Pelvic floor disorders are common in women, and they can put a damper on sex. Some examples of pelvic floor disorders include urinary incontinence (leaking urine), fecal incontinence (leaking stool), and pelvic organ prolapse (when a pelvic organ like the bladder, uterus, or rectum falls out of its normal position and drops down into the vagina).

Pregnancy, childbirth, menopause, frequent constipation, and obesity can all contribute to the development of a pelvic floor disorder, but many of these conditions can be improved through treatment. Nevertheless, for women who are not ready for or able to seek treatment for their pelvic floor disorder, the following are some ways to make sex more comfortable and enjoyable.

If you have incontinence:

• Talk about your condition with your sexual partner. If you have concerns about leaking urine or stool during sex, having a conversation about it with your partner beforehand may alleviate some of the stress you are feeling and allow you and your partner to come up with solutions together.
• Make sure to completely empty your bladder or bowel before anticipated sexual activity.
• Limit your fluid intake several hours before having sex to reduce the risk of leaking during sexual activity.
• Consider having sex in the bathtub or shower to mask any leaks that may occur (if the option of having sex in the bathtub or shower works for you and your partner).
• If you have bowel leaks, consider rinsing the rectum with water (anal douching) before sexual activity.
• Try to avoid sexual positions that put pressure on the bladder such as missionary. Instead, elevate your pelvis with the help of pillows while lying on your back. This will help to reduce bladder friction and reduce the risk of leakage.
• Relax your body through deep breathing and mindfulness exercises before having sex. This can help you to stay present and enjoy the experience, rather than feel anxious about it.

If you have pelvic organ prolapse:

• Have an honest conversation with your sexual partner about your condition. This may relieve some of the stress you may feel related to engaging sexual activity with pelvic organ prolapse.
• Know that having sex will not make your condition worse. If anything, having sex may improve your symptoms since it can help strengthen your pelvic floor muscles.
• Avoid upright sexual positions such as standing, “cowgirl,” and “reverse cowgirl,” because gravity will make your prolapse more prominent. Try modified missionary (lying on your back with your lower back supported by a pillow), “doggy style,” or lying on your stomach for a better experience.
• Practice mindfulness and other relaxation techniques to continue to find enjoyment in your sexual experiences.

References:

• Dubinskaya, A., & Eilber, K. (2020, December 3). As If You Need Another Reason to Avoid Sex. https://www.glissantlove.com/post/as-if-you-need-another-reason-to-avoid-sex
  
  
• National Association for Continence. (n.d.). Fecal Incontinence in the Bedroom. Retrieved June 13, 2023, from https://nafc.org/bhealth-blog/fecal-incontinence-in-the-bedroom/
  
  
• National Association for Continence. (n.d.). The Best Sex Positions If You Have Incontinence or Pelvic Organ Prolapse. Retrieved June 13, 2023, from https://nafc.org/bhealth-blog/the-best-sex-positions-if-you-have-incontinence-or-pelvic-organ-prolapse/
  
  
• National Association for Continence. (n.d.). Tips to Keep Incontinence from Interfering With Your Sex Life. Retrieved June 13, 2023, from https://nafc.org/bhealth-blog/tips-to-keep-incontinence-from-interfering-with-your-sex-life/
  
  
• (2017, December 20). Comfortable Sex Positions for Women with Pelvic Floor Disorders. https://www.pericoach.com/2017/12/20/comfortable-sex-positions-for-women-with-pelvic-floor-disorders/