Published: May 7, 2024

Urinary-Related Sexual Issues: Symptoms and Treatments for Women

By: Melissa Fischer, M.D.

Many people believe that as women mature, they don’t enjoy sex as much as men. This is a myth. The fact is many women of all ages want to enjoy sex even more. But sometimes, urinary health issues can get in the way.

Yes, there’s a correlation between intimacy and a woman’s urinary system. Infections, hormone imbalances, pelvic muscle weakness, and inflammation are common sexual interlopers. Researchers estimate that four in 10 women experience sexual problems at some point in their lives, thanks in part to these urinary issues.

Still, many women are unnerved by the symptoms because they can present so suddenly. You might abruptly experience a drop in your ability to become aroused, for example. Or experience vaginal discomfort – an estimated 40% of all women report pain during sex at some point.

These symptoms can surprise you, but they are natural – and treatable. It starts with opening up about it.

Why Your Urinary System Affects Sexual Enjoyment

Research links sexual activity with factors of overall good health, including reduced stress and improved sleep. For example, women with rewarding sex lives are less likely to have heart attacks, studies suggest.

Sexual wellness also contributes to urinary wellness. These are among the most common issues we treat that interfere with a woman’s sex life:

Painful intercourse ­– Many women believe that vaginal discomfort can be resolved simply with lubrication. This can be true, but other issues, including an infection, inflamed pelvis, lack of estrogen – even breastfeeding – can cause painful intercourse. Injectable lubricants and/or topical estrogen therapy can ease the symptoms. If the pain stems from menopausal vaginal atrophy and other options don’t provide relief, an outpatient laser therapy called MonaLisa Touch could provide relief by stimulating collagen production.

Pelvic organ prolapse ­– Childbirth is a key contributor to pelvic prolapse, when the bladder, uterus, or other organs slip through the vagina due to weak muscles. Nearly half of all women develop this condition, which can present numbness and pressure. Prolapse can be treated non-surgically through estrogen replacement therapy, pelvic-muscle exercises (Kegels), or small pessary devices that provide support when inserted into the vagina. For harder-to-treat cases, a surgical procedure can pull the vagina into position with the support of your own tissue or a synthetic mesh.

Interstitial cystitis (IC) ­– This confounding condition, also called painful bladder syndrome, occurs when the lining of the bladder breaks down and irritating urinary chemicals seep out. The pain is similar to that of a urinary tract infection. Women are 10 times more likely than men to develop IC, and it often strikes between the ages of 20 and 40. Typically, therapies address the symptoms. These include Kegels, oral medications, injected medications including Botox, and overextending the bladder (while you’re under anesthesia).

Urinary incontinence ­– Involuntary urine leaks can diminish sexual desire and make orgasm difficult due to the fear of having an accident. Your treatment depends on the type of incontinence: Stress, when urine leaks during pressure-related activities; urge, a hard-to-control need to urinate; or overflow, when the bladder doesn’t entirely empty. Care options can start with Kegels, bladder training, and/or pessaries. Depending on your progress, your doctor might prescribe a medication that strengthens the urethra or surgery to place a sling-like support beneath the urethra.

Certain medications – Some urinary drugs, like those prescribed for overactive bladder, can trigger sexual performance issues soon after you start or stop taking them. Other medications that can interfere with sex include those that treat high blood pressure, asthma, hormone imbalances, and depression.

It’s Time to Embrace a Healthy Sex Life. Let’s Talk

If you want to enjoy sex even more, we encourage you to open up about it. The urinary correlation is a medical issue that we talk about with our patients every day.

Diminished sexual desire is a reality, but it’s a myth to think it’s your fault.

You don’t have to live with sexual problems or go through them alone. Contact a physician at one of our 15 Southeast Michigan locations and start your whole health path to happiness.

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