Many women experiencing stress urinary incontinence (“SUI”) quickly realize one of the more embarrassing symptoms of the condition - bladder leaks during sex.  Unfortunately, this is a rarely talked about topic even though over half of women suffering from SUI have experienced untimely urine leaks during their intimate moments.  Over time, this can result in decreased sexual activity and loss of self-confidence which can impact overall mental health.

The bad news - there is no “silver bullet” solution to bladder leaks during sex.  The good news - there are some simple and proven tips that can really make a difference, helping you regain control so that you can once again enjoy the enjoyable!

Why does this happen?

In basic terms, stress urinary incontinence, which can have a variety of different causes, can occur any time pressure is placed on the bladder resulting in unwanted urine leaks.  Often this occurs during exercise and other physical activities including sex.  Keep in mind that this is different than feeling the need or “urge” to urinate during sex, which is more likely related to a separate condition called urge urinary incontinence (“UUI”) or commonly known as an overactive bladder.

Can I have sex while wearing my pessary?

Uresta and other traditional pessaries are designed to sit in the mid-vagina to provide support to the bladder and pelvic muscles surrounding the urethra.  Pessaries are positioned much lower than typical IUDs for example, which sit further up the vagina beyond the cervix.  Because of where pessaries are positioned, they will inevitably interfere with vaginal intercourse for both partners.  This is ultimately why we recommend removing your Uresta before sex.

What are my options?

So if my pessary can’t help me avoid embarrassing bladder leaks during sex, what else can I do?  Well, the answer is a few things.  Healthcare providers and sexual health specialists often recommend a combination of preventative measures that can help, some of which are listed below.

• Try “double voiding”: If you think intercourse may be on the horizon, take the opportunity to empty your bladder, and then a few minutes later do it again (even if you don’t feel like you need to). This second time will help get rid of any residual urine sitting in the bladder which may leak out during sex.
• Try different positions!: This is a nice excuse to switch things up a bit.  The most effective sexual positions at avoiding bladder leaks will differ from one person to the next, but remember the key is reducing pressure being placed on the bladder and lower abdomen.  Some women also find horizontal positions preferrable to vertical ones.
• Shower time? Although this isn’t a preventative measure, it’s a practical one.  Intercourse in the shower will help you take your mind off of the risk of leaks and can be part of the process of regaining your comfort level.
• Kegels: This is your best bet at preventing bladder leaks during sex. Strengthening your pelvic muscles will help keep your urethra closed, avoiding unwanted bladder leaks.  Don’t be discouraged if you have been unsuccessful with pelvic floor physio in the past.  Some women may find the benefits of strengthening exercises are actually more effective during sexual intercourse while their pelvic floor muscles are already engaged.  Kegels also have a number of other sexual health benefits beyond stress incontinence, which you can research on your own.
• Surgery: Although more invasive, surgery is certainly also an option that can be right for some women.  We always recommend you consult a licensed gynecologist with experience in incontinence procedures to better understand the benefits and risks associated with the various procedures.

And finally, the most important step:

• Talk to you partner: This is both the easiest and hardest step for most women.  The reality is, you aren’t likely able to totally hide this from your partner anyway, so might as well talk about it.  Elephants in the room rarely make situations easier.  Talking about it may reduce some of your own anxiety and may also help your partner be more understanding.

For more information and useful tips, don’t hesitate to ask your pelvic floor physio therapist, nurse continence advisor or sexual wellness specialist.

Don’t forget - Uresta can still help with your leaks outside the bedroom!

Uresta is a simple, comfortable and hygienic solution that can help stop your bladder leaks before they happen.  Click here for more information.