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Incontinence and Sex

There’s usually a couple of fluids flying around when it comes to having sex, but one you might not be expecting is pee.

Ashleigh Mason is a Holistic Physiotherapist & Mindset Coach with a special interest and training in Women’s Health Physiotherapy. She is passionate about educating and empowering women to feel strong & confident in their own bodies, unapologetically. We sat down with her to ask a few questions about incontinence and how it can affect your sex life. 


 

How common is incontinence during sex? 

Urinary Incontinence affects up to 38% of Australian women. The reported incidence of coital incontinence (the urine leakage that occurs during sexual activities) is very inconsistent and limited in the research, likely because it often goes unreported due to embarrassment.  
 

Can both men and women experience it? 

Yes, but it’s much more common in women. It’s mostly only observed in men after prostatectomy.  
 

What age group is it most common in? 

We don’t currently have the research to answer this definitively, but we know that over half of women living in the community with urinary incontinence (all types) are aged under 50 years. Again, coital incontinence is likely underreported by many people who experience it due to it being so taboo.  
 

What causes it? 

The most common cause is likely related to Stress Urinary Incontinence (SUI) which occurs as a result of a weak pelvic floor. Incontinence on orgasm could be linked to Overactive Bladder. Other causes can include bladder or urethral dysfunction and pelvic organ prolapse.  
 

How does it occur? 

Stress urinary incontinence is caused by the inability of the pelvic floor muscles to contract quickly on exertion, so when the bladder is placed under load/stress (eg penetration), the pelvic floor isn’t quick or strong enough to clamp the urethra shut, causing leakage.  
 

Is there a way to cure it? 

Management depends on what’s causing it, but in most cases it is treatable and often curable.  
 

How can it be managed? Ie exercise, treatment, medicine? 

In most cases, pelvic floor strengthening is the best treatment. A pelvic floor/continence physiotherapist (also sometimes referred to as women's health physiotherapists) would be able to assess your bladder and pelvic floor and provide you with an appropriate, tailored treatment plan. A urologist may also need to be involved in your care.    


What's your best advice for people?  


My best advice for anyone experiencing any type of incontinence is to seek help! 70% of people with urinary incontinence do not seek advice or treatment for their problem, which is devastating. Incontinence is a very common issue, but it is not “normal” and something you just have to live with. In the vast majority of cases it is manageable and often curable.  


Some other helpful info that many people may not know about is that sexologists can help too. I spoke to Meg Callander, a Melbourne-based sexologist, about how sexologists can help people with coital incontinence/incontinence during sex. She said It is likely that there can be increased sexual shame and anxiety due to the incontinence, which could be leading to low sexual self esteem, low desire and sexual avoidance. A sexologist could help clients work with these issues, as well as helping them also diversify their sex life so they can find new ways to comfortably enjoy sexual pleasure, either without penetration or by finding ways to adapt penetrative sex.  

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