Sexual Health / STDs Urology / Nephrology

Why might urination happen during intercourse?

It is possible for women to urinate during sex. During sex, pressure can be put on the bladder by the penis, fingers, or another object.

This is because the bladder in a woman’s body is close to the vagina and clitoris. As a result, prodding the bladder in some way during sex is a relatively common occurrence.

There is also some debate about whether female ejaculation is urine or another sort of fluid. Female ejaculation does not happen to all women, but some experience fluid coming from the urethra during orgasm.

Columbia University have described this fluid as not being urine or vaginal fluid. However, a different study claims that this fluid is the uncontrolled release of urine.

In this article, we examine the causes of urination during sex. We also take a look at treatment and management options, along with how to prevent urination from occurring at this time.

Causes

young woman hiding face under duvet
Women may urinate during sex due to pressure being placed on the bladder.

The main reason for women urinating during sex is because of incontinence. This is when someone urinates unintentionally and uncontrollably.

The National Association for Continence estimate that around 25 million people in the United States are affected by bladder or bowel incontinence in some way.

Women are up to five times more likely to be affected by urinary incontinence than men.

Urinary incontinence

Urinary incontinence (UI) is a common condition among women. As female reproductive and urinary systems share parts of the body, this condition can interfere with sexual intercourse.

One study reported that around 60 percent of women with UI experience some sort of urinary leakage during sex.

Doctors split UI into three different types:

  • stress urinary incontinence
  • urgency urinary incontinence
  • mixed urinary incontinence

Stress urinary incontinence

This is the most common type of UI that occurs during sex, with around 51 percent of cases being caused by stress urinary incontinence.

It occurs when an activity, such as sex, puts stress on the bladder. Other common triggers include:

  • laughing
  • lifting something heavy
  • coughing
  • sneezing

Urgency urinary incontinence

Urgency urinary incontinence refers to the sudden and uncontrollable need to urinate, which is a symptom of an overactive bladder.

In a properly functioning bladder, the need to urinate usually arises when it is around half full. People are able to wait until an appropriate time to use the toilet.

In urgency urinary incontinence, the bladder contracts too early, making a person suddenly need the toilet and sometimes leaking urine before they get there. The exact cause is unknown, but it appears to be more common in older people.

Mixed urinary incontinence

Mixed urinary incontinence is when incontinence can either be caused by stress or urgency. This form of UI is more common than just urgency urinary incontinence on its own.

Male incontinence

The opening of the bladder in a man’s penis closes during sex so that urine does not mix with semen. As a result, urination during sex does not often occur among men.

However, some men can experience incontinence during sex as a side effect of treatment for prostate cancer.

The American Cancer Society estimate that around 1 in 9 men will be diagnosed with prostate cancer during their lifetime. A common form of treatment for prostate cancer is radical prostatectomy, which is the complete removal of the prostate.

While often effective in treating cancer, one side effect can be incontinence when sneezing, coughing, exercising, or during sex.


Risk factors

senior couple watching tv
Aging and physical inactivity are risk factors for urinary incontinence.

Some women can be born with risk factors that make their chance of having UI more likely. These includes:

  • the urinary tract not developing properly
  • a family history of UI

Caucasian women are more likely to experience UI than Hispanic, Latina, African-American, or Asian-American women.

UI is not a disease but a symptom of another condition or event that has happened in someone’s life. There are some common risk factors for UI, which include:

  • childbirth
  • chronic coughing
  • menopause
  • physical inactivity
  • obesity
  • getting older
  • pregnancy

When to see a doctor

If someone thinks that they may be urinating during sex, they should speak to their doctor. This can help determine whether it is because of incontinence or something else.

If it is incontinence then the doctor will be able to discuss what may be the best treatment going forward.


Treatment options

The treatment options for UI are split into three areas:

Pelvic floor muscle training

Exercises for the pelvic floor muscle, also known as Kegel exercises, look to strengthen this part of the body. Stronger pelvic floor muscles can hold in urine better than weaker ones.

A medical professional will be able to help teach someone the exercises and when to do them.

Surgery

An operation can help treat UI. Surgery tends to be used if the area around the urinary tract needs extra support or if the bladder neck needs to be repositioned.

The surgery will require general anesthesia, and it will often take people around 2 to 3 weeks to fully recover.

There can be serious complications with surgery for UI. It is important for people to discuss this treatment option with a doctor, to see if it is the right course of action for them.

Medication

In cases of urgency incontinence, there are different sorts of medication that can be prescribed to help relax the bladder or decrease the bladder spasms causing incontinence.

Types of medication that doctors may suggest include antimuscarinics, tricyclic antidepressants, and beta-3 agonists.

Management tips

chocolate and wine
Both chocolate and alcohol can irritate the bladder.

There are some behavioral and lifestyle changes that people can make to try and help manage UI symptoms related to sex:

  • avoiding fluid intake in the hours leading up to sex
  • avoiding food and drinks that irritate the bladder, such as caffeine, chocolate, and alcohol
  • emptying the bladder before sex
  • losing weight if overweight
  • stopping smoking

Bladder training can also help. This practice involves urinating at specific times and gradually lengthening the time in between, to train the bladder to hold more urine.


Outlook

While peeing during sex can be embarrassing, many people will be able to prevent it or reduce how often it happens through lifestyle changes and pelvic floor exercises.

Speaking to a doctor about possible underlying causes and treatment options can also help.

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