Feeling the need to pee during sex can be confusing and alarming. However, it’s actually a normal sensation that can be caused by several things.
It’s most common to feel the need to pee during penetration and orgasm, due to the pressure on the bladder and penis during these activities.
1. Full Bladder
Millions of people have a problem called Overactive Bladder (OAB). It’s the ongoing urgent need to go to the bathroom, day or night. Sometimes it makes you leak urine (pee). OAB may also be a sign of some diseases like diabetes or multiple sclerosis.
When your brain signals the bladder that it’s full, muscles in the bladder squeeze to push urine out through the urethra. The urethra is long in men and ends above the penis; it’s shorter in women and opens at the top of the vaginal opening.
The bladder is about the size of a pear and sits in your lower pelvic area. Urine drains into it from the kidneys through a tube called the ureters. The urine leaves the bladder through a tube called the urethra, which runs down to the anus.
In the early stages of pregnancy, you need to have a full bladder for an ultrasound of the pelvic organs. After the 20th to 24th week of gestation, a full bladder interferes with visualization.
A full bladder can be caused by some medicines, especially anticholinergics and drugs that affect the muscle control of the bladder. Some of these are antihistamines (like Benadryl(r), antispasmodics and opiates like Vicodin(r)). Other medications that can cause urinary retention include some blood pressure medications, antipsychotics, sedatives and hormone agents.
2. Female Ejaculation
If you’re a woman, then the feeling of needing to pee during sex may actually be a sign that you’re about to experience female ejaculation. This is a completely normal function, though it may seem strange for those unfamiliar with it. Basically, the fluid that comes out of a woman’s urethra during sex is a mixture of urine and vaginal secretions from the vulva.
The reason this happens is because the bladder sits right next to the urethra, so during penetration (or even just having a penis or dildo inside the vagina), there’s often pressure on the front of the bladder that makes it feel like you need to pee. This is also why it’s common to hear the recommendation to always pee before sex: It helps prevent a UTI caused by sex-related bladder leakage.
Of course, if you don’t enjoy feeling the sensation of needing to pee during sex, it’s definitely not necessary. You can try to avoid the need by urinating before bed, not doing back-facing positions that put pressure on the pelvic area and trying to strengthen your pelvic floor muscles through exercise or masturbation. It might help to experiment with different sex positions, too, since some are more likely to trigger the feeling of needing to pee than others. Just make sure to check in with a pelvic floor physical therapist before making any major changes to your body!
3. Stress
Feeling like you need to pee during sex can be a real thing, and it isn’t something to be embarrassed about. The most common cause of it is urinating during penetration or urinating during orgasm, both of which are caused by two different types of urinary incontinence (UI). Having UI can lower sexual enjoyment and even ruin your libido completely, but there’s no reason to let that stop you from having sex or to settle for less than you deserve.
Of course, it’s possible that feeling of needing to pee isn’t actually a bladder issue at all. It could instead be female ejaculation or the natural moisture that occurs during sexual arousal: ‘The friction of a penis or dildo pushing against the urethra may confuse this sensation with urinating,’ says Ross.
If the need to pee during sex is a regular occurrence, it’s worth talking to your gynecologist or pelvic floor physical therapist to see what the issue might be. Usually, it’s down to weak or tight pelvic muscles and a few simple lifestyle changes can help. These include drinking plenty of water, not eating too many processed foods and hot spices, minimising caffeine and carbonated drinks, practising Kegel exercises regularly and exercising the pelvic floor in a variety of ways. Trying new positions during sex can also be beneficial, and using lubricant can reduce the risk of peeing or leaking.
4. Urinary Incontinence
Urinary incontinence (UI) is a common problem that can cause leaks during sex. It’s often triggered by sexual stimulation, which can cause pressure on the bladder and urethra, especially if your pelvic floor muscles are weak. This can also trigger orgasms, which may lead to urine leakage, especially if your detrusor muscle spasms. Urinary leakage during sex can be difficult to deal with, especially if you’re worried about it impacting your libido. However, urinary incontinence is not something that should determine your sexual life and there are many things you can do to help reduce it.
There are two main causes of peeing during sex – urination upon penetration and urination during orgasm. The bladder in the female body is quite close to the clitoris and penis, so it’s not uncommon that it can experience some pressure or bumping during intercourse. Similarly, it’s not uncommon that some women experience a little bit of bladder leakage during orgasm, as this is simply a combination of diluted urine and milky white fluid produced by glands in the urethra during an orgasm.
If you find that you have to urinate during sex on a regular basis, then it’s important to speak to your doctor or gynaecologist about it as soon as possible. They’ll be able to help you put together a plan to address the problem and improve your quality of life. For example, they may recommend making some lifestyle changes, such as avoiding foods and drinks that are high in caffeine or alcohol, which can act as bladder irritants. They might also recommend doing Kegel exercises to strengthen your pelvic floor muscles.
