The Impact Of Urinary Incontinence and Urgency on Women’s And Their Partners Sex Lives

This Swedish study focused on 99 sexually active couples and aimed to assess the impact of female UI and urgency on women’s and their partner’s sexual life and to elucidate the concordance of answers within couples. Women aged 18 to 74 with urinary incontinence (UI) and or urgency were recruited from four outpatient clinics. All women who had a partner relationship were asked to complete a specific semi-structured questionnaire regarding psychosocial function, partner relationship and sexuality. In addition they were asked to distribute a similar questionnaire and a return envelope to their partners.

The questionnaire about sexuality included sexual desire, vaginal lubrication, painful intercourse, and incontinence during sexual activity and overall satisfaction with the partner relationship and sexual life. The majority of the men (92%) and women (90%) considered sexuality to be rather or very important in their lives. Both 21% of men and women were unsatisfied with their sexual life; however the great majority, 95% was satisfied with their partner relationship.  Regarding the women’s urinary problems, 81% of the men and 72% of the women answered that they had an open communication.

Concerning their sexual life, 75% of the men and 64% of the women communicated openly.  The men significantly more often felt sexual desire than women: 22% of the men and 43% of the women stated that the woman’s urinary problems impaired their sexual life. These negative effects were illustrated by the following quotations from seven men and eight women.

Men:

  • She does not feel at ease with herself due to problems with her bladder. This affects me too, of course.
  • She has to go to the toilet just before intercourse.
  • My partner suffers from the problems with her bladder. This leads to reduced desire.
  • She does not have desire as often as before.
  • Sometimes she lacks desire or has to do a wee-wee. She cannot really relax and enjoy.
  • She does not feel clean.
  • Unfortunately my wife does not regard herself as attractive as before.

Women:

  • I seldom feel fresh and I am anxious of the smell of urine. I do not feel attractive.
  • I am disgusted, not fresh.
  • I feel dirty, and uneasy, disgusting.
  • It is hard to enjoy and relax due to the worry about leaking urine.
  • Some positions are out of the question. I find it heard to let myself go, worrying about leakage.
  • A sex-life poorly functioning, I never dare to relax because then I leak. We have to interrupt because I must go to the toilet and yet I leak.
  • The leakage is small but creates uncertainty and a feeling of not being fresh.
  • I cannot manage to have intercourse because I get disgusted by the smell of urine that occurs at once. I feel worthless as a person because I leak.

Regarding orgasm ability, 6% of the men and 14% of the women thought that it had decreased due to the women’s urinary problems. Twenty two percent of the men and 27% of the women reported the woman had difficulty reaching orgasm. Forty nine percent of the women were worried about leaking urine during sexual activity. However, 94% of their partners did not share their woman’s anxiety.

Women with mixed urinary incontinence were significantly more often worried about leaking during sexual activity than women with SUI and/or UUI. Twenty three percent of the men and 39% of the women reported the woman in fact leaked urine during sexual activity. This leakage was considered a problem to some degree for 84% of the women and for 35% of the men.

Female urinary leakage during sexual activity was reported by both men and women to happen most commonly during penetration and/or orgasm. In 61 of the couples, both the mates expressed that had no need for information or advice concerning sexual issues related to the woman’s urinary disorder. However this need was warranted by at least one mate in 22 couples and 13 couples were uncertain.

For patients where treatments for UI and urgency symptoms require a regime with behavioral changes, training programs, and sometimes life-time medication, it can be assumed that involving partners in the management would be helpful.

As reported in the Journal of Neurourology and Urodynamics.

Tamanini JTN, Santos JLF, Lebrao ML, Duarte YAO, and Laurenti R.

Impact of Female Urinary Incontinence and Urgency on Women’s and Their Partners’ Sexual Life. N & U 30: 1276-1280 (2011).