Loss of urinary control during sexual intercourse

Posted by Ditza Katz in Sexual Dysfunction, Women's Health 03 Sep 2014

The fear, or actual, loss of urinary control during sexual intercourse is a cause of concern for many women even though it may not happen at all.

Why the worry about this urinary incontinence? The main contributing factor is the proximity of the urethra to the vagina: they share a common wall, and both ‘feel’ it during sexual intercourse.  The way the urethra expresses discomfort or worry is through the sensation of burning and the urge to urinate, even if the bladder itself was just emptied.

Of course, nature created a reliable system that does not malfunction yet there could be potential ‘close calls’ such as

  • The penis is thicker than average, which makes it rub ‘harder’ against the urethra
  • The vagina is dry, and the thrusting of the penis irritates the urethra
  • Menopause has set in, and the estrogenic protective cushioning surrounding the urethra has thinned out
  • You are nervous about the act, or may have vaginismus
  • You experience pelvic floor dysfunction
  • You are fresh from childbirth and the ‘plumbing’ has not yet restored itself to normal tone and control
  • You have gotten into the the habit of ‘holding your urine’ during sexual penetration, which boomerangs into involuntary urine leaking
  • You have had injuries, surgeries, organ prolapse, or other medical conditions that compromise your urinary control system

The list can go on but the message is clear: while the female urogenital anatomy is easily reactive to adversity, proper diagnosis and management will often solve the problem and alleviate the worry of losing control during intimate moments.