Is it possible to pee while I orgasm?

Dear Readers, 

Are you coming or going? Sometimes it can be hard to tell! It’s most common for people assigned female at birth (AFAB) to feel the need to pee during orgasm and, in some instances, actually leak urine during sex. This is because of the proximity of the urethra to the clitoris and the bladder to the vagina. Generally, people assigned male at birth (AMAB) don’t often have this issue because their anatomy prevents it. That said, AMAB people who’ve had their prostates removed may experience this as a complication of having it removed. If you want to know more about the types of liquids that can be emitted during sex and potential treatments for leaking, come on and read more! 

Why might you feel like you need to pee during sex? 

For some people who have AFAB anatomy, it can be common to feel the need to pee during sex. Many anatomy diagrams display the mere centimeters that exist from both the clitoris, the vaginal opening, and the urethral opening. Because of the clitoris’s close proximity to the opening of the urethra, when the clitoris is massaged, it’s possible to accidentally stimulate the urethra. During penetrative sex, a penis, fingers, or other objects may also put pressure on the bladder, resulting in the feeling of needing to pee. 

Why might urine leak during orgasm? 

Sometimes you might not just have the sensation of needing to pee during sex—you might actually release some urine. Leaking urine during orgasm can occur both in AFAB and AMAB people, though it’s more common in AFAB people. This is because in people AFAB, sexual secretions mostly come from the vagina and not the urethra and there’s no anatomical process in place to prevent urine from leaking out. 

For AFAB people, liquid leaking during orgasm could be a few different things. It’s possible that you might be squirting, ejaculating, or experiencing urinary incontinence. 

• Squirting is the release of a large amount of urine from the bladder during sexual stimulation.  
• Female ejaculation involves the expulsion of a liquid that isn’t urine. In contrast to the liquid released during squirting, this liquid is thicker and milkier. It also typically isn’t released in such high volume.  
• Stress urinary incontinence is the inability to control your bladder when pressure is placed on it. AFAB people who have urinary stress incontinence sometimes leak urine during activities like laughing, sneezing, or orgasming. This is more common among people who have given birth. You can gain some control over incontinence by practicing Kegel exercises, which strengthen the pelvic muscles around the vagina and urethra. Stress urinary incontinence can also exist in people AMAB who’ve had a prostatectomy, or surgery to remove the prostate. This surgery can weaken the muscle that controls the release of pee. In fact, people who’ve undergone radical prostatectomies often experience a condition called climacturia, which is when pee leaks during orgasm. 

For people AMAB, anatomy suggests that peeing and coming at the same time is unlikely, aside from in those who have had a prostatectomy. During sexual arousal, muscles at the base of the bladder contract in order to close off the passageway from the bladder into the urethra, the tube through which urine and semen leave the body. This makes it impossible for urine to be released during ejaculation. What may look like urine to you and your partner might actually be a different liquid. It might be pre-cum, a clear fluid that’s released from the tip of the penis shortly after getting an erection. It could also be semen, which comes in different consistencies, including thick and whitish, clear and watery, or a combination of the two.  

What can you do if you feel the need to pee during orgasm? 

If you experience stress urinary incontinence during sex, there are a few lifestyle changes you can make that you might find helpful: 

• Use the bathroom before having sex. 
• Avoid excessive liquid intake before sex. 
• Try different sex positions that place less pressure on the bladder. 
• Use more lubrication. 

If you experience climacturia, you might develop similar coping mechanisms, such as;  

• Emptying your bladder before sex 
• Wearing a condom to collect pee that comes out during orgasm 
• Using penis loop devices that put pressure on the urethra to stop leaking 

Some people find that these strategies may be uncomfortable, and in the case of penis loop devices, even cause bruising. But no matter your reproductive anatomy, you might find working with a pelvic floor specialist to be helpful in meeting your unique needs and goals.  

Hopefully this helps!