Peeing During Sex

Medically Reviewed by Amanda Savage

Peeing during sex is more common than you might think. However, it certainly isn’t an issue that you should let dictate your sex life.

In fact, it's so common that around 20% of women under 60 have experienced some level of incontinence while getting frisky with their other half.  It’s sometimes referred to as ‘coital incontinence’ or ‘sexual incontinence’.

For those affected, it can be a stressful experience. Anxiety about future leaks can wreak havoc with your libido – even killing your drive and leaving you feeling staunchly unsexy.

Luckily, there’s no reason to live with the burden of weeing during sex forever, nor should you go through it alone. There are ways you can immediately tackle the problem to help you regain control of your sex life and get back to feeling yourself.

Why do we pee during sex? 

It’s important to understand the common causes of peeing during sex to know how to combat it. It's usually down to one of two causes – namely, urination upon penetration and urination on orgasm – both caused by two distinct types of incontinence issues. 

Urination upon penetration is the most common form and happens when pressure is placed on the bladder and the urethra when you’re sexually stimulated through penetration. If you have a weakened pelvic floor – whether through childbirth, surgery, or any long-standing medical conditions – penetration can cause stress incontinence, which may mean a small dribble during sex.

To help identify the problem, keep an eye out for leaks when you cough or sneeze or during strenuous activities like running or picking up heavy objects, as this could be a sign of a wider condition.

Urination on orgasm is often caused by a phenomenon known as ‘urge incontinence’. Orgasms can cause the surrounding bladder muscles (known as detrusor muscles) to spasm, causing you to leak as contractions put additional pressure on your bladder. Coital incontinence can be a side effect of an Overactive Bladder (OAB) so, be sure to check with your GP to find out if this is the case.

Symptoms of coital incontinence

Other than peeing 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 incontinence

If you suffer from any form of urinary incontinence you will likely leak during sex as a result of penetration or because of 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.

Coital incontinence risk factors

If you pee during sex, part of the problem could be stemming from wider lifestyle habits or other health complications.

The following are factors known to increase the risk of female incontinence during sex:

• Pregnancy and childbirth
• Going through menopause
• Having a urinary tract infection (UTI), bladder infection or cystitis
• Having bladder stones or constipation
• If you’re on medication (for example, specific blood pressure medications)
• Previous urinary tract or gynaecological surgery
• Ingesting large quantities of natural diuretics such as coffee or alcohol

Treatments for peeing while having sex

If you find yourself suffering from coital incontinence, you can begin treatment right away. Treatments for urinating during sex range from lifestyle changes all the way through to surgery in more serious cases, so it’s a problem you don’t have to take lying down.

Kegel exercises

The most important step for gaining back control is strengthening your pelvic floor muscles. Introducing Kegel exercises helps condition your pelvic floor, slowly strengthening the surrounding muscles, leaving you more in control.

Pelvic floor exercises can be complex, so check out our Pelvic Floor Exercise Hub for advice on workouts and understanding the signs and symptoms of pelvic floor weakness.

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.

Lifestyle changes

Making small, manageable lifestyle changes can drastically improve your pelvic floor strength and help you get a grip on the issue of peeing during sex.

For example, maintaining a healthy weight is key. Carrying extra weight puts unnecessary strain on your pelvic floor, which can cause it to weaken over time – so, get active!

Limited diuretics

Diuretics increase the formation of urine in the kidneys, making you need to go more frequently. Eating spicy food, smoking, or drinking too much alcohol and coffee sets your kidneys into overdrive, so it’s important to limit these where possible. 

Don’t forget to speak to your GP, too. Your doctor will be able to recommend pelvic floor exercises to suit your specific conditions, as well as refer you for further treatment if necessary.

Male incontinence during sex

Although rare, incontinence issues can affect men too. Although men have a natural biological mechanism that prevents a man urinating and ejaculating at the same time, men with health complications – for example, those who have undergone a radical prostatectomy – can find themselves occasionally springing a leak.

It’s recommended men with any form of incontinence also stay away from bladder irritants like coffee, fizzy drinks and alcohol and practice a technique known as double voiding to make sure you’ve got everything out.

If you suffer from male incontinence, men can also benefit from kegel exercises. For more information, read our Kegels for men guide for advice.

Managing your sex life

For women suffering from incontinence during sex or receiving treatment, it can be tempting to shy away from it altogether.

However, there is always a way to spice up things in the bedroom – even if you’re in the middle of getting treatment – so there’s no need to kiss your sex life goodbye.

Lubricate

Incorporating a bit of extra lubricant into your sex and foreplay can reduce the chances of peeing during sex. Using lube doesn’t mean you’ve lost your lustre – if anything, it’s the opposite and can inject some excitement into your sex life. 

Too much friction can make the bladder more reactive when penetration takes place so consider introducing lube into your routine full-time.

Understand your body

Ultimately, you know your body best. If you’ve been suffering for a long time, chances are you know what habits are more likely to cause peeing during sex. Keep an eye out for patterns – whether you’re struggling to control leaks while drinking alcohol or at specific times of the day – and use these to prepare.

If you’re in a long-term relationship, sex can become more routine. On the days you know you’re likely to have sex, avoid bladder irritants or limit them as best you can. 

Change positions

Unfortunately, certain sexual positions can put additional pressure on the bladder. Although, with a positive outlook, this can be seen as the perfect opportunity to spice things up in the bedroom. 

Try out different positions which put less pressure on your bladder. This is usually when you are in control. You could also try having sex in the shower, which helps to disguise any leaks and keeps you feeling fresh.

Luckily, we also have plenty of suggestions for positions for incontinence that you and your partner can both enjoy, so don’t shy away from experimenting.

Open a dialogue

Communication is key. Often, the negative impact of coital incontinence is just as psychological as physical. 

Feelings of stress, anxiety and even depression are part and parcel of persistent health problems, so it’s important you put yourself first. Communicating with your partner and being honest is often the first step in alleviating any pressure.

Medically Reviewed by Amanda Savage