Urinary incontinence can be embarrassing — from a minor leak while sneezing, laughing, coughing or exercising to more frequent episodes that interfere with the quality of life.
Contrary to the common belief that such loss of bladder control affects only elderly women, some studies show that a significant number of young and middle-aged women (including post-menopausal women) also face the problem.
While an array of treatments (such as medication and pelvic-strengthening exercises) is available for urinary incontinence, some experts say sexual intercourse too is effective in such cases.
“Sex can reduce urinary incontinence as its basic movements are similar to pelvic floor strengthening exercises like in Kegel exercises,” says Dr Prashanth Ganesh, urologist and andrologist, Apollo Hospitals, Bangalore.
How does sex reduce urinary continence?
Explaining the strengthening mechanism of the pelvic muscles, Dr Ganesh says that for toning, the pelvic floor muscles require contraction and relaxation without straining the abdomen — and sex does just that, though unknowingly. The pelvic floor is tightened throughout the pre-orgasm phase of sex, and orgasm occurs when the pelvic floor relaxes after that phase. When the muscles get toned, they hold the uterus, bladder and rectum firmly, and consequently reduce incontinence.
A 2015 study also indicates a positive association between pelvic floor strength and sexual activity. It compared the strength and tone of pelvic floors of sexually and non-sexually active women. Women who claimed they did not engage in sexual activity had weaker pelvic floor strength than those who did engage in sexual activity.
Childbirth is a common cause of urinary incontinence in women due to weakened pelvic floor muscles. According to a 2022 study, postpartum pelvic floor muscle strength in women who have undergone uncomplicated vaginal deliveries can be significantly improved with the addition of sexually induced orgasm as a therapeutic tool along with physical exercises such as Kegels.
Role of pelvic floor muscles in urinary incontinence
According to the Continence Foundation of Australia, the pelvis floor is made up of layers of muscle and other tissue. These layers stretch like a hammock from the pubic bone at the front to the tailbone at the back, and from one sitting bone to the other (side to side).
These muscles work with the stomach, back muscles and the diaphragm (breathing muscle) to support the spine and the pelvic organs (bladder, bowel and uterus) to control the pressure inside the abdomen. When you contract the pelvic floor muscles, they lift the pelvic organs and tighten the openings of the vagina, anus and urethra. Relaxing the pelvic floor allows the passage of urine and feces.
When weakened, the pelvic floor muscles can create problems with bladder and bowel control, leading to incontinence.
Sex vs Kegel exercises
There are many pelvic-strengthening exercises, but they must be done the right way — and preferably under expert supervision. The next best option is Kegel exercises which involve contracting and relaxing the pelvic floor muscles. These primarily target the pubococcygeus muscles, which are crucial in bladder and bowel control. Moreover, they can be done anytime and anywhere without disrupting daily tasks. But are Kegels enough?
In 2022, researchers from TSS Shripad Hegde Kadave Institute of Medical Sciences, Sirsi, Karnataka, said that sex along with Kegel exercises can help the pelvic muscles recover better when compared to Kegels alone. For its research, the team advised participants — all of them first-time mothers — in one group to do Kegels daily. Those in the other group were advised to initiate self-initiated or partnered sexual activity-induced orgasms, alongside participating in traditional Kegel exercises.
Women in the second group were found to have stronger pelvic floor muscles and better sex lives.
Too much sex doesn’t loosen pelvic muscles
Dr Mala Sripad, an Ahmedabad-based gynaecologist, says while Kegel exercises can get monotonous, the pleasure associated with sex can contribute to reduced stress and improved mental health, which may indirectly benefit pelvic muscle function.
“There is a misconception that too much sexual activity weakens pelvic muscles,” she adds. But it should be noted that overuse or strain without sufficient recovery can lead to muscle fatigue.
“This is a rule that applies to all muscles in the body, not just those in the pelvic floor,” Dr Sripad says, advising anyone experiencing pain or discomfort to consult a healthcare professional.
Takeaways
- Sex reduces urinary incontinence by strengthening the pelvic floor muscles, according to some studies.
- Kegel exercises by themselves are not too effective in building pelvic floor muscle health.
- Too much sexual activity doesn’t loosen the pelvic muscles.
