Urination during sex
Passing urine during intercourse, and being unable to control it, happens to many women. No one seems to talk about this, so a sufferer thinks she is the only one with the problem.
Is urination during sex common?
- In about two-thirds, the leakage occurs when the penis enters the vagina (penetration).
- In about one-third, the leakage occurs only at orgasm.
What causes urination during sex?
- a study in six women showed that their ‘female ejaculate’ fluid contained the same amount of acid phosphatase as their urine
- a study of just one woman did find high levels of acid phosphatase in the fluid she released at orgasm, but the method used to analyse it was unreliable.
What can be done about urination during sex
- Empty your bladder before sex.
- Cut down on caffeine-containing drinks and alcohol.
- Do not drink excessive amounts of fluid – not more than 1.5 litres (2.5 pints) over 24 hours.
- Discuss the problem with your doctor, especially if you have leakage at other times.
- Your doctor may prescribe oxybutynin or a similar drug for you. Medication may be particularly helpful if you experience leakage at orgasm, rather than during penetration (European Urology 2007). You should take this about 1 hour before sex (if you can plan that well ahead!).
- Alternatively, your doctor can prescribe imipramine, to be taken in the evening. This is normally given as an antidepressant, but it also has effects on the bladder (which is why a similar drug is used to treat bed-wetting in children). If your doctor suggests it, it is because of its bladder effects, not because he or she thinks you are depressed. The dose will be lower than given for depression.
- If none of these deals with the problem, or if you experience leakage mainly during penetration, you may have a weakness of the bladder neck. Therefore it would be worth asking for a referral to a gynaecologist, preferably one who specializes in urogynaecology. An operation to strengthen the bladder neck might be appropriate. Unfortunately this operation is successful in controlling leakage during intercourse in only two-thirds of people.
- In the end, you and your partner may simply have to come to terms with the problem, and enjoy your sex life in spite of it. If it is causing a real problem in your relationship, or affecting your feelings about yourself, a few sessions with a psychosexual counsellor can be very helpful.
- You can also contact a number of organizations for help and advice.
Dr Phil Hammond looks at the frustrations of bed-wetting, with a little help from ‘Henry’, in his informative and entertaining video guide on bed-wetting.
Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, October 1st 2010
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