Why Some Women Experience Peeing During Sex?

Peeing during sex is a common concern among women, yet we tend to keep mum about this topic. If you’ve ever experienced urine leakage during foreplay, intercourse, or orgasm, please know that you are not alone and that this is both normal and manageable.

In fact, as many as 60% of women experience some level of coital incontinence, or peeing during sex. It all comes down to the unique anatomy of the female reproductive organs and urinary tract.

In this article, you’ll learn more about what causes urinary incontinence during sex, how to manage it, and how to enjoy your sex life more.

Understanding Women’s Anatomy

Before we talk about why peeing during sex happens, let’s explore the anatomy of the female pelvic organs.

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The female pelvis contains the organs of two separate and essential systems—the female reproductive organs including the ovaries, the fallopian tubes, the uterus, the cervix, and the vagina, and the urinary tract made up of the kidneys, the ureter, the bladder, and the urethra.

All of these organs are beautifully arranged within the pelvic cavity and protected and kept in place by the pelvic floor muscles, which also help control bowel movements and urination.

Urinating During Sex: What Causes It?

Peeing during sex, also called coital incontinence, is the involuntary release of urine during sexual activity. A variety of factors and conditions can contribute to this eventuality. Some are related to the architecture of a woman’s body, which is designed to accommodate a growing baby, and some are related to the physical changes we all experience as we age.

One feature of a woman’s body is the relatively short length of the urethra, typically ranging from 4.8 to 5.1 cm. By contrast, a man’s urethra is approximately 20 cm long. Because it is so short in women, activities such as coughing, jumping, laughing, and sexual activity can sometimes be enough to cause bladder leaks.

This is more of a risk when the pelvic floor muscles are weak, which can happen due to pregnancy and childbirth, carrying excess body weight, repeatedly lifting heavy objects with poor form, and simply growing older.

Types of Leaks

There are three main types of urinary incontinence—urge incontinence, stress incontinence, and mixed incontinence. And not all urinary incontinence is actually incontinence. Some fluid leakage is related to sexual arousal, namely squirting and female ejaculation.

• Urge incontinence is when you regularly experience a strong, sudden need to pee that is very difficult to delay. The bladder contracts and spasms, regardless of how full it is, and you may not be able to prevent urination.
  
• Stress incontinence happens due to pressure on the bladder or the pelvic area from a growing baby, heavy lifting, or intercourse. During sex, the weight of your partner, sexual stimulation, or challenging sexual positions can cause you to pee.
  
• Mixed incontinence is urinary leakage due to a mix of urge and stress incontinence.
  
• Squirting is a phenomenon some women experience once or twice in their lives, while for others it happens every time they are sexually active. Squirting is the sudden release of urine and vaginal fluids through the urethra during orgasm or arousal. This might be a small amount of liquid or the entire contents of the bladder.
  
• Female ejaculation is different from squirting and urinary incontinence, although it’s often mistaken for one or the other. Female ejaculate is a milky fluid that comes from the paraurethral glands, which are located on either side of the urethra. Much like male ejaculate, or seminal fluid, female ejaculate contains prostate-specific-antigen (PSA), fructose, and glucose.
  

For women, ejaculation is not necessarily linked with orgasms; it can happen any time a woman is aroused. The volume of squirting liquid and female ejaculate is also different. While squirting can soak the bedsheets, ejaculate is typically only about 1 ml of liquid.

Medical conditions that can cause female urinary incontinence

Sometimes bladder control is affected by a medical condition. The most common culprits include:

• Urinary tract infections, often caused by E. coli bacteria from the gut or an excess proliferation of Candida albicans yeast. They present with painful urination, frequent urination, and an uncomfortable need to pee although you just went. Symptoms can worsen during sex.
  
• Interstitial cystitis is an inflammatory disease of the bladder, also called bladder pain syndrome. IC is often mistaken for a UTI because the symptoms are similar, but with IC sufferers feel relief only when they are peeing. If left untreated, interstitial cystitis reduces the sufferer’s ability to control their bladder and can cause pain and discomfort during sex. We still don’t know what causes IC, but the condition is more common in women and can be aggravated by allergies, infections, and certain autoimmune diseases. Read more about interstitial cystitis, its causes, and treatment.

• Pelvic floor dysfunction is an inability to control the pelvic floor muscles. Being able to contract and relax these muscles at will is essential for managing urination, bowel movements, and sexual intercourse. A pelvic health specialist can determine the cause and suggest treatment options.
  
• Vaginal atrophy is a problem typically associated with menopause. The vaginal walls become thinner, drier, and more fragile as the body shuts down its estrogen production. This can lead to discomfort during sex and leave you more susceptible to infections and urinary problems, including urinary incontinence. Regular sexual activity (with or without a partner) increases blood flow to the vaginal tissues and can be helpful for maintaining your vaginal health. Lubricants and vaginal moisturizers also help.
• Certain medications such as diuretics, Alpha-Blockers, muscle relaxants, and opioids can make it more challenging to control your bladder and worsen your urinary incontinence.
  

Tips to Reduce Sexual Incontinence

Empty your bladder before and after sex

To avoid accidents in the heat of the moment, come prepared. Visit the restroom before hitting the sheets. With an empty bladder, you’ll feel less pressure in your pelvic area during sex.

Also, remember to urinate after sex to flush unwanted bacteria from your urethra. This will help prevent a urinary tract infection that can cause bladder problems and make discomfort during sex much worse.

Avoid fluids an hour or so before sex

When you’re sufficiently hydrated, the fluids you drink become urine within about 15 minutes. If you stop drinking an hour or two before having sex, your body should have enough time to process the fluids so you can come empty-bladdered to your partner.

Be mindful of what you eat

If you have urinary incontinence, avoid strong foods and drinks that can irritate the bladder. Alcohol, caffeine, citrus fruits, spicy foods, carbonated drinks, and artificial sweeteners are all known to make incontinence worse.

Enzymes and other elements in these foods and beverages irritate the inner walls of the bladder, signaling to the brain that you need to go, even if the bladder isn’t full enough.

Experiment with different sex positions

Certain sex positions exert more pressure on your pelvic floor, causing stress urinary incontinence. Some are missionary style, doggy style, and standing or scissor positions. Try positions that allow you to control the action.

Better sex positions to try:

• Being on top gives you more control over movement, speed, and depth of the penetration.
  
• Seated positions can be more comfortable because your pelvic muscles don’t need to work as hard at holding in urine.
  
• Try using pillows to adjust the height of your pelvic floor to find the sweet spot that works for you.
  

Exercise your pelvic floor muscles

Kegels, or pelvic floor exercises, are effective in strengthening the pelvic floor and are one of the best methods to manage urinary incontinence and prolapse. These exercises are done in short sets of squeezing and releasing the muscles to build strength and elasticity in the pelvic floor.

Once you know what you’re doing, you can do Kegels anytime, anywhere, and no one will even notice.

The muscles you want to strengthen are the same ones you use to stop the flow of urine in the middle of peeing or to clench your anus when holding in gas.

If you struggle to activate your pelvic muscles, use a Kegel device designed to make identifying these muscles and doing your Kegels easier:

• Squeeze the pelvic floor muscles slowly for a count of eight.
  
• Relax completely for a count of eight. This is just as important as the squeezing!
  
• Repeat both steps eight times. Increase repetitions over time as your muscles grow stronger.
  

Remember, when you are squeezing the pelvic floor, breathe normally and keep your butt and thighs relaxed.

Learn more about incontinence, urinary prolapse, and Kegel exercises.

Train your bladder

Bladder training is conditioning yourself to pee on a schedule. If you usually rush to use the toilet right before leaving home (even though you don’t need to) or pee every time you shower, you may be mistraining your bladder.

These seemingly harmless habits condition your brain to associate certain activities and times of day with urination. So, whenever you hear a shower running, you’ll automatically want to pee even if your bladder is empty. In the long run, little habits like these can worsen urinary incontinence.

You can avoid this problem by training yourself to pee at certain times. Most of us urinate 6–7 times a day, with some going between 4 and 10 times. If you find that you have to go more often, schedule your toilet breaks and try to maintain the same schedule over time.

You can gradually extend the time between restroom breaks and have more control over your bladder. With time you will feel the need to pee less often.

Communicate with your partner

For many people, peeing during sex can be embarrassing, especially if your partner doesn’t understand why it happens.

Explain the anatomy of your body to your partner so they can understand why you might experience some leakage during sex. Together, you can find positions that reduce the pressure on your pelvic floor.

If you squirt during sex, explain that not only is this completely normal, but in most cases, it’s a sign of sexual pleasure. Many couples agree that understanding female ejaculation and squirting has enhanced their sexual intimacy.

When to Seek Medical Advice

Female urinary incontinence is a common part of many women’s lives, but it doesn’t have to cramp your style or impede your sexual satisfaction. There are many ways to manage and treat urinary incontinence.

Depending on the level of discomfort you experience, your doctor may recommend lifestyle changes and the pelvic floor exercises we mentioned before.

However, if that doesn’t help, there are various medications your doctor can prescribe, including anticholinergics that calm an overactive bladder or beta-3 adrenergic agonists such as mirabegron that relax the bladder muscles allowing you to urinate fully in one go.

Surgeries and procedures to treat coital and urinary incontinence

In severe cases, when lifestyle changes and medication don’t help, there are surgical options that can provide relief, including:

• Sling surgery involves placing a sling or tape under the urethra to help support it and prevent urine leakage.
  
• Bladder neck suspension surgery, in which the bladder neck and urethra are lifted and supported. This is typically used to alleviate stress urinary incontinence.
  
• Artificial Urinary Sphincter (AUS) implantation is a procedure in which a device is surgically implanted around the urethra to control urine flow. This surgery is used in more severe cases.
  
• Sacral nerve stimulation, in which a small transmitter is implanted under the skin in the upper buttock area to send electrical impulses to the sacral nerves and help regulate bladder function. This is commonly used for overactive bladder and urge incontinence.
  

Wrap-Up

Stress urinary incontinence and peeing during sex are both common experiences. There is no need to feel embarrassed or let a little bladder leakage affect your sex life. There are many ways to manage peeing during sex and increase your comfort and well-being, despite coital incontinence.

We hope you have found these tips on how to manage peeing during sex and improve your sex life valuable. We always encourage our readers to seek medical attention when an issue presents itself, and to choose health and comfort over pride or stoicism.

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