Intimacy and Incontinence Incontinence c

Intimacy and Incontinence
Incontinence can impact several aspects of your life: travel, exercise, work, quality of life, and even sexual function. Approximately 1/3 of women with stress urinary incontinence avoid sexual activity because of their fear of incontinence. Let’s talk about some ways to regain confidence in the bedroom:
1.) Seek treatment. This may start with a trip to your PCP, OBGYN, midwife, urologist, or urogynecologist to discuss your incontinence and make sure there are no systemic issues. While at this visit, I recommend asking if pelvic floor physical therapy is appropriate/recommended.
2.) Address your diet. Avoid drinking caffeine or excess fluids prior to intercourse.
3.) Prepare your bedroom. Consider using a mattress cover or laying down towels on the bed to lessen worry about ruining your bedding.
4.) Pay attention to your bladder. Urinate before sexual activity and take a break during sexual activity to use the bathroom if needed. When you do urinate, try double voiding. Double voiding is where you urinate, stand up, sit back down, and try to empty again. Keep your abdomen and pelvis relaxed and sit fully on the toilet for best results.
5.) Try different sexual positions. Sidelying, kneeling, or woman on top may be better positions for your bladder. Your physical therapist can instruct you on different variations of these positions to help minimize pressure on your bladder or straining through your abdomen which can create more leakage.
6.) Avoid excess exercise prior to intercourse. If your muscles are fatigued, it will be harder to control leakage. The best time of day to attempt intercourse is early in the day.
7.) Talk to your partner. You may be surprised at how supportive your partner is and how much more relaxed you feel after. Your partner may be relieved to know that you haven’t been avoiding sexual activity from lack of interest. Open dialogue will also allow the two of you to plan sexual activity and gives you another person to discuss your treatment options with.
Urinary incontinence is difficult to discuss, let alone discussing how it impacts your sexual function. However, your healthcare providers, including your physical therapist, are here to listen and help you with these issues. Please speak up and seek treatment to help you improve your sexual function and quality of life!

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