Almost 1 in 3 women would experience urinary leakage in adulthood. Incontinence is a handicap that compromises many aspects of life, including sexuality. How to talk about it with your partner? How to face the difficulties as a couple?

What are the pathophysiological aspects of incontinence that interfere with sexuality? (Experiment in men and women)

Incontinence can be linked to different factors.

It can be linked to an overactive bladder, that is to say one which reacts too strongly. It may be due to muscle failure of closing the bladder. It may be related to an obstacle that prevents the bladder from emptying properly (such as when the prostate is too big), causing the bladder to struggle to empty and this eventually leads to incontinence. This can also be due to the drop in natural hormones at the time of menopause, or even to drugs.

Urinary incontinence can still be present due to neurological disease because the nerves that allow the bladder to relax, fill or empty when needed do not work well.

And then for every person with incontinence, there can be several causes involved.

Besides the causes, there are contributing factors: overweight, chronic constipation, excessive consumption of fluids, very intensive physical activity …

What therapeutic management of these aspects can be proposed to promote “normal” sexuality?

The management of incontinence is linked to its cause (s).

It may be drug treatment (overactive bladder, prostate adenoma, menopause), perineal rehabilitation, surgery or a change in drug treatment involved in incontinence.

The main thing is to have a good balance sheet to understand exactly what is at the origin of this incontinence in order to treat it in the best possible way, and therefore the most effective.

What psychological or emotional difficulties do women experience with incontinence? What about the men?

The difficulty with incontinence is the fear that those around you will notice this problem. Also some people tend not to leave their homes for fear of not finding a toilet on time or of having a leak. And even with effective protection, they can be afraid of odors.

You really have to learn to differentiate the often exaggerated fear and the reality, because the reality is that in 99,9% of cases, no one other than the person concerned realizes that this concern exists.

Other people have no fear of those around them, but just feel uncomfortable with this problem. They would sometimes have to talk to a shrink to reduce this discomfort and continue to live normally… in addition to treating the problem of course!

How can these psychological and emotional aspects affect their relationship?

The partner is the closest person, and therefore the one against whom it is most difficult to hide this incontinence problem. The psychological aspects that can affect the couple relationship are:

– The fear of no longer being desirable. Indeed, when you suffer from incontinence, you may be afraid to put off the other. And feeling desirable is essential in order to experience desire yourself.

– The feeling of being put off by incontinence. If you have this incontinence problem in mind, it can actually block attraction to others. You are afraid of smelling the smell, of getting wet… But it is quite rare in reality!

– Fear of urinating during intercourse. It is an extremely common fear that in women often blocks access to orgasm and in men can lead to avoidance of sexual intercourse.

– And then, the spacing of intercourse can occur because of these fears on one side or the other.

What advice do you give to couples in difficulty because of the incontinence of one of the partners?

The main thing is to seek effective treatment. Incontinence is a common problem and there are solutions depending on the cause of the incontinence. You must not sit back and do nothing with this problem, which can ruin your life as a couple and your life.

We know that many affected people do not dare to talk to their doctor and allow this difficulty to deteriorate for a long time. It’s a real shame because for a doctor it’s a trivial problem in fact!

How to talk to your partner about incontinence?

If you hesitate to talk about it, you don’t necessarily have to force yourself! The main thing is to take care of yourself to treat urinary incontinence and get better.

In a relationship, it is essential to preserve the magic of sexual attraction. If one feels that the other may be bothered or blocked by urinary problems, it may be better to take care of them alone. Not everything is necessarily good to share as a couple.

That said, when the problem becomes very blocking, we can talk about it by simply saying that we have urinary system problems during treatment and that it should improve, and that is because of this that sex is more difficult these days.

It is important to say something to another if you tend to fear or avoid sex. This prevents the partner from feeling rejected for a difficulty that has nothing to do with him (or her) or the quality of the relationship.

If incontinence causes a relationship problem in the couple, it can be very positive to see a couple therapist, or even a sex therapist if this problem causes sexual difficulties.