by Lauren Streicher, MD
For the approximately 30% of adult women who suffer from involuntary loss of urine, they are not just afraid to laugh, sneeze, cough or run without wearing a diaper or a pad – they are also afraid to have sex. In fact, close to 30% of women with incontinence report that sexual activity causes them to lose urine … a libido killer if there ever was one.
If like many women you go into avoidance mode and your partner never knows your “headache” is because you really just don’t want to pee on him, not because you don’t want to have sex with him, it’s good to know that there are better solutions.
Kegel exercises, while commonly recommended, rarely completely alleviate the problem but may be helpful if performed correctly.
Sling procedures are minor surgical procedures that elevate the bladder neck to prevent leakage. While highly effective for stress incontinence (the kind that makes you lose urine when you cough laugh or sneeze), some women prefer not to have surgery.
Pelvic-floor muscle training, along with behavior modification and biofeedback with an experienced pelvic-floor physical therapist, are also highly effective, but relatively few women have access to a personal pelvic-floor physical therapist.
A new device can help the fitness of your pelvic floor and eliminate or greatly reduce incontinence. This silicone device, which you can obtain from your doctor and use at home, is placed in the vagina and inflated in order to assure comfortable (but close) contact with the vaginal walls. During brief therapy sessions, a gentle electrical stimulation (the appropriate level is determined in the doctor’s office) occurs which enables strengthening of pelvic floor and bladder muscles. A hand-held control unit provides voice coaching and visual biofeedback. The results are impressive.
The point is: Incontinence is common, but common is not the same as normal, and there are a number of options to go from diapers to dry. It’s a matter of starting the conversation with your doctor to say, “This is important to me and I want to do something about it” instead of just accepting it and letting it ruin your sex life.
Sexual function is complex and whether the issue is incontinence, pain, dryness, loss of libido or the inability to have an orgasm, the solutions are not one-size-fits-all any more than one speculum fits all! My upcoming book, SexABILITY, will be a comprehensive look at all the things that can sabotage one’s sexual health, and more important, how to fix it. In addition, you will see how you compare to other women when it comes to sexual practices and sexuality. So, please take 5 minutes to participate in mySexABILITY survey.