Sex, Exercise, and Stress Incontinence
Stress incontinence is when you leak urine during movement that puts pressure on your bladder. It can happen when you least want it -- like the middle of a workout or during a romantic evening. Here’s a look at what’s causing it and some tips to make it better.
What’s Going On?
“The problem, whether [it] occurs during exercise or sex, has a common denominator,” says Beverly Whipple, PhD, RN, professor emerita at Rutgers University in New Jersey.
“Stress incontinence is related to the strength of the pelvic floor muscles,” Whipple says. These are the ones you use to stop your urine midstream. The weaker they are, the more likely you are to leak.
Several things can weaken your pelvic muscles over the years, including:
- Extra weight
Don’t Let It Stop You
When incontinence happens during intimate moments, women -- even those in stable marriages -- can feel anxious, says Amy Rosenman, MD, a gynecologist at UCLA Medical Center Santa Monica. This can lead to sexual dysfunction.
Rosenman, who’s also co-author of The Incontinence Solution, says the most important thing you can do is to talk to your spouse about it. You may find it’s a relief to get the problem out in the open, she says.
By the same token, don’t let fear of a wet spot on your workout pants stop working out altogether. You can also try these precautions for either activity:
- Go to the bathroom beforehand to empty your bladder
- Cut back on fluids before (but not so much that you get dehydrated)
- Experiment with new positions or exercises that don’t put pressure on your bladder
Stress incontinence may happen to everyone at some point or another, but if it starts to mess up your daily routine or becomes frequent, talk to your doctor. He may refer you to a urogynecologist -- a gynecologist that specializes in urology -- who will do a physical exam and some tests.
Try This at Home
There are things you can do at home to control stress incontinence. At-home options include:
- Kegels -- an exercise for your pelvic muscles. Start with 3 sets of 10 squeezes a day. No one will even know you’re working them out.
- Vaginal weights that you hold in place with your muscles. As you get stronger, you’ll use heavier weights.
- Bladder training, including journaling, to determine the best times to go.
- Diet changes. Extra weight can make incontinence worse, so a healthy diet may ease your symptoms.
- Pads/panty liners. If your leaks are light, over-the-counter pads and liners that fit in your underwear can help catch extra urine.
- Rubber bed sheets will help catch extra fluid and protect your mattress.
Talk to Your Doctor
If your incontinence doesn’t respond to at-home therapy, you may need medical treatment or surgery. Some options are:
- Biofeedback, a monitor that records the control of pelvic floor muscles to help with training.
- A pessary, a device that fits in the vagina to support the bladder and prevent leaks.
- A catheter, a tube hooked to a bag that catches urine.
- Medications like mirabegron (Myrbetriq) to help with overactive bladder, and Botox injections. Women going through menopause may try estrogen.
- Surgery is rare but can help when there’s a blockage or the bladder is in an unusual position.