Leakage During Life’s Intimate Moments
Oftentimes, the reason a patient finally makes an appointment to discuss urinary leakage is that she is experiencing leakage during intimate moments. For many patients, this is an extension of other times they experience urinary frequency, urgency, or leakage.
Although it’s not an easy topic to discuss, it’s important to understand what’s causing these issues in order to start on the right track toward a solution.
Urinary urgency and urge incontinence cause leakage to happen at any time without warning. Many patients experience increased these pelvic floor complaints with certain bladder irritants such as caffeine, alcohol, tomato-based foods, or citrus – many of the things that seem to be associated with an enjoyable date night. Remember that the top wall of the vagina is in very close proximity to the bottom wall of the bladder. Because of this, vaginal stimulation may irritate the bladder causing the urge to urinate or even leakage to occur from bladder contractions or spasms.
Leakage with urgency can be helped in a number of ways. Pelvic floor strengthening, either with the help of a pelvic floor physical therapist or a consistent focus on kegel exercises can help reduce urge incontinence and improve sexual responsiveness. There are also medications that can help urgency. Some patients who only leak with sexual activity may improve with short-acting medications used just prior to intimate moments. Botox injections into the bladder reduce bladder spasms and can last up to 6-12 months. InterStim therapy, a minimally invasive pacemaker-like unit for the bladder, reduces bladder spasms and leakage as well.
Stress incontinence is leakage with cough, sneeze, exercise, or movement. Like any event that may cause stress incontinence, intimate moments often involve movement, which changes vaginal and bladder positions. These changes can result in leakage from a lack of support around the tube you urinate through. Pelvic floor therapy can help with stress incontinence. Other options for this type of incontinence include surgery such as a sling to provide greater support.
If you’re experiencing leakage during sex, remember:
- Cut down on bladder irritants such as caffeine, alcohol, tomato-based foods, or citrus on date nights.
- Consult a pelvic floor physical therapist so she can give you advice on strengthening your pelvic floor.
- Do your kegels! The goal is to squeeze for 10 seconds, relax for 10 seconds, and repeat 8-10 times.
- There are medications that can help urgency, which you can take before sexual activity to prevent leakage.
- There are alternative options for preventing leakage include Botox injections, InterStim therapy, or a sling to provide greater support.
Intimate moments should not be worrisome moments. Leakage should not prevent you from enjoying time in the bedroom. There are many ways to help stop this from happening, so don’t be afraid to discuss this with your health care provider. You are not alone.