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Stress incontinence in women

WebMD Feature
Medically Reviewed by Dr Rob Hicks

Embarrassment, exercise, sex and stress incontinence

Many women in the UK have stress incontinence but are suffering in silence. Stress incontinence is when you leak urine by accident usually because your pelvic floor muscles are weak. It can be anything from a trickle to a stream.

It can have a huge impact on many aspects of a woman's life. Relationships, confidence and careers can be affected by it. For some it can stop them leaving the house making them isolated – on a so-called 'bladder leash'.

"It massively affects my life, it stops me going out, I can't go on long car journeys and I avoid certain social events because I'm worried I'll lose control," says a 67-year old woman from Gloucestershire who wants to remain anonymous because of the stigma that she feels comes with it.

She is certainly not alone. The NHS estimates that as many as 6 million people in the UK experience some form of urinary incontinence and it affects more women than men. Even though huge numbers of women are living with it many are too embarrassed to get help, so the actual number could be much higher. Women may not want to talk to their GP about it or admit they have a problem.

Female stress incontinence is not just an issue for the older woman, even though more women over 40 do experience it. Young women are also affected.

"It can have a significant impact on your quality of life, social life, sporting activities, working life and your sex life," says Peter Cooke, consultant urological surgeon and spokesperson for the charity The Urology Foundation.

A survey carried out for The Urology Foundation found 60% of people admitted they'd be embarrassed to speak about urinary incontinence, more so than weight, family, money and relationship issues.

Sex and stress incontinence

It can be an awkward problem that stops some women living a full life and can put a strain on personal relationships.

It's not just lifting something heavy or having a coughing fit that can trigger a leak but stress incontinence can occur at intimate moments.

It's not uncommon for some women to leak urine when they have sex. The extra pressure of having a partner on top can lead to a leak.

"As it's quite embarrassing some women will withdraw from having sex altogether rather than talk about their problem with their partner," says Denise Knowles, psychosexual therapist for Relate. "Go for a wee before having sex so you can reduce the risk of it happening," suggests Denise.

Try to avoid having too many drinks before having sex. The less fluid you've consumed the less likely it is that some will leak out. Maybe try to change sexual position to make it less likely. If the woman's on top, there's no pressure on her abdomen so less chance of leakage. The possibility that you might have a little wee during sex is enough to make women feel inhibited and tense and less likely to enjoy sex. If it happens, it happens. Your partner will probably not even notice. The best idea is to talk to them about it even if it's awkward. Your partner may feel the reason you don't want to have sex is because you don't find them attractive anymore. Knowing there's an actual medical reason that can be helped will probably be a relief to them.

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