Coital Urinary Incontinence

Coital incontinence is when you leak a small amount of urine, or fully empty your bladder, during sexual intercourse or masturbation. In women it is often misinterpreted as female ejaculation when in small amounts. Coital incontinence is likely to occur if you are sexually active and suffer from another form of urinary incontinence. You can be left feeling unclean and no longer desirable. As such, studies suggest coital incontinence has the biggest impact on quality of life, more so than any other form of incontinence.

If you are suffering, take reassurance that you are not alone, approximately 20% of women under 60 report suffering from coital incontinence. With true figures expected to be higher. Men can also suffer from coital incontinence, whether they themselves are incontinent or their partner suffers.

There are many treatments available to resolve urinary incontinence. We have listed the specific ways you can reduce the amount you leak during sex below.


Symptoms of Coital Urinary Incontinence

Other than leaking during sex, there are other symptoms you may experience if you suffer from coital incontinence:

  • bladder pain
  • urge and stress incontinence
  • nocturia - excessive night time urination
  • reduced stream when urinating
  • flow stopping without the bladder being empty

Causes of Coital Urinary Incontinence

If you suffer from any form of urinary incontinence you will likely leak during sex as a result of the penetration, and the contraction and relaxation of your pelvic muscles.

Coital incontinence can be classified depending on what time the urine leaks during sex; penetration incontinence, during intercourse, or during orgasm. There are several events that can cause it to occur in the moment:

  • Penetration incontinence associated with stress incontinence - Penetration puts pressure on the bladder and/or urethra, causing them to leak urine.
  • Penetration incontinence due to a pelvic organ prolapse - If your pelvic floor muscles are weak, your bladder and/or urethra can prolapse (bulge) into the vagina and even outside of the vagina in advanced cases. This leaves the bladder and urethra more vulnerable to penetration incontinence.
  • During intercourse as a result of weak pelvic muscles - If you have weak pelvic floor muscles, you will have less sensation around the opening to the vagina and urethra, meaning not only will sex feel less exciting, but you can leak urine without always realising.
  • During orgasm as a result of detrusor muscle over activity and/or an overactive bladder - To empty your bladder, you voluntarily contract your detrusor muscles. If it contracts too often, whether involuntarily or provoked when under pressure, it can expel urine at inopportune moments such as when you orgasm. During orgasm you may also relax your urethra, allowing the urine to leak.

To read more about these causes, and the events that can lead to you developing any form of urinary incontinence, visit the Causes and Diagnosis page.


How to Stop Coital Urinary Incontinence

To avoid leaking during sex there are a few things you can do:

  • Pelvic floor (Kegel) exercises - The most important thing you can do to reduce any form of incontinence is strengthen your pelvic floor muscles to give you better control. Other benefits include enhancing sexual sensation and improving your bowel movements. Read more in our Pelvic Floor Exercise Hub.
  • Experiment with sexual positions - Try out different positions which put less pressure on your bladder. This is usually when you are in control.
  • Limit how much you drink and avoid bladder irritants (diuretics) - This includes avoiding smoking, caffeine and spicy food.
  • Empty your bladder before sex - If you suffer from overflow incontinence as well you may not be able to fully empty your bladder. However, the less in your bladder, the less you can leak.
  • Have sex in the shower - Disguising any leaks and keeping you feeling fresh.
  • Maintain a healthy weight - Carrying more weight puts you at a high risk of developing a form of incontinence as you are putting your pelvic floor under unnecessary strain which causes it to weaken.
  • Speak to your GP - Your GP can support you in developing a specific pelvic floor exercise plan, as well as advising you on the specific treatments that will work best for you.

To read about the other treatments available for general urinary incontinence, visit our incontinence treatment page.


Sources

Abrams, P. (2003). Urology. Describing bladder storage function: overactive bladder syndrome and detrusor overactivity. [online] 62(5), p28-37. [viewed 18/04/18]. Available from: http://www.goldjournal.net/article/S0090-4295(03)01050-1/fulltext

Arnold, J. McLeod, N. THani-Gasalam, R. Rashid, P. (2012). RACGP. Overactive bladder syndrome: Management and treatment options. [online] 41(11), p878-883. [viewed 18/04/18]. Available from: https://www.racgp.org.au/afp/2012/november/overactive-bladder-syndrome/

Aschkenazi, S. O. Goldberg, R. P. (2009). Expert Review of Obstetrics & Gynecology. Female Sexual Function and the Pelvic Floor. [online] 4(2), p165-178. [viewed 18/04/18]. Available from: https://www.medscape.com/viewarticle/705592_15

Costantini, E. Porena, M. Giannitsas, K. Athanasopoulos, A. Balsamo, R. Masiello, G. Natale, F. Carbone, A. Mahfouz, W. Finazzi Agrò, E. Kocjancic, E. Illiano, E. (2016). ICS 2016 Tokyo. Coital incontinence: prevalence and risk factors in incontinent women. [online] International Continence Society, 2016 [viewed 18/04/18]. Available from: https://www.ics.org/Abstracts/Publish/326/000299.pdf

Espuña, P. M. Puig, C. M. (2008). International Urogynecology Journal and Pelvic Floor Dysfunction. Coital urinary incontinence: impact on quality of life as measured by the King's Health Questionnaire. [online] 19(5), p621-625. [viewed 18/04/18]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17973067

Karlovsky, M. E. (2009) The Female Patient. Female Urinary Incontinence During Sexual Intercourse (Coital Incontinence): A Review. [online] 34(1), p1-5. [viewed 18/04/18]. Available from: https://pdfs.semanticscholar.org/492a/9485311552004068f319556d05f53d876cde.pdf

Oh, S. J. Choo, M. S. Kim, H. S. Kim, J. C. Lee, J. G. Yun, J. M. Kim, D. Y. Paick, J. S. Lee, J. Y. Chung, B. S. Min, K. S. Kim,Y.H. Jung, H. C. Son, H. Jeong, J. Y. Rho, J. Lee, K. S. Park, W. H. Ku, J. H. (2008). Gynecologic and Obstetric Investigation. [online] 65(1), p62-67. [viewed 18/04/18]. Available from: https://www.karger.com/Article/Abstract/107978

Pastor, Z. (2013). The Journal of Sexual Medicine. Female Ejaculation Orgasm vs. Coital Incontinence: A Systematic Review. [online] 10(7), p1682-1691. [viewed 18/04/18]. Available from: http://www.jsm.jsexmed.org/article/S1743-6095(15)30405-7/fulltext

Temml, C. Haidinger, G. Schmidbauer, J. Schatzl, G. Madersbacher, S. (2000) Neurology and Urodynamics. Urinary Incontinence in Both Sexes: Prevalence Rates and Impact on Quality of Life and Sexual Life. [online] 19(1), p259-271. [viewed 18/04/18]. Available from: https://pdfs.semanticscholar.org/c792/597ad1a95916b8e4053862ba392394cdbb00.pdf

York Morris, S. (2017). Peeing During Sex: Causes, Treatment, and More. [online] Healthline, 2017. [viewed 24/04/18]. Available from: https://www.healthline.com/health/peeing-during-sex