Need to Pee During Sex? How Overactive Bladder Affects Your Sex Life

Things are heating up in the bedroom, and you and your partner are about to get intimate … until, of course, your bladder has a different plan, and the urge to pee starts tugging on you like a whiny toddler.

“Over the course of a lifetime most women will have some issue with urgency and/or incontinence during sexual activity,” says Lauri Romanzi, MD, a urogynecologist in New York City. “What’s less common is to have that symptom all the time during sexual activity.”

How Overactive Bladder Can Affect Your Sex Life

Urgency, the need to go to the bathroom suddenly, is the root symptom of overactive bladder. If you have overactive bladder, you know all too well that this means a sudden urge to pee can pop up at the most inconvenient times—like during a broadway show, a work presentation, or, yep, sex. Plus, sexual activity, especially for women, can directly press on the bladder, which can also trigger the urge to urinate, says Dr. Romanzi.  

Sometimes, though, the problem isn’t physical. “With overactive bladder you’re always worried that you’re going to have to interrupt what you’re doing—even if you do pre-void,” says Dr. Romanzi. Anticipating that you may have the urge to pee during sex is not only a mood killer in that moment, but it can affect your desire for sex as a whole.“It can have an impact on libido. It makes [patients] anxious and embarrassed. It’s a problem,” she says.

One study published in the Journal of Sexual Medicine conducted a series of focus groups to assess the sexual health of women with OAB. Both continent and incontinent women reported difficulty achieving orgasm due to fear of leaking or anxiety related to sexual intercourse. Approximately one-third of the women said they wouldn't bring up their sexual issue with their doctor, but all women expressed concern about the impact of OAB on their sex life.

How to Improve Your Sex Life with Overactive Bladder

To ease your OAB anxiety during sex, give these tips a try.

• Empty your bladder before having sex. You can even try “double voiding” which is going to the bathroom, waiting a few minutes, and then going again to make sure it’s all gone. Trying these lifestyle changes for OAB may help too.
• Experiment with different positions. A new position may help put less pressure on your bladder.
• Work your Kegels regularly. Regular pelvic floor exercises have been shown to help man and women OAB and incontinence. An added bonus?  Studies have shown that by strengthening your pelvic floor muscles you may improve your ability to orgasm and find sex more satisfying. Here’s how to do a Kegel exercise. 
• Talk about it. While it may be an uncomfortable conversation to have, talking to your partner about your concerns may relieve some of your OAB anxieties.

If overactive bladder is affecting your sex life on a regular basis, it’s important to talk to your doctor. “The earlier you come in for treatment, the more likely you are to have a complete response or more robust response in every aspect of your life that the overactive bladder is impacting,” says Dr. Romanzi. And that includes feeling OAB symptoms during sex. “The urgency during sexual activity will reduce when the therapy for overactive bladder is successful.”