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Urinary Incontinence health centre
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This article is from the WebMD Feature Archive

Sex, exercise and stress incontinence

Workouts and romance may both trigger “accidents”, but stress incontinence treatments can bring relief.
WebMD Feature
Medically Reviewed by Dr Rob Hicks

Stress incontinence has an annoying way of showing up at the most inopportune times.

You're jogging along, feeling great - and then you realise your running shorts are damp with urine. Later that night, during a romantic rendezvous with your partner, a trickle of urine appears again, definitely spoiling the moment.

Lest you think stress urinary incontinence is a problem only of middle-aged or elderly women, think again. Surprisingly, young women actually have more stress incontinence during sex than older women, according to Dr Amy Rosenman, a gynaecologist and co-author of The Incontinence Solution.

When incontinence occurs during intimate moments, women feel anxious, Rosenman says, even if they are in stable marriages. This could even lead to sexual dysfunction.

The same anxiety can occur during a workout, where you may end up with an embarrassing wet spot on your shorts for the world to see.

Stress incontinence due to weak pelvic floor muscles

The problem, whether the stress incontinence occurs during exercise or sex, has a common denominator, says Beverly Whipple, a professor and a sexuality researcher.

"Stress incontinence is related to the strength of the pelvic floor muscles," Whipple says. The weaker those muscles are, the more likely you are to have symptoms of stress incontinence - leaking urine during physical activity, such as exercise, sex, sneezing, laughing or jumping - in the absence of bladder contraction.

While many women experience minor leakage from time to time, at any age, if it becomes more frequent or interferes with your normal routine, you should seek medical advice. There is an array of very effective treatments for stress incontinence.

If you have had several pregnancies and childbirths, your pelvic muscles and tissues may have been stretched and damaged. With age, the muscles can weaken, too, although stress incontinence is not an inevitable part of ageing. Excess weight can also weaken pelvic floor muscles and cause stress incontinence.

Pelvic floor exercises can help stress incontinence

Strengthening the muscles of the pelvic floor is crucial, experts agree.

One recommended way to do that is through pelvic floor exercises, according to the NHS.

First, some anatomy: at the bottom of the pelvis, many muscle layers stretch between your legs, attaching to the pelvic bones at the front, back and sides. If you think of the muscles you would use to stop the flow of urine, those are the ones you will be targeting when doing your pelvic floor exercises.

Pull in or squeeze these muscles, pretending you are trying to stop urine flow. You should hold that squeeze for a count of five, then rest - this is a slow pull-up. Repeat five times. Then do a set of five fast pull-ups, holding each one for one to two seconds. Repeat sets of five slow and five fast pull-ups for five minutes. The NHS recommends that you try to do five minutes of these exercises at least three times a day.

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