By Josey Vogels

As a sex columnist, I find people I’ve just met often tell me things perfect strangers probably have no right knowing. Like “Maria,” who recently confided that she’s so afraid of losing control of her bladder that she no longer enjoys sex with her husband. Now, I know some folks are into water sports (and I’m not talking white water rafting), but I think it’s safe to say most of us don’t enjoy peeing during sex.

Unfortunately, for women like Maria who suffer from a condition known as “urge incontinence,” peeing is not optional. When she’s gotta go, she’s really gotta go.

“There are usually no warning signs,” says Kelli Berzuk a physiotherapist specializing in incontinence and pelvic pain and author of I Laughed So Hard I Peed My Pants: A Women’s Essential Guide for Improved Bladder Control. “Women suffering from urgency feel an intense pressure and a need to void immediately. This can happen anywhere and at any time.”

Which can be a tad embarrassing. But that’s the problem, say Berzuk. Despite the fact that it’s estimated that half the female population will at some point experience some form of incontinence (according to the Mayo Clinic), leaky bladders aren’t exactly considered appropriate cocktail party discussion material. And not all of us have a sex columnist handy to chat with about it.

There is, however, plenty that we gals can do before things get really bad.

First step: Admit you have a problem. “Many women don’t have a clue that they qualify as being incontinent,” says Berzuk. “If we learn to look for warning signs, we can do something about it.”

Like ease up on the Diet Coke. “Caffeine, artificial sweeteners and carbonated beverages can irritate the bladder lining, and over time, cause urgency,” explains Berzuk.

Smoking and alcohol can also contribute to bladder dysfunction and incontinence, whether that’s leaking when you sneeze or laugh, or having to go to the bathroom a zillion times a day.

But be warned, holding off on liquids so you won’t have to go as often may actually worsen the problem. Besides, holding your pee too long stresses out your bladder. Having said that, going too often -- more than, say eight or nine times a day -- could signal an already irritated bladder. A woman with a healthy bladder should pee between five and nine times in a day and up to one time at night, says Berzuk.

And while you may pride yourself on your balancing skills as you hover precariously over a less-than-pristine public toilet seat, your bladder is literally bearing the brunt.

“Healthy bladder function is all about the relationship between the pelvic floor muscle and the bladder muscle,” explains Berzuk. “When you relax your pelvic floor muscle, it sends a message to your bladder muscle to contract and empty. If you’re hovering, your legs are contracting and your abdomen is contracting, so the pelvic floor muscle isn’t relaxed and you’re pushing the urine out. “Voiding should be a passive event, it should never be forced.” 

So, next time, cover the seat with toilet paper if you must.

You also wanna whip those pelvic muscles into shape through Kegel exercises (squeezing like you’re stopping the flow of urine). Just make sure you’re doing them right. Berzuk says at least one major study showed that over half of women do their Kegels incorrectly. “Some women actually worsen incontinence problems by bearing down rather than pulling the muscle up and in,” she says.

Strong pelvic floor muscles can also help stop pee leakage during sex. (FYI, female ejaculation and urine loss are two different things so make sure you’re not thinking you’ve peed the bed when you’ve actually just enjoyed a healthy G-spot orgasm. The main clue: pee is yellow and can smell, while ejaculate is clear and odourless.) Certain sexual positions may help if incontinence is a problem, says Berzuk. “Lying down is better,” she says. “If you’re standing or sitting, gravity is pushing the pelvic organs downward, and putting pressure on your pelvic floor muscles. Deep thrusting can also trigger bladder muscle spasm.”

But, she stresses, every woman’s anatomy is different and it’s best to try various positions to see what works best for you.

While it’s certainly true that pregnancy and childbirth also put added pressure on the bladder and pelvic muscles, you’re not automatically sentenced to incontinence.

“[It’s best] to strengthen your pelvic floor muscles before you get pregnant,” Berzuk says. “That way, you’ll know how to find that muscle and gingerly work it even when everything feels throbby, bruised, and mushy down there after childbirth.” What fun. Combine worrying about spending our adult life in diapers with long bathroom line-ups and an inability to write our names in the snow, and it’s clear women get a raw deal in the pee department.

Luckily, female incontinence is treatable. “Ours is caused by muscle neglect, hormonal changes, weight gain, and so on, while men usually become incontinent as a result of nerve damage caused by prostate enlargement or prostate surgery,” explains Berzuk. Speaking of surgery, Berzuk advises women who are considering a “bladder lift” to practice good peeing habits and keep those muscles strong. “You’ll stand a much better chance of it succeeding,” she offers.

While it’s time to admit that bladder control problems aren’t reserved for old gals or those of us who’ve popped out a bunch of kids (“We’re seeing this now in teenage girls involved in high-impact sports”), we don’t have to accept it as part of life as a woman.

“It’s important to address the problem rather than the symptoms,” says Berzuk. “If we were able to talk about it more easily with other women, we could recognize the signs early on when we can still do something about it.”

So, ladies, next time you’re at a party and see a woman drinking a Diet Coke and crossing her legs when she sneezes, strike up a conversation. Tell her about this great book you’ve been reading about pee.

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