoid sex because they fear leaking, I’ve never heard anyone say her partner won’t have sex because of it.

“It’s not going to harm you to have sex if you have prolapse,” Dr. Rush reassures. “You may find that some positions are more comfortable than others. If it’s not bothering you, you don’t have to have it fixed."

On the other hand, if the condition is causing you discomfort, you should see a physician for possible solutions.

Dr. Rush affirms that bladder issues shouldn’t interfere with a healthy sexual relationship.

“Live your life and enjoy it,” he says. “If your partner isn’t bothered by the bladder issue, don’t let it become an issue for your relationship.”

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