How common is leaking?

Research has shown that about 40% of women who are 30-50 years old leak urine.  About 17% of women who are older than 20 leak.  This number includes all women: those who have never been pregnant and those who have had 5 deliveries, skinny women and fat women, runners and couch potatoes.  Of all of these leaking women, only a quarter will seek care and only half of these women will actually get care. So, about 12% of leaking women receive the help they need. This lack of care is important when you consider the devastating effect leaking has on quality of life. For many women, quality of life is linked to intimacy and your sex life and leaking urine does not make women feel sexy.

Leaking has a negative effect on sex

These statistics really bother me: we need to do better.  Even though some women are not be bothered by their leaking, others are definitely bothered and just don’t know what to do.  Just a small amount of leaking can have a huge negative impact on quality of life.  When it is significant enough, women start avoiding activities that they enjoy, like going out, exercise and sex.  In fact, the worsening in quality of life strongly correlates to the impact leaking has on your sex life.  More leaking causes more sexual dysfunction.

Some women avoid sex because of fear of odor or changes in body image.  They may just not feel as attractive or confident.  Other women will actually leak during intercourse.  Studies show that when asked, 24-66% of women who leak, leak during intercourse.  I say “when asked” because no one ever volunteers this information.  Leaking can have a negative effect on arousal, desire and orgasm. Consequently, this leaking around intimacy results in impaired body image, fear of leaking during intercourse, avoidance of sex and even complete abstinence. 

These issues start very subtly. You may avoid sex without really thinking about why.  However, the negative impact on relationships over time is substantial. And if you are thinking this only happens to older women, think again.  A study in Physical Therapy and Sport looked at 50 female athletes who had never been pregnant and were older than 18.  In this group, 48% had bladder leaking.  The athletes who leaked were almost three times more likely to develop female sexual dysfunction.  I love this study because it just shows how common this issue is.  And it makes you feel better when you realize leaking can happen to a 20 year old athlete who has never had kids.

Will fixing my leaking help my sex life?

The good news is that when bladder leaking is corrected, sexual function improves.  This has been shown with any therapy for leaking including pelvic floor muscle training, medications and surgery.  Interestedly, when partners are interviewed, they notice an improvement in sex life too, especially when asked about affection during sex and communication about sex. One more reason is to address your leaking. And just so you know, both stress incontinence and urgency incontinence can cause leaking during intercourse. It can take some detective work to determine why you are leaking. You could get started by making small behavioral changes that have been shown to help leaking.

1. Lukacz ES et al. Urinary Incontinence in Women: a Review. JAMA 2017;318:1592-1604.

2. Krhut J et al. Effect of severity of urinary incontinence on quality of life in women. Neurourol Urodynam 2018;37(6):1925-30.

3. Duralde ER et al. Urinary incontinence and associated female sexual dysfunction. Sex Med Rev 2017;5(4):470-85.

4. Dos Santos K et al. Female sexual function and urinary incontinence in nulliparous athletes: an exploratory study. Phys Ther in Sport 2018;33

5. Chu CM et al. Impact of urinary incontinence on female sexual health during midlife. Wmens’ Midlife Health 2015;1:6