Why Do I Always Have to Pee During Sex?

Dear Doctors,

I’ve just recently started to become sexually active so I’m not really sure what’s “normal” and what’s not.

The handful of times I’ve had sex though, it feels like I have to PEE! Sometimes I feel the urge to urinate so badly that I get distracted and lose interest in the middle of sex. Once it ruined the experience completely and we had to stop.

Some of my friends said this is normal but it seems a little excessive… Is this normal? Is there anything I can do to prevent feeling this way or at least get past it so it’s not a distraction?

Any advice is appreciated!

Cynthia

*** Our two-part post written for MsMuslim ***

PART I

Dear Cynthia,

This is such a common concern voiced so often by women that we dedicated a chapter to it in our book, Parting the Curtains, but here goes a short – first part – explanation:

The urethra (urine tube) lies in the ceiling of the lower vagina and is intimately involved during intercourse when the penis, during thrusting, rubs against it. To ease that friction, our urethra’s underside is cushioned by estrogenic tissue, sort of like bubble wrap between it and the vaginal canal/penis. Isn’t nature smart?

However, there are situations when the urethra gets rubbed to a disruptive degree and it will tell us that by speaking ‘urinese:’ urgency to urinate, frequent urination, burning, etc. You see, every body part speaks its own language when it tells us that something is wrong: the intestines speak differently than our joints, and headaches are felt differently than an ear infection. Again, the body sets up distinct, alert signs within its complex system.

So, when would this rubbing turn into urethral chafing? If your vagina is dry (insufficient hydration or lubrication, during/after taking antibiotics), if he stays inside you longer than your vaginal skin can take, if you are menopausal (low estrogen levels), if you are nervous upon intercourse thus tighten your vagina against the urethra (vaginismus), if you have frequent successive intercourse (a common cause of honeymoon cystitis), if his penis has certain curvature issues (Peyronie’s disease), medical issues, certain medications, and more can all have an effect on your vagina.

Lastly, intercourse should not cause urethral chafing and no, it is not normal to always have to urinate during or right after intercourse. You may want to explore why this is happening to you and speak with your doctor as needed, in order to take corrective measures.

PART II

In Part I – we explained the reasons and causes for urinary urgency (urethral rubbing) associated with the intercourse.  In this Part II, we’ll expand on this urethral call from a psychosomatic aspect, with the assumption that there is no underlying medical issue involved and that you emptied your bladder beforehand at your normal frequency.

Many women cater to this urge to urinate because they truly believe it is a ‘bladder call’ (full bladder) even if they urinated recently. By doing so, they permit their bladder – a trainable reservoir – to hold less and less urine and validate the need to urinate more and more frequently than normal.  Do you really want this to happen?  Can you see yourself jumping out of bed in the midst of an intimate sexual moment to cater to the altered bladder?  The urethra does not contain urine; it is merely a tube that connects the bladder (where urine is held) to the opening of the genitals for voiding.  In other words, a urethral call is merely a rubbing complaint!

Not only is the bladder a trainable reservoir, but it is also connected to our stress response system, which means that distress and anxiety are easily triggered.  Case in point: you feel the urge to pee, you cater to it, you do this every time you feel the urethra calling, your bladder is now shrinking incapacity, and then you begin to panic if you cannot act on it…  Or if you are in the midst of a sexual moment and have to stop it in order to run to the toilet — how do you explain that to the partner?  Embarrassed? Will you now consider refraining from engaging sexually in fear of urinary urgency?  Will you then worry that you may lose urinary control?  The more these associations, the more panicky the bladder becomes, and – voila – you have just found yourself having a problem that disrupts your life…

Let’s pull it all together: recognize a ‘real’ need to urinate (full bladder) vs. a benign urethral call, take measures to sort out any disruptive urethral chafing, understand the trainable aspect of the bladder and the mind, and seek medical advice if you need further intervention.

We hope this helps!

The Doctors