Mar 27, 2023

Sex and incontinence: why your sex life doesn’t have to end

27_3_23 incontinence HC

There’s a common misconception that older people are not sexually active, however, there are some factors that contribute to lower rates of intimacy among the demographic, like incontinence. 

For older people living with incontinence, anxiety and embarrassment are typical side effects that bleed into both everyday activities as well as those that happen in the bedroom. 

Fear of wetting themselves during any sort of sexual activity with an intimate partner is something many older people stress about and it often sees them retract from having a healthy sex life. 

Society has a part to play too – as the topic is often laughed at or not discussed at all which causes many older people to shy away from the conversation with intimate partners, family and friends.

Despite the stigma, having incontinence isn’t something to be ashamed of, and it certainly doesn’t mean you have to put off having sex. 

Consultant, Sonya Meyer, works with continence maintenance company, Confidence Club, and spoke with HelloCare about how older people can stay sexually active while living with incontinence. 

So what can you do?

The key is communication

Like most difficult or awkward conversations, they shouldn’t be avoided. 

Ms Meyer said talking about your fears and anxieties is the key to managing anxiety around the subject and it also allows your partner to understand your point of view. 

“Sexuality starts with a positive mindset and being comfortable in your own skin,” she explained.  

“Basically, just bring it up and be honest and open.” 

A healthy sexual partner should be able to have these conversations with you and they should never make you feel upset or uncomfortable about your condition. 

Talking about sex isn’t always easy for anyone, but it is something you can practice at a slow pace until you grow more comfortable and confident.

Creating ‘the mood’

Nothing kills the mood more than anxiety and ‘doing the deed’ may not be on your mind if you are hyper-focused and worried about incontinence.

Ms Meyer said investing time in setting the mood and establishing or “diarising” a time for having sex can help you and your partner prioritise intimacy and alleviate anxiety.

She suggested simple things like wearing something that makes you feel good or swooning each other during a romantic date beforehand to help get yourself in the mood. 

“Making yourself feel desirable is a good thing to help you feel good about yourself and help set the mood,” Ms Meyer said.

“Diarise this if you have to so you have a dedicated time for being intimate.” 

Taking care of the physical elements

Both before and after sex, there are preparation steps you can take to help alleviate worry and make sex more enjoyable.

Beforehand, Ms Meyer recommended emptying your bladder before sex, washing, putting down a sheet and having some towels close by to help put your mind at ease.

“Washing yourselves can even be a part of foreplay.”

During sex, there are positions that you can use to help lift pressure from the bladder. 

According to America’s National Association for Continence, you should avoid ‘missionary’ and ‘doggy-style’ positions. Instead, try a sideways or ‘modified missionary’ position with pillows under your lower back which reposition the bladder and help reduce the chance of leaking.

Strengthening your pelvic floor

When we talk about our pelvic floor and pelvic floor exercises – or Kegel exercises – we often only hear of women doing them. But in reality, a strong pelvic floor is vital for all to help manage and curb the effects of incontinence.

The pelvic floor is a sling-like muscle that stretches from the back to the front of our bodies and holds all of our pelvic organs like our bladder.

Like our other muscles, the pelvic floor weakens, stretches and loses its tone as we age – contributing to incontinence issues in all genders. 

A weakened pelvic floor is often exacerbated by pregnancy and childbirth but it also holds a man’s prostate, a gland that enlarges in almost all men as they get older and further stretches the pelvic floor.

“Pelvic floor exercises for both men and women can help control the loss of urine and can also help with orgasm,” Ms Meyer said.

“It doesn’t matter what age or gender, we should all still be doing our pelvic floor exercises.”

How do you do pelvic floor exercises?

Generally, they are where you squeeze and lift your pelvic floor muscles to tighten and strengthen them.

Pelvic Floor First – affiliated with the Continence Foundation of Australia – outlines pelvic floor exercises for both the male and female anatomy but you should consult a continence or pelvic floor physiotherapist for tailored exercises to meet your specific needs.

For more information about sex and incontinence, visit the Continence Foundation of Australia’s website or you can call the Australian National Continence Helpline on 1800 33 00 66 for a confidential discussion with a Nurse Continence Specialist.

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