Am I Peeing During Sex?
Do you ever feel you’re peeing during sex? If you have, it may create embarrassment, less interest in having sex, struggling to reach orgasm, or even put a strain on your relationship. The good news is, we know why this is happening to you- and your pelvic floor is to blame! If you’re tired of peeing during sex and ready to enjoy sex again, keep reading to learn how to solve your pelvic floor problem!
What is Happening?!
Often leakage during sex, or ‘coital incontinence’ is divided into three categories: leakage with penetration, leakage with orgasm, and “squirting”. Let’s break down the three types below and dive into how you can stop peeing during sex.
Leakage with Penetration
Studies suggest that this form of leakage is associated with stress urinary incontinence, which is caused by an activity that increases pressure or stress on the pelvic floor (think coughing, sneezing, jumping). With vaginal penetration from a partner or an object, there is pressure placed on your bladder and urethra (tube that urine flows out). If the pelvic floor muscles supporting the urethra are too tight or weak, they may be unable to keep the urethra closed with the added pressure resulting in urine leakage.
Leakage with Orgasm
Studies suggest that this form of leakage is more common in women with bladder or pelvic floor muscle overactivity. Bladder overactivity is an involuntary muscle contraction of the bladder wall often triggering an involuntary loss of urine. During an orgasm, the muscles surrounding the bladder can spasm, causing you to leak urine as the contractions place additional pressure on the bladder.
Squirting
This last one is a little different as the cause of squirting is still being researched, but we do know that it is a large, involuntary fluid release from the bladder. This release of fluid can occur before, during or after an orgasm. While the fluid isn’t truly urine, it resembles watered down urine and is odorless. Squirting is not necessarily a sign of dysfunction and can be a normal part of sexual function. However, it can be hard to differentiate between leakage and normal release of fluid, so if you have concerns about this, mention it to your Pelvic Floor PT, OBGYN, or other sexual health provider.
So, how can pelvic floor physical therapy help?
A pelvic floor physical therapist has an important role in assessing and treating:
Pelvic floor strength, coordination and mobility
Scar tissue restrictions from surgeries or tear(s) during birth
Pressure management and core strength
Not all dysfunction is caused by weakness, often your pelvic floor is overactive and unable to fully contract and relax. This makes it difficult for the tissues to respond to added stress, pressure or stimulation during sex or orgasm. Seeing a Pelvic Floor Specialist to work on ‘breaking up’ the scar tissue, letting go of tension in your pelvic floor and managing core pressure will improve the surrounding muscle’s ability to contract and relax. This will also decrease leakage during sex and may even improve orgasm quality (yay!).
Should I just do more kegels?
Doing more kegels is definitely not the answer if you’re experiencing leakage during sex. The first step to this problem is to get your pelvic floor evaluated by a specialist. As discussed above, the pelvic floor may be overactive or tight instead of too weak. By doing kegels blindly and without a pelvic floor exam, symptoms may worsen and exacerbate the issue!
With both forms of leakage during sex, you are likely experiencing an underlying pelvic floor dysfunction. One of the least invasive forms of treatment to address the cause of leakage is pelvic floor physical therapy. If you’re ready to take the next step to better sex, check out our FREE download “7 Easy Steps to END Incontinence”!
References
Constantini, E. (2018). Coital Urinary Incontinence. ICS Committees. Retrieved November 29th, 2022 from, https://www.ics.org/committees/standardisation/terminologydiscussions/coitalurinaryincontinence
Pastor, Z. (2013). Female Ejaculation Orgasm vs. Coital Incontinence: A Systematic Review. The Journal of Sexual Medicine, 10 (7), 1682-1691. https://doi.org/10.1111/jsm.12166