Hi! I’m Tori, and I’m a doctor of physical therapy who specializes in pelvic dysfunction
and I think that pelvic health and pelvic issues should both be more openly discussed
and widely understood because everyone has a pelvis!
So, today we are going to discuss why some women and people with vaginas might pee when
they orgasm, during vaginal penetration, or both.
First of all, if you are not leaking urine during any other activities other than sexual
ones, I highly encourage you to investigate the fluid to be make sure that it is, in fact,
urine. There is such a thing as female ejaculation as well as squirting and I’ve run into women
in the clinic who have mistaken these events as urinary leakage. If you want to learn more
about female ejaculation and squirting, you can check out this video.
If you know that you’re truly leaking urine secondary to vaginal penetration, orgasm,
or both—this may be due to pelvic floor dysfunction.
Your pelvic floor acts as a sphincter around your urethra, and you want that sphincter
to remain closed until it’s time to urinate. Sometimes weakness in the pelvic floor translates
to weakness in that urethral sphincter, and, because the act of vaginally accepting an
object or a penis requires pelvic floor relaxation, a weaker sphincter will sometimes open during
vaginal penetration and let out some urine.
An orgasm is the repetitive contraction of the pelvic floor followed by a big relax.
Sometimes, if someone’s pelvic floor is weak, that big relax ends up relaxing that
urethral sphincter causing some leakage. Other times, if someone already has an overactive,
sensitive bladder, because the pelvic floor and the bladder have an inverse, reflexive
relationship—where, during normal urination the bladder contracts to squeeze out urine
and the pelvic floor relaxes to open that urethral sphincter—repetitive pelvic floor
contractions followed by a big relax cause bladder spasms, which feel like urgency, and
those spasms can result in leakage.
The medical term for this is “coital incontinence,” and usually coital incontinence is secondary
to stress incontinence—leaking urine due to physical activity like coughing, sneezing,
laughing etc., urge incontinence which is sometimes called overactive bladder—leaking
urine due to urgency around urination, prolapse—where the bladder has lost some support within the
pelvis, or a combination of the three. All of these can be improved and treated with
the guidance of a pelvic physical therapist, and, if you live in the United States, I’ve
got a directory for you in the description below to help you find a provider near you.
You are not alone in your experience, you do not need to suffer in silence, and you
are worthy and deserving of treatment if it’s something that you want to pursue. And that
is why you might pee when you orgasm, during vaginal penetration, or both. Thank you so
much for watching, and be sure to join me on the 10th and 20th of every month for future
pelvic PSAs, with surprise PSAs on the 30th when I can make them, where I attempt to cover
an interesting pelvic health or pelvic issue topic in 5 minutes or less! See you next time!