We all want a satisfying sex life. But sometimes, medical conditions can get in the way of that. If you struggle with incontinence or pelvic organ prolapse, sex can often be a source of great anxiety. Fear of leakage, odors, or even pain can sabotage intimacy and leave you feeling undesirable or anxious when it comes to intercourse. There are many things you can do to prevent incontinence and pelvic organ prolapse from interfering with your sex life. However one of the simplest things you might try changing is your sexual position.
Your sexual position can make big difference when it comes to easing anxiety about leakage or pain and enjoying sex. Certain positions can put lots of pressure on the bladder, making it more likely that you may have an episode of stress incontinence. And if you have pelvic organ prolapse, some positions may feel more uncomfortable than others. Here are a few sexual positions you may want to try, depending on your condition.
Sex Positions If You Suffer From Bladder Leakage:
Just as you may experience bladder leakage when you sneeze, laugh, or workout, putting extra pressure on your bladder or urethra during sex can also cause incontinent episodes. This shouldn’t hinder your sex life. While it may make you feel anxious, there are ways to avoid bladder leaks during intercourse. Women who are concerned about leakage during sex should avoid positions that put extra pressure on these areas.
Avoid: The missionary position, or all fours.
Try: Lying on your back with some pillows underneath your lower back. This position raises your pelvis and helps to reposition your bladder, reducing the extra pressure.
Sex Positions If You Suffer From Pelvic Organ Prolapse:
Pelvic Organ Prolapse (POP) is a condition in which your pelvic floor is weakened to the point that one of your pelvic organs (bladder, uterus, or rectum) “falls” into your vagina. Many women with POPs report feeling a heaviness or bulging feeling in their vagina, or a feeling that they are sitting on top of a ball. In severe cases, the pelvic organ may protrude past the vaginal opening.
While this condition may leave you feeling uncomfortable and anxious about sex, rest assured that sex is still completely possible and will not affect the POP at all. Many women report having great sex even with a POP and, since it is extremely difficult for non-medical professionals to detect a prolapse, your partner probably doesn’t even know it’s there.
However, certain sexual positions can create discomfort in women with POP. Here are some positions to avoid, and some to try:
Avoid: Standing, “Cowgirl” or “Reverse Cowgirl” (where the woman is sitting on top). Gravity is not on your side here, and sitting or standing upright will only create more pressure on your pelvic floor during sex.
Try: Modified Missionary Position: Woman is lying on her back with a pillow under her pelvis and her partner is on top.
From behind: Woman is lying flat on her stomach or in supported kneeling position with her partner entering the vagina from behind. (Note: Avoid this position if you have a rectal POP.)
Above all, be sure to communicate with your partner about what feels good and what doesn’t. Sex should be enjoyable for both of you so if something feels uncomfortable or doesn’t make you feel good, speak up. And, if you’re still having difficulty finding a position that works for you, talk with a pelvic floor physical therapist. They’ll help create a custom treatment plan to strengthen up your pelvic floor muscles, and can suggest other tips that may make sex more enjoyable to you.
If you are worried about leaking during sex, you may also want to practice kegels. Kegels can help strengthen your pelvic floor so that you have more control over bladder leakage. Want to learn how to perfect your kegel? Read our how-to guide!