Peeing during sex: Causes and treatment

Your body releases fluids during sexual intercourse. While this is the usual, some people also have the urge to get up and pee during sex. For starters, you’re not the only one. It is a common thing that can happen to anyone, especially those who experience urinary continence. It is a condition in which you have trouble controlling your bladder and leak urine. This is not the only reason why you may urinate during sexual activity. It may also be a sign of urinary tract infection that affects 50-60 percent of the people in the world. Don’t worry as there are treatment options, so just relax and enjoy your sex life.

What are the causes of women peeing during sex?

Peeing during sex may be due to the following reasons:

1. Weak pelvic floor muscles

The pelvic floor muscles support the bladder, uterus, and other pelvic organs. “Weakness in these muscles, often caused by pregnancy, childbirth, ageing, or lack of exercise, can lead to difficulty controlling the bladder, especially during sexual activity,” says obstetrician and gynaecologist Dr Chetna Jain.

2. Overactive bladder

An overactive bladder results in a sudden and uncontrollable urge to urinate. During sex, physical stimulation can sometimes trigger this urge, leading to leakage. Urge incontinence, or urgency incontinence, often occurs as part of a group of symptoms called overactive bladder syndrome, as per the UK’s National Health Service. It is when the bladder muscle becomes very active, and you feel a sudden and very intense need to pee. In such cases, peeing during sex, particularly while reaching orgasm, is common.

3. Urinary Tract Infection

Urinary tract infection or UTI is a common infectious disease experienced by many people in the world. It affects more than 150 million people across the globe in a year, according to research published in BMC Infectious Diseases in 2023. UTI can irritate the bladder, causing frequent urges to pee. “The physical pressure from sex may trigger these urges, resulting in leakage of urine,” says the expert.

4. Anatomical issues

Certain anatomical conditions can contribute to unintentional urination during sex. “One of the conditions is the pelvic organ prolapse, where the bladder or uterus descends and presses on the urethra,” says the expert. It is usually happens after giving birth to a child.

5. Urinary incontinence

Urinary incontinence, a condition where the bladder cannot hold urine properly, may be the reason behind peeing during sex. This can be due to nerve damage, muscle weakness, or age-related changes. About a quarter of women with at least monthly urinary incontinence may complain about peeing during sex, as per research published in the American Journal Of Obstetrics And Gynecology in 2018.

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6. Sexual arousal

“Sexual arousal can trigger a reflex that mimics the feeling of needing to urinate,” says Dr Jain. The increased blood flow and heightened sensitivity in the pelvic area can cause this reflex, leading to urine leakage during sexual activity.

Is it urine or female ejaculation?

It can sometimes be challenging to distinguish between urine and female ejaculation, as both can occur during sexual arousal or activity. Here’s how to tell the difference between urine and female ejaculation:

1. Location and source

• Urine: Pee is expelled from the bladder and exits the body through the urethra.
• Female ejaculation: It is a release of fluid from the Skene’s glands (sometimes called the female prostate), which are located near the urethra but are distinct from the bladder. A 2017 study, published in The Journal of Sexual Medicine, showed that 69.23 percent of women ejaculate during sexual stimulation.

2. Fluid appearance

• Urine: Pee is typically pale yellow in colour due to the presence of urobilin, a pigment formed from the breakdown of hemoglobin.
• Female ejaculation: The fluid released during female ejaculation is usually clear, colourless, or slightly cloudy.

3. Amount of fluid

• Urine: The amount of pee released during sexual activity is usually a small to moderate quantity. It is generally expelled in a steady stream rather than a sudden gush.
• Female ejaculation: The amount of fluid from female ejaculation can vary widely. Some women experience a small amount, while others release a more significant quantity, which might seem like a “gush” or “squirt.”

How to stop peeing during sex?

To stop peeing during sex you need to get yourself treated if there are underlying issues. However, there are some things you can do to avoid it:

1. Pelvic floor exercises

“Pelvic floor exercises, such as Kegels, are one of the most effective ways to strengthen the muscles that control the bladder,” says the expert. These exercises help improve muscle tone, reduce the risk of leakage, and increase control over urinary function.

2. Bladder training

Bladder training helps to regain control over their bladder by gradually increasing the time between bathroom trips. This helps reduce the urge to urinate during activities like sex. All you have to do is track your bathroom habits, and gradually increase the time between bathroom visits by 15-minute intervals. Over time, try to hold off the urge to pee for longer periods, training the bladder to hold more.

3. Pessary for pelvic organ prolapse

If pelvic organ prolapse is causing urinary incontinence or leakage during sex, a pessary may provide relief by keeping the bladder and other pelvic organs in place. “It is a medical device inserted into the vagina by a doctor to support pelvic organs,” says the expert.

4. Medication

If you are peeing during sex because of an overactive bladder or urge incontinence, medications that relax the bladder muscles and control the frequency of urges may be prescribed. “Anticholinergics and beta-3 agonists are often prescribed to control overactive bladder symptoms,” says the expert.

5. Addressing constipation

Chronic constipation can contribute to pressure on the bladder and pelvic floor muscles, which may lead to urinary leakage during sex. “Treating constipation can alleviate this pressure and reduce symptoms,” says the expert. Eat a fibre-rich diet with a good number of fruits, vegetables, and whole grains, and stay hydrated.

6. Surgery

In more severe cases of urinary incontinence, particularly when it’s caused by a prolapsed bladder or pelvic floor damage, surgical interventions may be necessary. Bladder sling surgery, in which a mesh sling is placed around the neck of the bladder, may be suggested. It is to support the bladder and prevent peeing during sex.

7. Treating infections

Urinary tract infections can cause irritation and urgency to pee during sex. Have antibiotics prescribed by a doctor if a UTI is diagnosed. “Drink plenty of water and practice good hygiene to prevent recurrent UTIs. Cranberry supplements or juices might help prevent urinary tract infections, though it’s important to consult with a doctor first,” says the expert.

Peeing during sex may not always have to do with sexual arousal. It may be a sign of urinary incontinence or an infection that needs medical attention.