5 Urinary Issues that Can Interfere with a Woman’s Sex Life

By: Nicole Szell, D.O.

Love may be blind, but when urinary issues get in the way of sex, it can be blindsiding.

This is the case with four in 10 women experience sexual problems at some point in their lives, thanks in part to urinary infections, pelvic inflammation, and muscle weakness. This includes 40% of the nearly 6.4 million adult women who live in Florida.

The sexual side effects of these conditions are blindsiding because many are just so sudden, such as an abrupt drop in sexual arousal or physical pain during intercourse. Many women take these symptoms personally, as if they are at fault. As a result, a lot of women become embarrassed to talk about it.

Yet like many unexpected events in our lives, the conditions behind these symptoms are common, natural, and often unavoidable. And they can be treated in a variety of ways.

Linking Urinary Wellness with Sexual Health

There are overall health reasons for women to enjoy an active sex life. Sex can reduce stress, improve sleep, and lower blood pressure. Women with active sex lives are less likely to have heart attacks, research suggests. Women with active sex lives later on in their “golden years” also usually live longer.

But when urinary wellness suffers, so can your sex life. Following are some of the urinary-sexual issues we treat for women:

Vaginal pain ­– Characterized by a chronic ache, itching, and burning, vaginal pain can result from nerve damage, an overreaction to yeast or inflammation, or muscle spasms. (Broader pelvic pain, meanwhile, can be brought on by fibroids or endometriosis.) Treatments typically start with pelvic-muscle exercises (Kegels) and medications, including nerve blockers. If the condition does not respond to these options, our team of urologists can perform reconstructive surgery.

Painful intercourse – Vaginal dryness is usually caused by a lack of the female hormone estrogen, which is commonly associated with genitourinary syndrome of menopause. However, some medications and breastfeeding can contribute to dryness as well. It can make intercourse painful, even producing blood with sexual activity. You can approach treatment by regularly applying lubricant or through regular use of maintenance vaginal estrogen therapy. If these options do not provide relief, ask your doctor about outpatient laser procedures that resurface the vaginal endothelium.

Interstitial cystitis (IC) ­– Also called painful bladder syndrome, IC describes symptoms that occur when the bladder lining breaks down. The pain can feel like a urinary tract infection, and women are 10 times more likely than men to develop IC. Your prescribed treatments will depend on the symptoms and can include Kegel exercises, bladder training, medications, nerve stimulation to block the pain, or even procedures that help to re-surface the lining of the bladder. This procedure is known as “hydrodistension” and is performed by our expert team of urologists.

Pelvic organ prolapse ­– When your pelvic muscles weaken due to childbirth, strain, or post-menopausal hormone changes, the body parts they hold in place can drop through the vagina. Nearly half of all women develop pelvic prolapse, which can cause vaginal numbness and pressure. Non-surgical approaches include Kegels and small silicone devices (pessaries) that hold the organs in place. More advanced cases could be treated with reconstructive surgery or a hysterectomy.

Urinary incontinence ­– Bladder problems can weaken your ability to control urine leaks, which can be a mood killer when it comes to sex, let alone achieving orgasm. We can determine the kind of incontinence to treat with a simple physical exam. Stress incontinence – when urine leaks during pressure-related activities – can be treated with Kegels, bladder training, pessaries, or a medication to strengthen the urethra. Urge incontinence – the hard-to-control need to urinate – can be treated with medications that calm bladder muscles, including Botox.

Don’t Feel Awkward About Good Health

If you’re experiencing a change in sexual enjoyment, it’s likely due to another health issue that you can seize control of. Talk about it with your partner, friends, and your doctor. You might just love the results.

The staff at Advanced Urology Institute are your partners in good overall health. You can read about all the women’s health conditions we treat, with symptoms and treatment options, on our website.

By: Nicole Szell, D.O.

Remember when being accident-prone meant you had a knack for tripping on uneven sidewalks? If you’re among the more than 33 million U.S. men and women living with overactive bladder (OAB) today, then accident-prone has taken on a potentially more awkward meaning.

OAB, a common condition characterized by the sudden and frequent urge to urinate, affects an estimated 40% of women and 30% of men. Yet many of them never seek a doctor’s help. Instead, they try to cope with OAB symptoms because they’re embarrassed, aren’t aware of available treatments, or just don’t know how to bring the issue up.

But we do know how to bring it up. OAB and incontinence are so common, in fact, that our urologists talk about it every day.

Why Your Bladder Becomes ‘Overactive’

OAB is a condition in which the bladder squeezes out urine at the wrong time; typically before it is full. While this issue becomes more common with age, OAB also can be brought on by illness or changes to your urinary system. Among them:

• Obstructions including bladder stones, tumors, constipation, or (in men) an enlarged prostate
• Hormonal changes from menopause (in women)
• Chronic, recurrent UTIs
• Pelvic floor dysfunction
• Diabetes
• Misfires by the nerves that control bladder muscles
• Neurological disorders including Parkinson’s disease, multiple sclerosis, or stroke

Getting Ahead of OAB: Your Treatment Options

The most common symptoms of OAB include needing to urinate more than every two hours, urine leaks (incontinence), and waking up more than twice a night to urinate. If you experience these symptoms, your doctor can help, starting with a physical exam and urinalysis to screen for OAB. Other possible tests include going to the bathroom to determine how much your bladder empties or to assess the strength of your urine stream.

If your symptoms require it, your doctor might also perform one of the following tests:

Cystoscopy – Examining the inside of the urinary tract using a slender, camera-equipped scope.

Urodynamics – Gauging bladder pressure using two scopes, in the urethra and the rectum.

Your Step-By-Step Therapy Options

Depending on the diagnosis, your doctor will likely advise non-invasive therapies first, such as:

• Liquid and diet restrictions –Reducing caffeine, alcohol, and artificial sweeteners (bladder irritants); keeping a healthy weight; and avoiding liquids two to three hours before sleeping.
• Kegels – Performing pelvic-strengthening exercises daily and at regular intervals.
• Bladder training – Holding off on going to the bathroom for as long as you can, then gradually extending the waits.
• Pelvic floor physical therapy – Performing physical therapy exercises to strengthen and tighten the pelvic muscles.
• Biofeedback – While sitting in a comfortable chair (fully clothed), two sensors are used to measure the activity of the muscles that control bladder functions. This technique is used to help train patients on how to properly perform pelvic floor therapy.
• EMSELLA Chair – Patients sit in a comfortable chair-like device (fully clothed) that uses high-intensity focused electromagnetic energy to strengthen the pelvic floor muscles.

If you do not respond to the above therapies, the doctor might suggest the following.

Medications

• Oral prescriptions – Muscle-relaxing drugs can ease involuntary bladder contractions.
• Botox – When injected into the bladder, Botox has proven effective in relaxing the bladder. Often, Botox is advised in cases where the patient does not respond to oral medications.
• Estrogen replacement therapy (for menopausal women) – Reintroducing hormones to strengthen genital tissue.

Nerve Stimulation

• Sacralneuromodulation – Think of this approach as the “pacemaker for the bladder.” The doctor implants a thin wire equipped with an electrode under the skin by the sacral nerve, which controls the bladder. The electrode delivers pulses to the nerve.
• Tibial nerve stimulation – Here, electric pulses stimulate the sacral nerve via the tibial nerve, near your ankle. Rather than an implant, the electrode is delivered through a needle, usually over 12 weekly sessions.

You Can Make Accidents a Memory

Your first step to skipping urgent bathroom runs can start now. Keep a “bladder diary” to record your symptoms, how often they occur, and the activities that cause leakage. Then share it with your AUI doctor. Together, we will find a solution.

Don’t spend another night with OAB on your mind. Explore our OAB treatments and a video that explains our surgical options.

There’s good reason Florida counted 300,000 new residents in 2023. With 237 sunny days a year and consistently warm temperatures, we have an ideal playground all year long. But those sunny days can also contribute to one of the most common causes of kidney stones: dehydration.