Incontinence: Ask the Expert

Many women with incontinence report that they have leakage during sex.  Leakage may occur with penetration, which is thought to be secondary to stress incontinence, or with orgasm, which is thought to be secondary overactive bladder symptoms.  I am not aware of any research that relates incontinence symptoms to the size of the sexual partner.  We are also not sure that stress incontinence is an inherited problem, although I often have patients who state that they think the problems run in their family.   If you are having leakage with intercourse, some suggestions that we give our patients follow a “PEARLs” anagram.  

l  Position yourself on your back or side

l  Empty your bladder

l  Absorbent pads

l  Rx-use anti-cholinergics to decrease urgency

l  Lubricants

My guess is that you are at risk for developing incontinence other than when you have intercourse, and it might be a good idea to start to do pelvic floor exercises regularly, which may prevent bothersome incontinence from happening with sexual activity and may also help prevent the development of incontinence at other times.