Although this is a very sensitive topic, understanding the difference between coital incontinence and female ejaculation is a subject that a tremendous number of people are interested in learning more about. I’m going to answer this question as scientifically and pragmatically as possible so that members of the incontinence and light bladder leakage community can become more comfortable with it, feel more confident, and enjoy sex more fully. 

First, the bad news: There is not nearly as much research into coital incontinence as we would like. There simply haven’t been enough willing participants or clinical studies to produce a good body of work – but on the bright side, there are sure to be plenty of discoveries in the near future that will help us better understand the relationship between human sexuality and continence conditions.  

What Is Coital Incontinence?

What we do know is this: Coital incontinence is involuntary bladder leakage during sex. This is different than the urge to urinate. Coital incontinence involves the actual loss of fluid, as opposed to other conditions which present as the urgent need to go. 

Studies suggest that among all forms of incontinence, the one with the biggest impact on quality of life is coital incontinence. It’s far from uncommon, either – about one-in-five women under 60 reports suffering from it.¹  It’s even more prevalent among those who suffer from another form of incontinence. In one study, 60 percent of women who have some form of general incontinence experienced leakage during sex. ² Fortunately, there are ways to minimize these episodes so you and your partner can get more enjoyment from the act. 

Coital incontinence is classified by when you experience urine leakage – is it when penetration occurs, during intercourse, or during orgasm?³  This matters because there are a number of physiological factors that can cause leakage to occur. For example, penetration puts pressure on the bladder and/or urethra, and this stress can result in urinary leakage. During intercourse, involuntary leakage could be due to weakened pelvic floor muscles. And during orgasm, the involuntary contractions of the detrusor muscles may cause leakage.

What Is Female Ejaculation?

As far as female ejaculate goes, it is different than bladder leakage. Studies have found that female ejaculate is composed of a smaller quantity of whitish secretions from the female prostate (known as the Skene Gland) or a squirting of a larger amount of diluted and changed urine². Both may happen simultaneously, but the “ejaculate” component is different from urine.

How To Manage It And Treat It

So what can you do about it? One practical solution is to use a highly absorbent under-pad to absorb leakage. Another is to make sure that you urinate before and after sex. The rationale for the ‘before’ part is obvious, but going to the bathroom in advance and afterward is also a good practice because it reduces the risk of developing a UTI. 

Experimenting with different sexual positions is a great idea because there may be some that put less pressure on your bladder. Limiting how much liquid you drink before sex can be helpful, as can avoiding bladder irritants such as alcohol, caffeine, and spicy foods. And give shower sex a shot, too – it can be great fun, and it’s good for disguising leaks. 

Finally, consider seeing a physical therapist to learn if you have a pelvic floor condition. In many cases, incontinence can be caused by either a “too-weak” or “too-tense” pelvic floor. A pelvic floor physical therapist can help determine that for you, and provide you with either strengthening or relaxation exercises to ensure that your muscles are working as they should.

References:

1. Karlovsky, M. E. (2009) The Female Patient. Female Urinary Incontinence During Sexual Intercourse (Coital Incontinence): A Review. [online] 34(1), p1-5
2. Jha, S., Strelley, K. & Radley, S. Incontinence during intercourse: myths unravelled. Int Urogynecol J 23, 633–637 (2012).
3. York Morris, S. (2017). Peeing During Sex: Causes, Treatment, and More. [online] Healthline, 2017. 

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