Admittedly, it’s not the most romantic sweet nothing to whisper into your partner’s ear.
The erotic murmuring, “Sorry darling, I may pee slightly during sex” is not one of the most orthodox of come-on lines – but, bearing in mind the number of women who suffer from incontinence, maybe it should be.
So it’s no surprise that many women fear that casually mentioning a touch of stress incontinence during foreplay will add a dampener to the occasion.
With one in three women battling bladder weakness, many of them choose to say nothing … to anybody – not their friends, doctors or sexual partners. Some prefer to avoid sex altogether.
Research of women aged 30 to 70 has shown that women with incontinence issues were not only more likely not to have sex, but they also had less desire and satisfaction than women without the problem.
While it is socially more acceptable for women to giggle about the perils of dodgy bladder control when exercising, sneezing and coughing, they really don’t share surreptitious giggles about the fear of stress incontinence in the bedroom.
But, according to relationship and sex therapist Rachel Morris, not talking about it is the biggest problem of all.
“A lot of young women avoid talking about it because they think it’s an old woman’s problem, but there are lots of different causes. Women don’t want other people to think they are weird, but the statistics show that one in three women suffer. Not just one in three women over 40.
“It could be a short-term problem associated with an infection. It’s not just caused by childbirth and the menopause. Some women simply don’t have good pelvic floor muscles. Sometimes there are things you can do about it, but you don’t know until you tell someone.”
The first stop, Morris says, is always to talk to your GP, who will tell you if it is an infection that can be sorted out with a course of antibiotics. Alternatively, it could be due to a reduction in oestrogen because of something like the menopause, when hormone replacement therapy or oestrogen pellets could be prescribed.
“Your GP could help, so you don’t even need to talk to your partner. The trouble is if you are avoiding sex because you are scared of incontinence and you don’t do anything about it. If that includes not talking to your partner, they are quite likely to imagine it is them you are avoiding, not the sex. Which creates a whole different problem in your relationship.”
However, choosing the time and the place to tell all is never easy.
“Ideally, don’t have the conversation in bed when you are both naked and feeling vulnerable, when sex is about to take place or just has. I am a therapist and I understand how difficult it often is for people to say things out loud. It is easier to say something when you are side by side and not looking at each other, when you are going for walk, for example, and you are not likely to be interrupted.”
Morris has other practical advice too, from finding the right sex positions (spooning – lying side by side – is better than acrobatic moves where gravity will not be your friend) to changing your drinking habits.
“If you know you are going to be having sex, don’t drink anything for a while before, especially drinks with a high sugar content or caffeine, which can act as diuretics and make you want to wee,” she explains. “Restrict yourself to just sipping water in the hour or so before.”
One woman would only have sex when she and her husband had both been drinking heavily, hoping he wouldn’t notice, and if he did she could blame it on being drunk. Not a great basis for a happy love life.
“Empty your bladder before sex, and when you think you are empty try to go again. It may be unromantic, but you can also always get up for a quick wee after foreplay,” says Morris. “A lot of women want to go to the loo after they orgasm. You can explain to your partner in a flattering way that sometimes when you are really excited your body really lets go and that may include some wee. You can say: ‘I just want to check that doesn’t freak you out.’ They may take it as a compliment.”
It should obviously be easier to have the conversation with someone you are in a long-term relationship with, but what you have to remember is it is a common biological fact and isn’t anything to be embarrassed about.
“Stress incontinence happens if your pelvic floor muscles are weak. You can improve them with kegel exercises – squeezing and releasing your vaginal muscles when you urinate or are having sex.
“The trouble with women not talking about the problem with each other, as well as their partners, is that they don’t know how normal and very ordinary it is,” says Morris. “People are squeamish, but, when I lived in Paris, they regarded such stuff as ordinary, healthy conversations.”
As incontinence affects one in three women over 35, we should all be having more open conversations about this everyday condition that impacts women of all ages. Find out more at tena.co.uk/ageless
