Doctor Answers: Why Do I Feel Like Peeing During Sex?

Unintentionally peeing during sex is a condition referred to as coital incontinence. 

It is a common issue, particularly in women. Studies show that up to 60% of women who are affected by urinary incontinence experience weeing during sex. 

For many people, urinating during sexual intercourse is embarrassing and can lead to low self-esteem, decreased sexual satisfaction, reduced sex drive, or even complete avoidance of sex. The good news is that there are many available treatment options to combat peeing during sex.

If your sex life has been suffering because of urine leaks during coitus, read on to learn about the possible causes, how to manage it, and how to differentiate urine from other fluids that you may release during sex.

To provide a medically accurate and thorough answer to the question, “Why do I feel like peeing during sex?” we interviewed Dr. Victoria Alex, a licensed medical doctor specializing in women’s health and urinary function. Dr. Alex addressed direct questions regarding the sensation of needing to urinate during sexual intercourse, as well as related experiences such as “women peeing during sex” and “why do I pee when I orgasm?” Her expert insights are explored during this in-depth interview process, contributing valuable clinical perspectives and evidence-based guidance to this topic.

With the increasing frequency of questions like “why do I feel like peeing during sex but nothing comes out?” and “is it normal to urinate during intercourse?”, this article aims to clarify misconceptions and provide practical advice concerning urinary sensations and leakage during sex. All information presented here has been carefully reviewed and validated, utilizing medically sourced references to ensure accuracy and reliability for medical professionals and patients alike.

Q: What causes peeing during sex?

Dr. Alex answers: Let’s delve into why you might feel pressure to urinate or even leak urine during intercourse, a concern that’s more common than you may realize. There are several forms of urinary incontinence (UI) that can lead to this sensation or actual urine leakage, each with distinct underlying causes. Understanding these can help illuminate why you feel like you have to pee during sex or experience bladder pressure during sexual activity.

1) Stress incontinence

Stress incontinence is actually the most common form of urine leakage that happens during sex. It arises when the pelvic floor muscles, responsible for supporting your urinary system, are weakened. These muscles act as a supportive sling for the bladder and urethra and are meant to withstand pressure created by laughing, coughing, sneezing, lifting heavy objects, or having sexual intercourse.

If these muscles lose strength, any activity that increases abdominal or pelvic pressure (including sexual penetration) can result in urine leakage. Common risk factors for stress incontinence include:

• Obesity
• Previous vaginal childbirth
• Previous pelvic surgery
• Pregnancy

For women with stress incontinence, the ‘stress’ from penetration during sex often triggers the urge to pee or leads to actual leakage. This is a large reason why many describe the feeling as “urge to pee during sex” or “pressure to pee while having sex.”

2) Urge incontinence

Normally, you don’t feel the need to urinate until your bladder is half full. But in those with urge incontinence, also called overactive bladder, the bladder contracts unexpectedly – even with small amounts of urine present. This can lead to strong, sudden, uncontrollable urges to pee, which sometimes occur during sexual arousal or orgasm.

Possible causes of urge incontinence include urinary tract infections, medications that increase urine production, and nerve damage from conditions like diabetes or stroke. Sometimes, no clear cause is found. For many women, peeing during orgasm or feeling an overwhelming urge to urinate at that moment is linked to this condition because the pelvic muscles contract rhythmically, potentially stimulating the hyperactive bladder.

3) Mixed incontinence

Some people have features of both stress and urge incontinence; this is known as mixed incontinence. In this scenario, both increased abdominal pressure and sudden, uncontrollable urges to pee can trigger leakage during sexual activity. Mixed urinary incontinence is actually more common among women than urge incontinence alone. Individuals with mixed symptoms may leak urine during both penetration and orgasm, leading to confusion about whether the sensation is related to sexual arousal or simply the body’s urge to urinate.

4) Prostate removal (in men)

For men, a special sphincter muscle at the base of the bladder usually closes during erections to prevent urine from entering the urethra during sexual activity. However, after surgical prostate removal for issues such as prostate cancer, this mechanism can be disrupted, resulting in urinary incontinence as an unfortunate side effect. This can manifest as urine leakage during sex or orgasm.

If you notice you frequently feel like urinating during intercourse, have a strong urge to pee during sex, or experience bladder pressure during sexual activity, you’re not alone. Identifying which type of incontinence you may have is the first step in addressing the issue and seeking targeted treatment.

Q: What is the difference between urinating during sex and orgasm, and could it be something else?

Dr. Alex answers: This is an excellent question and an area that often causes confusion. You may be asking: “Is it normal to urinate during intercourse?” or “Why do I feel like peeing during sex but nothing comes out?” Often, women wonder whether what they’re experiencing is actually peeing, female ejaculation, or squirting.

Studies have shown that during sexual arousal and orgasm, some women release a clear to grayish fluid referred to as female ejaculate. This fluid originates from the paraurethral glands (sometimes called Skene’s glands), which are located near the urethra and share similarities with the prostate.

Additionally, another type of release, often called “squirting”, can happen. There is sometimes confusion with “squirting vs peeing”. However, squirting fluid is essentially diluted urine that is expelled forcefully from the urethra during intense sexual excitement. Some women may both ejaculate and squirt during orgasm, which further complicates distinguishing the experiences.

Because the female urinary and reproductive systems are so closely intertwined anatomically, sexual arousal can create sensations that mimic the urge to urinate. That’s why many women report that they feel like peeing during sex but nothing comes out, or they have the urge to pee right before orgasm. This phenomenon connects sexual arousal and the need to urinate.

So how can you tell what fluids you are releasing during sex?

You may want to place a towel beneath you during sex to collect and observe any fluids afterward. Pay attention to the volume, color, and odor. If it’s a large amount, has a yellowish tint, and an ammonia smell, it’s likely urine. If you’re still uncertain and asking yourself, “Did I squirt or pee?”, a doctor can help with testing and clarification. Remember, female ejaculation and squirting are both natural, though easily mistaken for peeing during orgasm or sexual activity.

If you ever wonder, “Is squirting during sex peeing?” or “Why do I feel the urge to urinate during sex?”, know that it’s possible to experience either or both. Communication and clarification with a medical professional can provide reassurance and answers tailored to your body.

Q: Is coital incontinence (urine leakage during sex) normal?

Dr. Alex answers: Unintentional peeing during sex, also known as coital incontinence, is not considered medically “normal.” Ideally, we have control over urination, regardless of activity type. However, the urge to pee during sex or an accidental urine leak is quite common and nothing to be ashamed of.

For example, one study involving 505 sexually active women attending a urogynecology clinic found that over half (56%) experienced urine leakage during sex. So, while it’s not the baseline standard, having this issue is much more typical than many people think.

If you’re wondering, “Is it normal to want to pee during sex, is it normal to urinate during intercourse, can you pee during sex, or is it normal to pee during sex?”, the answer is that it’s common – even if not considered physiologically normal. If this happens to you, it may signal an underlying, treatable cause and isn’t something you should silently endure.

Many women and men feel embarrassed by this problem. But rest assured, it affects a significant portion of the population. If you’re concerned, talking to a healthcare provider is the first step toward resolution.For those interested in natural enhancements for sexual health and management options for peeing during sex, programs and supplements formulated to support pelvic floor strength and urogenital function, such as those available at the Sexual Health Program, may offer additional holistic support alongside medical interventions. Always consult with your healthcare provider before starting any new regimen.

Q: How can I stop leaking urine or feeling the urge to pee during sexual intercourse?

Dr. Alex answers: Many people search for solutions on how to stop feeling like needing to pee during sex or how to manage discomfort associated with the urge to urinate during intimacy. 

The first step is to seek medical advice. When you consult your physician, they’ll start with a comprehensive medical history and a physical exam. Additional tests may clarify which type of incontinence is present and help determine an effective treatment plan. Here’s what your doctor may recommend based on the underlying cause and specific needs:

1) Pelvic floor exercises

Kegel exercises are a frontline strategy for strengthening your pelvic floor muscles. By repeatedly tightening and releasing these muscles, you improve both muscle tone and bladder control. Evidence shows that Kegels not only reduce urine leakage but can also increase genital blood flow and enhance sexual pleasure. These can be performed anywhere, discreetly at your desk, in the car, or at home, and under the guidance of a pelvic floor physical therapist for optimal results. Regular practice enables many women to reduce or eliminate peeing during sex and regain sexual confidence.

2) Bladder retraining

Bladder retraining involves following a set schedule for urination, regardless of urge, with the goal of gradually increasing the time between emptying your bladder. Relaxation techniques are taught to help suppress sudden urges, ultimately increasing your bladder’s capacity and control. This approach is often combined with pelvic floor exercises for maximum benefit. Over time, you’ll be able to hold urine comfortably for three to four hours, significantly reducing bladder pressure during sex and the urge to pee during sexual arousal.

3) Lifestyle changes

Simple lifestyle adjustments can go a long way toward preventing and managing coital incontinence:

• Losing weight: Managing obesity helps alleviate undue strain on the pelvic floor, directly reducing stress incontinence and the risk of women peeing during sex.
• Using lube: Addressing vaginal dryness can minimize pelvic friction and irritation, both of which can heighten the urge or need to urinate during sex. Incorporating adequate lubrication and longer foreplay preps the vaginal area and mitigates UTI risks that may trigger urgency.
• Avoiding diuretic substances: Cutting down on diuretics like caffeine and alcohol, known to increase urine production, can help manage urgency and prevent urge incontinence episodes during sex.
• Emptying your bladder: Peeing right before engaging in sexual activity minimizes the amount of urine available for accidental leakage, decreasing the likelihood of feeling like you have to urinate mid-activity.
• Experimenting with sex positions: Certain positions that relieve bladder pressure, such as lying on your side, being on top, or penetration from behind, can reduce the risk of unintentionally peeing during sex. Discover the most comfortable positions through communication and experimentation with your partner.
• Improving communication: Honest dialogue helps you and your partner find workable solutions. It’s vital to remember you’re not alone, and beyond being a medical concern, urinary incontinence is a shared experience for many couples.

4) Medications

If pelvic strengthening and behavioral modifications aren’t enough, your doctor may prescribe medications. This may be especially useful if urge incontinence is a major factor causing peeing during orgasm or a constant urge to urinate during sex. Medications like solifenacin (VESIcare) and darifenacin (Enablex) are designed to relax the bladder muscle and minimize involuntary contractions. In some stubborn cases, Botox injections into the bladder muscle can offer relief by reducing overactivity and urgency.

5) Surgery

For individuals with severe, unmanageable urinary incontinence, surgical options may be discussed. Procedures generally aim to reposition the bladder neck or reinforce support to the urinary tract. These interventions are considered only after conservative methods fail, as they carry significant risks and possible complications. Make sure to have a thorough discussion with your doctor about the pros and cons before deciding on surgery.Ultimately, if you regularly feel like urinating during intercourse, or constantly wonder “Why do I feel like peeing during sex but nothing comes out?”, know that effective strategies exist. Whether your situation involves peeing during orgasm, mixed incontinence, or simply pressure to pee while having sex, a combination of pelvic floor rehabilitation, behavioral changes, and (if necessary) appropriate medical interventions can help reclaim your confidence and sexual comfort. If you’re not sure if it’s squirting or peeing, or you’re experiencing recurrent symptoms, a healthcare professional can help untangle the answer and offer a tailored pathway to relief.

Patient Questions About Peeing During Sex, Bladder Health, and Intimacy

Q: Can menopause increase the chances of peeing during sex or make bladder control worse in women?

Dr. Alex answers: Yes, it can. Menopause leads to a significant reduction in levels of estrogen in a woman’s body. Estrogen helps maintain the strength and suppleness of the structures in the pelvic area. The sudden drop in estrogen during menopause can cause weakening of the muscles of the pelvic floor and thinning of the urethral walls. These changes can contribute to most forms of incontinence, increasing the risk of women peeing during sex.

Reduced estrogen during menopause can also lead to thinning and dryness of the vaginal walls. This increases the risk of developing urinary tract infections, which can cause increased frequency of urination and worsen the symptoms of incontinence.

The good news is that the effects of menopause are not unavoidable. Not every woman experiences these changes. Additionally, if they do occur, they are very treatable. Options include pelvic floor strengthening exercises, estrogen creams, and hormonal replacement therapy. 

Q: Are there specific sexual positions that can help reduce pressure to pee while having sex?

Dr. Alex answers: 

Most definitely! If you struggle with peeing during sex, it is best to go for positions in which your partner does not apply a lot of weight on your pelvic area. This reduces the pressure on your bladder and should help keep the urge to pee at bay. Positions to try include:

• Being on top: In addition to giving you a sense of power and control, there is virtually no weight on your bladder in this position. You also get to determine the depth and pace of penetration, which means you can control the amount of pressure you feel in your pelvic area.
• Lying sideways: This is another great position that takes weight off your pelvic region and reduces pressure on your bladder.
• Modified missionary: While the traditional missionary position may put a lot of pressure on your bladder, modifying the position by having a pillow under your lower back can help. Raising your pelvis this way alters the position of your bladder and can help reduce the pressure on it during penetration.
• From behind: You can also experience less bladder pressure with penetration from behind, provided that you have some support for the front of your body (by lying flat on your stomach, lying on top of some pillows, or kneeling with support). It is best to avoid the traditional all fours position. The pull of gravity on your pelvic organs while in this position can increase bladder pressure during penetration.  

Q: How does being overweight impact peeing during sex, and can weight loss help manage symptoms?

Dr. Alex answers: Obesity can increase the risk of peeing during sex for several reasons:

1. Increased intra-abdominal pressure: Obesity, especially central obesity, increases the pressure on organs in your abdomen and pelvis. This constant high pressure strains the pelvic floor muscles and other supporting structures, weakening them over time. This can reduce the amount of control a person has over structures like the bladder and the urethral sphincter, leading to incontinence (most commonly stress incontinence).
2. Increased risk of urinary conditions: Obesity increases the risk of conditions like diabetes and kidney disease. These can affect urinary function and exacerbate urinary incontinence.
3. Oxidative stress: Oxidative stress refers to the effect caused by the accumulation of harmful substances called free radicals in the body. These free radicals can cause widespread damage to organs in the body. Various studies show that obesity is linked with increased oxidative stress. Some studies suggest that increased oxidative stress caused by obesity may increase the risk of urinary incontinence by causing alterations in substances such as collagen, which are crucial to the integrity of the pelvic floor muscles and other supporting structures.

Weight loss can help reverse these effects. One study showed that losing just 5 to 10% of body weight resulted in a significant improvement in urinary incontinence symptoms.  

Q: What role do common medications play in peeing during sex, and should I talk to my doctor about my prescriptions?

Dr. Alex answers: Some medications can worsen incontinence during sex by causing increased urination, retention of urine, or relaxation of the muscles around the bladder. Here are some common ones:

Alpha blockers or alpha-adrenergic antagonists (e.g., prazosin, silodosin, and tamsulosin): These drugs are used to treat high blood pressure and symptoms of benign prostatic hyperplasia. They help to relax the muscles around the bladder neck, making it easier to pass urine. This effect can worsen symptoms in people with urinary incontinence. 

Diuretics: These drugs are used to treat conditions such as high blood pressure, heart failure, and kidney disease. They work by causing the kidneys to push excess water and salt out of the body. This causes increased frequency of urination.

Antidepressants: Some antidepressants (e.g., tricyclic antidepressants) have properties that reduce the ability of the bladder to contract, leading to retention of urine. This can cause a type of incontinence called overflow incontinence.

Antihistaminic drugs: These drugs are often used for treating allergies and motion sickness. Like certain antidepressants, some antihistaminic drugs can cause urine retention and overflow incontinence.

If you’ve been wondering, “Why do I feel pressure to urinate during sex?” and you now think that medications may be the cause, speak with your doctor. Discuss all your prescribed and over-the-counter medications with them. They may change the medications to an alternative, adjust the dosage, or alter the time you take the medications to combat the side effects.  They may also be able to identify and give advice on other factors that may be contributing (e.g., constipation and obesity).

Q: Are there natural remedies or supplements that may help with urge to pee during sex or bladder pressure during sex?

Dr. Alex answers: Some supplements and natural remedies that have been shown to be beneficial in reducing symptoms of urinary incontinence include:

Magnesium: Magnesium is essential for proper nerve and muscle function. If you are deficient in magnesium, it could cause or worsen urinary issues. Taking magnesium supplements may help with urinary incontinence, particularly in people who have a deficiency of it. 

Pumpkin seeds: Pumpkin seeds are nutritional powerhouses. In one study, pumpkin seed oil was shown to reduce symptoms of overactive bladder.

Gosha-jinki-gan (GJG): This Japanese supplement is a mix of ten herbs.  Various studies have shown GTG to be beneficial in managing symptoms of overactive bladder and improving urinary function.

Soy: Soy products such as soy milk and tofu are rich in phytoestrogens. These substances may mimic the effects that estrogen has on the body. Menopausal women who are battling incontinence may benefit from increasing their soy intake.

If you want to use a supplement or natural extract, it is always best to consult with your doctor first. This is especially important if you have a chronic condition and are on long-term medication. A product being natural does not mean it is safe for everyone. Also, remember that supplements are not replacements for medical treatment. 

Q: Bladder pressure during sex: when should I worry that it signals an underlying condition beyond simple incontinence?

Dr. Alex answers: Incontinence during sex, in itself, is not life-threatening. However, if it occurs along with certain symptoms, it may be a sign of a serious problem that requires urgent medical attention. These symptoms include:

• Pain during urination: Having urinary incontinence as well as a burning sensation when you urinate could be a sign of a urinary tract infection (UTI).
• Cloudy urine: If your urine looks cloudy, it may be an indication of a UTI. Untreated UTIs can lead to sepsis, septic shock, and death.
• Blood in your urine: Blood in the urine can be caused by several conditions, including a urinary tract infection, kidney or bladder stones, kidney or bladder cancer, prostate issues, and glomerulonephritis.
• Weak urine stream: A weak urine stream occurring along with incontinence may be a sign of benign prostatic hyperplasia. Untreated BPH can lead to serious problems like kidney failure.
• Pain during sex: In conjunction with incontinence, pain during sex could be an indication of an underlying problem, such as vaginal or cervical cancer. 

If you experience any of the above symptoms alone or alongside urinary incontinence, please seek evaluation by a medical professional as soon as possible.

Conclusion

If you often find yourself wondering, “Why do I feel like peeing during sex?”, know that you are not alone and that this is a common concern for many people. Changes in bladder sensations during intimacy can happen for a variety of reasons, including hormonal shifts, certain medications, body weight, or the way your pelvic muscles work. While this feeling can sometimes be uncomfortable or cause worry, it usually isn’t a sign of anything seriously wrong. Simple steps like adjusting positions, making small lifestyle changes, or trying pelvic floor exercises can often help. If the feeling is bothersome or doesn’t get better, talking openly with your doctor can give you support and more specific options. Remember, your comfort and confidence matter, and you do not need to feel embarrassed about discussing peeing during sex or any other related questions. Getting the answers you need can help you enjoy intimacy without unnecessary stress or worry.

Our Medical Review Process

At Ben’s Natural Health, we are committed to delivering information that is clear, trustworthy, and grounded in science. Every piece of our content is authored by healthcare experts and undergoes a thorough review every 12 to 24 months, guaranteeing it remains precise, research-based, and updated with current scientific findings. We rely exclusively on peer-reviewed studies and authoritative medical publications for our references. Each article offers complete citations and direct links, ensuring transparency and reliability. To find out more about our approach and criteria, visit our medical review process.

Our Editorial Guidelines

For more than 25 years, Ben’s Natural Health has led the way in delivering trusted, evidence-based natural health information. Our stringent editorial standards allow readers to have confidence in our material. All articles are created by certified medical professionals, including doctors, dietitians, nutritionists, fitness specialists, or surgeons, and each piece undergoes independent review. We clearly display each expert’s qualifications, experience, and complete biography at the top of articles. For an in-depth look at our writing and verification process, please see our full editorial guidelines.

Medical Disclaimer

The content offered on this blog is intended for informational purposes and should not replace professional medical guidance, diagnosis, or treatment. Even though material is created and reviewed by licensed physicians, it isn’t personalized medical advice. Always consult your primary healthcare provider or a qualified health professional before making decisions related to your health. Do not ignore or postpone obtaining medical guidance because of content found on this blog. Any use of the information here is strictly at your own discretion and risk.

Explore More

How To Clean Your Genitals After Urinating.