Loss of Bowel and Bladder Control During Sex

man sitting on the side of the bed head in hands looking worried.
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Whether you use clinical terms or plain language, the fear of either urinating (peeing) or defecating (pooping) during sex stops a lot of people from exploring sex with a partner, and for those who are already having sex, it can really get in the way of enjoying it.

While urinary and fecal incontinence may not have a direct impact on sexual function or response, they can have a huge impact on our sex lives, largely because of fear and shame about the loss of bowel or bladder control during sex, and our very narrow ideas of what sex is supposed to be.

The image of great sex that we see splashed across the media and even in our sex education, is of an act of beauty and power, one that is weirdly sanitized. In practice, sex involves usually sweaty bodies exchanging some, and often several, sorts of fluids. But we rarely see that kind of sex on display and as a result, we all have unrealistic expectations of what a sexy body is.

If you live with reduced or no control over your bowel or bladder, whether it's temporary or permanent, you don't have to give up sex. It's easier said than done, I know, but here are some steps you can take that might change the way you and your partner feel about having sex again.

Name It

Going to the bathroom, having an "accident", a "bm", feces, shit, fart, bladder problems, urine, piss, pee. These are all words for something all of us do, and most people avoid talking about at all costs. Some people think that it's important to stop using euphemisms and call it what it is. Educators would be more likely to suggest that you take some time and really think about it for yourself.

What words feel okay for you to use when talking about your fear or the actual situation of losing bowel or bladder control during sex? When we keep things vague and don't name them specifically, it can be easier to think about the problem as being, generically, about "us." Even when it feels that way, you are not the problem, and you're also not alone.

Do Some Homework

There's an obvious difference between loss of bowel control during sex, which can result in having a bowel movement, and loss of bladder control during sex, which can result in leaking urine. But there are also all sorts of reasons why people lose control of bowels and bladders during sex. It can be temporary or permanent, the result of disease, or treatments, excitement or stress, and the loss of control may be full or partial. Sexual stimulation can increase incontinence, but so can certain liquids and foods.

The specifics of what's happening in your body matter, particularly when you want to come up with creative ways to deal with it. You may want to start by learning a little on your own about the general conditions and if you already know what the cause of your loss of control is, digging into the specifics of that cause. Online or book research is a good place to start, but you may also want to...

Speak About It With Others

If you have access to a doctor or other healthcare practitioner, they are a great first place to start asking questions about your body and what's happening in terms of control over bowel and or bladder function. This can feel like a scary conversation to start but consider the fact that it is that way because none of us have any practice doing it. Also know that while health care providers may be uncomfortable talking about sex, talking about bowel and bladder function is something they are trained to do.

Speaking of sex, you should know that wanting to have sex without feeling embarrassed or worried is a perfectly good reason to bring this topic up. We're often given the message (subtly or not so subtly) by health care providers that sex is the last thing we should worry about, that it's a luxury. But you're the one that gets to decide this, and even if you've never asked about bowel and bladder control, if you want to ask about it in the context of sex, that is as legitimate a reason as any. Sexual pleasure is part of sexual health, which is part of overall health.

Talk With Partners

A lot of the anxiety associated with losing bowel or bladder control during sex comes from the way we talk (or don't talk) about sex in relationships. If you're thinking about sex with a new partner, or with an old one but you've now got different control over your bowels and bladder, no matter how "unsexy" it seems, talking about it with a sexual partner in some way is probably the best way to reduce the anxiety.

What this conversation looks like will depend on you and your partner, but if it's a new partner some people find it easier to practice first, either alone or with a good friend. Even though partners are usually less turned off that you'd think, timing is an important consideration, as they may have their own expectations to deal with.

Take Care of Yourself

The pressures of "normal" are intense in our society. The truth is that few, if any, of us, actually fit the ideals of what is "normal." Still, many manage to fake it, and we can't underestimate the kind of emotional and psychological weight that any of us who aren't able to fake it carry. A lot of advice you'll get will be of the "have a positive attitude" and "make the best of it" kind. This is well-meaning but doesn't acknowledge how hard it is to deal with something as socially and politically threatening as urine or feces during sex.

If you want to change your own way of dealing with these issues and help partners do the same, you need to try and take care of yourself in general -- emotionally, psychologically and physically. This could mean being with friends or family, doing things that bring you pleasure alone and with others, or anything else. The important thing is to remember to give yourself plenty of breaks and appreciate the very tough work you're doing challenging so many of society's restrictions.

Expand What You Mean by Sex

Most of the time when people talk about sex, they mean intercourse. If intercourse is the only kind of sex you think there is, then bowel and bladder control will always be the same issue when you're having sex. But sex is more than intercourse, and some sexual activities will come with less pressure around bowel and bladder control.

There are, for example, all sorts of ways of having sex with your clothes on, if that's something that will let you feel more comfortable and enjoy sex more. There are ways of having sex that involves more or less direct contact with each other's genitals (using sex toys, for example).

None of this means you necessarily have to drop intercourse from your sexual options, but one of the great obstacles to enjoying sex is the relatively limited kinds of sex we allow ourselves to explore.

Experiment With Sex Positions

Regardless of the kind of sex you're having, exploring different sex positions can change the chances of losing control of your bladder or bowel. For example, sex positions that put pressure on the abdomen can increase pressure on the bladder. An alternative would be to be on your side, or on top.

If you're concerned about losing bowel or bladder control during oral sex, experiment with a position where your partner feels most comfortable. The idea is to open up new options, and remember that there aren't just two or three acceptable sex positions; a great sex position is one that lets you do what you want.

Make Time for Sex

We all plan for sex. Whether we plan five minutes or five days in advance, the idea that sex just happens spontaneously belongs to the fantasy of pornography and Hollywood movies. It can feel like a drag and "unromantic" to schedule sex, but if sex is important to you, it might be part of what you need to do in order to enjoy it. Also, it's a compliment to tell your partner you want to have sex so badly you're willing to schedule it!

You can time sex, and you can also time your bowel and bladder routine. If you don't just have occasional or temporary loss of bowel or bladder control, you probably already have a bowel and bladder routine schedule for yourself. Scheduling sex for when you have an empty bladder and empty bowel is obviously one way to reduce urine and feces during sex. You can also catheterize before sex and keep a catheter in during sex; you just need to keep it out of the way.

Avoid Certain Drinks

In general, trying to have an empty bladder will reduce the chances of urine leaking during sex play. In particular, avoid alcohol, coffee, and other caffeine-containing drinks prior to having sex. They are diuretics, so your bladder will fill up more quickly if you're drinking them.

Get Wet on Purpose

We're taught that there are only a few kinds of fluids to expect during sex (maybe some sweat, male ejaculate if there's a man in the picture, occasionally a few tears of joy, etc.) But real sex is always messy to some extent. Our bodies are full of liquids, and when we really let go, those liquids want to come out.

One way to deal with this is to put yourself in a situation where fluids are less of a big deal. Having to deal with some feces on your partner's beautiful duvet cover is understandably stressful. Getting down in the bathroom and bathtub is a way of keeping everything wet, and making clean-up a lot simpler. It's what drains were made for! Have towels and sheets at the ready.

Speaking of duvet covers, you can also make sure to have towels handy when you're having sex away from convenient drains. You can protect your mattress with plastic sheets, which are inexpensive, and there are also rubber sheets, which cost more but make less noise.