How can I be intimate with my partner when dealing with incontinence?

Sonya Meyer, National Clinical Specialist  at MoliCare, reassures people with incontinence-related concerns that it is normal and very human to wonder about maintaining a level of sexual activity and enjoying intimacy after an incontinence diagnosis.

After all, sexual intimacy is an important part of many relationships and it’s common for people to link their sexual identity and a positive state of wellbeing to sexual activity.    “We understand that some people are concerned about being intimate with their partner after they find out they are dealing with incontinence,” Meyer says. “It’s not uncommon for both women and men to ask: ‘What if my partner and I want to have impromptu sex? I’m a little embarrassed because I am afraid that I may wet myself.’”

The Continence Foundation of Australia (CFA) indicates that more than 4.8 million Australians experience bladder or bowel control problems. Urinary incontinence also affects up to 13% of Australian men and up to 37% of Australian women.    According to the American Foundation for Urologic Disease, one in three women with stress incontinence also avoid sexual intimacy because of fear of leakage during intercourse or orgasm.

“These statistics demonstrate that you are not alone: incontinence is widespread and there are many other people out there dealing with it, just as you are,” Meyer says. “But with the right help, techniques, products and lifestyle tips, many cases of incontinence can be managed. And most people can continue to live a sexually intimate and fulfilling life with incontinence, if that is something they want and choose to do.” More on dealing with incontinence here.

Meyer explains that, like everything else health-related, incontinence issues are varied and diverse, and it's true emotional impact will often depend on how a person manages the condition and their state of mind. “There are many aspects of your life that you can continue to enjoy after a diagnosis, in the same way as you did before you developed incontinence, with just a bit of planning and forethought.” 

Learn to be comfortable with who you are today and embrace sexual intimacy with a positive state of mind.  “Little things like dressing intimately, putting on a long dress or nice clothes that make you feel sexy are important to people with incontinence issues, because quite often people who are incontinent don’t feel good about themselves," Meyer says. “Sometimes, it comes down to a mindset.” 

Of course, maintaining a positive attitude is easier said than done. But Meyer believes that talking about what you are going through and sharing your fears with your partner can help.  “A major step towards developing a new sense of sexual self-confidence post-diagnosis is to discuss your fears, concerns and health with your bed partner. Try to talk to your partner about your incontinence worries in a mature and mutually beneficial way.”  You might also want to chat to your partner about experimenting with various sexual positions that put less pressure on the abdomen, bladder and urethra.  Discuss any equipment you use to manage your incontinence, so your partner knows what to expect. If you use a catheter, consult a medical professional to find out if it can be temporarily sealed and the leg bag removed.  “It takes two to engage in sexual intimacy, so both people need to be comfortable, accepting, understanding and informed. By having an open conversation, your partner will most likely also be put at ease.” 

If you are in an intimate moment with your partner, don’t be shy to say ‘hold that thought’. “Go into the bathroom, empty your bladder or change your incontinence pad. A catheter can also be removed and a new one inserted before sexual intimacy. This is also the time where you can have a quick wash.”  Be sure to have a shower or bath after sex as well to avoid any increased risk of developing a urinary tract infection, and encourage your partner to do the same.  “If the person has an open conversation with their partner about the fact that they may need a minute during an intimate time to ‘freshen up’, and the partner is aware of it, then there’s no reason why they can’t have sex.”

Although you might have other things on your mind at the time, be aware of the amount of fluids you consumed prior to sexual intimacy. Be prepared for any leaks during sex by putting towels or washcloths over your bed or the place where you want to be intimate.

There’s no shame in asking for help to manage your health, for more proven tips on incontinence management or to discuss your medical issues with a professional. It’s always better to seek and find a solution than to suffer in silence. So if you are struggling with more questions than answers about your condition, visit your GP and ask to be referred to a urologist – an incontinence specialist.  You can also ask to see a sex therapist or a counsellor with a specialty in this area. Otherwise, the CFA can provide information on products, medical diagnoses and even health professional referrals. They also provide various free resources targeting key concerns faced by people with incontinence to help you treat your bladder and bowel control challenges. Call the National Continence Helpline for a free, confidential discussion with a continence nurse advisor on 1800 33 00 66.