By Joseph Gauta, MD, FACOG
Thanks to modern technology and treatment options, you don’t have to let loss of bladder control interfere with your life any longer. With proper treatment you will no longer spend time planning the fastest route to the nearest restroom in hopes of avoiding an accident. Not only can incontinence sabotage your daily activities, it can also put a damper on your sex life. Although talking about the intimate details of your sex life may not be comfortable, rest assured that you are not alone when it comes to this issue. According to the American Foundation for Urologic Disease (AFUD), one in three women with stress incontinence avoid sexual intimacy because of fear of leakage during intercourse or orgasm.
Don’t lose hope. The following tips can help you eliminate embarrassing incontinence episodes during sex.
Learn bladder-strengthening techniques.
Your urogynecologist can help you retrain your bladder. Your physician can help you determine a natural pattern of urination so you can develop a schedule of timed bathroom breaks. You will go to the restroom according to this schedule whether you feel the need to or not. When you feel the need to urinate between breaks you can use natural suppression techniques such as Kegels, relaxation or distraction. The goal is to teach your bladder to hold more and increase the time between bathroom breaks.
Take time to prepare for sex.
During sex you’re more likely to leak. If you have stress incontinence, you’re more likely to leak with penetration due to pressure on the bladder. If you have urge incontinence, you’re more likely to leak during orgasm.
There are many things you can do to decrease the likelihood of involuntary leakage during sex. You’ll need to experiment to see which of these works best for you:
• Make sure you are well hydrated with water, but don’t drink any fluids an hour before sex
• No coffee or teas for several hours before sex
• If your worried about leaking on your sheets, prepare by putting towels down
• “Double Void” prior to having sex. After you urinate, relax your bladder by massaging the abdomen, and then try to urinate again to completely empty the bladder.
• Take bathroom breaks during sex. Women with urge incontinence should take a break between foreplay and intercourse or between intercourse and after-play.
Start the conversation.
Although many people are often not comfortable about talking about their sex life, you should begin the conversation, especially with your partner. It is worth a few minutes of blushing if you are able to enjoy sex without the worry of leaking. Be honest; let your partner know your concerns and that you are seeking medical help with your incontinence. If you have been avoiding sex, reassure him that it is because of your issue and has nothing to do with him. Be sure he understands that you are still sexually attracted to him and you want to be more active but you are embarrassed about the leaking. Once he knows what the issue is, chances are your partner will understand and be happy to help in any way he can. If talking privately isn’t working and you need assurance and confidence, it may prove helpful to talk with a couples counselor or sex therapist.
Talking may not be your partner’s strong suit, but trying new positions will likely be something he gets excited about.
Here are a few options to try:
• It works your pelvic muscles and you can control the depth of penetration. When you’re on top, it’s easier to control the depth of penetration and to work those deep pelvic muscles you’ll want to strengthen.
• Side entry. This position puts less weight on your abdomen and is also easier for you to control penetration.
• Rear entry. This position put less pressure on your urethra and bladder.
Seek professional help.
Ask your doctor for a referral to a urogynecologist who specializes in incontinence. Although this isn’t an easy topic to talk about, a urogynecologist is very comfortable in finding solutions for your problem. Incontinence is a very common problem. It is estimated that nearly one out of three women over the age of 40 struggles with incontinence at some point, but only 20 percent seek help. Adult diapers is a $1.5 billion dollar industry and on pace to surpass baby diapers. Wouldn’t you rather find a solution than continue to suffer in silence? When looking for a physician make sure they are well trained specifically on the latest therapies and are well equipped with the most current equipment available.
Use Pelvic Floor Therapy.
A medical professional that offers pelvic floor therapy, can help you rebuild strength in the abdominal muscles that support the bladder, using a program of exercises known as Kegels. Many women try doing pelvic floor exercises on their own and don’t get the full benefit because they’re not doing them correctly. A study found that 80% of women could control their incontinence by working with a medical professional specifically trained in pelvic floor therapy. In addition to Kegels, there is biofeedback and electrical stimulation for the pelvic floor.
If needed, there are medications
available that work.
Medication is normally used when efforts to retrain your bladder and pelvic floor therapies haven’t worked. There are many drugs that can block the signal that trigger the contractions of the bladder. There are many options available to help you with this embarrassing problem. Regain control of your sex life and seek help today.
Florida Bladder Institute