Q:For years I have had trouble holding my urine during sexual intimacy. I'm in my 40s and have had children and I have a ridiculously small bladder. I'm always thinking about it and although my husband says it's no big deal, I am so worried about being embarrassed that it's holding me back. Is there any hope for me?

A: A study released this month from the University of Miami highlights this problem. Women who have had children, who are perimenopausal or who have a small bladder capacity may be at increased risk for urinary problems. But those who begin to suffer incontinence suffer in their sexuality.

The study showed that when compared to women who have a leakage problem, women with an overactive bladder who were dry had improved desire for sexual activity, had better vaginal lubrication, achieved orgasms more frequently and reported higher sexual satisfaction. But for some women, even the thought of a compromise in hygiene can create performance anxiety that can be detrimental to her sexuality.

As urologists, we have fairly sophisticated tests to help us understand which women are more likely to have these problems. Once we can identify the problem, we can identify who is likely to be helped with medications, surgery or simple changes in diet or fluid intake. Once we can improve your bladder situation, you can focus on your lovemaking, not your urinary habits.

Dr. Marc Gittelman is a board-certified urologist.

Join the discussion

Note: If this is your first time using our NEW commenting system, you will have to LOG OUT and then LOG BACK IN.

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. In order to post comments, you must be a registered user of MiamiHerald.com. Your username will show along with the comments you post. Thank you for taking the time to offer your thoughts.

     Showing: Oldest first Newest first Most-recommended first Least-recommended first

@Nyx.AuthorDisplayName@ wrote on @Nyx.PostedAtTime@:

@Nyx.CommentBody@

@Nyx.Recommender@ @Nyx.AbuseReporter@