We recently conducted a survey which showed that 81% of people believed incontinence negatively affected their social life [1]. So you can imagine how this emotional burden from a social perspective can also be experienced in intimate relationships.

Urinary or faecal incontinence, or any bladder or bowel issues for that matter, can place a huge amount of stress and anxiety on the person experiencing it. It can be challenging for them to come to terms with the condition themselves, let alone having to communicate it to their partner.

We completely understand those reservations, but we’re here to tell you that you can still have wonderful relationships with incontinence, it just takes communication and some physical adjustments.

Before diving into intimacy following an incontinence diagnosis, it’s important to communicate with your partner about your experience and symptoms to ensure you have their understanding and support, and that you avoid any discomfort.

Firstly, find a space where you feel comfortable to have a conversation. Let your partner know how you’re feeling (whether that be worried or anxious), they will no doubt calm any nerves you have. Let them know what you need, whether that be simply to listen, or the support you need from them.

You can detail the type of incontinence you experience, what the symptoms are and how this could impact intimacy. This is also a good time to express the things you might be nervous about during intimacy. Let your partner know about any equipment you need to manage your condition (such as a catheter) so they know what to expect. If you do use equipment, speak to your medical professional before getting intimate with your partner, to be sure you know how to work around them without damaging the devices or impacting your symptoms.

If you find feelings of shame or embarrassment overwhelming and difficult to overcome, it can be extremely beneficial to seek help from a therapist or psychologist. They can provide you with professional advice and practical tools to overcome these feelings yourself, and then with your partner.

We also have more incontinence conversation tips if you need more support in how to get things flowing with your partner, or in any other relationships.

Once you’ve discussed incontinence and you both feel ready for intimacy, these are some things you should consider to best manage your incontinence symptoms:

• Manage your intake of fluids before intimacy. You can speak to your doctor about what reduction of fluid will be appropriate for your circumstances.

• Empty the bladder and/or bowel prior to intimacy. This also helps prevent urinary tract infections.

• If you use a catheter, you can remove it or leave it in if preferred. Males can tape the catheter to the shaft of the penis, wear a condom and use lubricant, while females can tape the catheter to the thigh or abdomen.

• If you use a drainage bag, you can cover it, place it out of sight or seal it off.

• Do any of your hygiene care before intimacy - you can even incorporate it into foreplay. For example, showering with your partner.

• Find out what treatments will help with any spasms or pain associated with intimacy. If you experience hypersensitivity, for example, you can try placing an ice pack on the relevant area prior to intimacy.

• Pick the right moment. Perhaps there are certain times of day you notice your incontinence symptoms are more prevalent, so you can choose to be intimate at another time if you want to avoid that.

• Have a water-based lubricant on hand. For women, water-based lubricant closely mimics the vagina’s natural pH and can help avoid any discomfort or pH-related issues such as thrush.

It’s also important to note that intimacy can mean something different to every couple and doesn’t necessarily have to involve penetrative sex. Other forms of intimacy can include: 

• Kissing

• Touching

• Massage

There are a number of ways to make intimacy more comfortable when you have incontinence, for both you and your partner.

Finding sex positions that work for you and prevent discomfort can be extremely helpful. What positions are deemed comfortable will be different for everyone, so it may be worth speaking to your doctor or a pelvic physiotherapist to find out which positions will be most comfortable.

Some positions you may find beneficial could include:

• Side-lying positions which prevent bladder spasms

• Modified missionary using a pillow underneath your pelvis to help support the spine and move pelvic organs out of the way

If you do see a pelvic physio, they may also recommend some pelvic floor exercises that may help strengthen and/or relax your pelvic floor to both help with bladder or bowel control and also manage sexual discomfort.

Waterproof bed and furniture protectors are great for an added line of defence if you’re concerned about leaks or mess during intimacy. We stock both disposable protectors and washable protectors that are breathable, highly absorbent and comfortable. Simply place one on top of your bedsheet and you’ll have peace of mind that any leaks will be absorbed. You can then dispose of the protector if it’s not reusable, or throw the washable version in the washing machine between uses.

If you’re worried about any incontinence-related odours that might dampen your mood, light some scented candles. These will not only enhance the romance but will mask any unwanted smells. Just be sure to keep those candles away from anything flammable and where they won’t get knocked over!

Music is another great mood booster, and can also help you to relax and let go of any tension or stress you might have.

Some medications can affect libido or sexual function, and even exacerbate incontinence symptoms. If you’re on medications, discuss any concerns you have regarding your incontinence and intimacy with your doctor. They can then recommend any alternatives or workarounds for intimacy.

For any emotional or mental hurdles experienced when it comes to your incontinence and intimacy, there are plenty of people out there who can help. You can speak to a therapist, psychologist, or your GP. This can either be solo or alongside your partner. They’ll be able to provide practical advice on how you can improve and enjoy intimacy.

You may even find some online community forums of people with incontinence where you can speak confidentially about your experience and those of others. However, just remember these forums are not the same as seeking professional advice.

The National Continence Helpline is another great, and free, service that has continence nurse specialists available to listen and offer confidential advice and support. They can also help refer you to other specialists or medical professionals who might be able to help. You can call them on 1800 093 629, between 8 am and 8 pm (AEST) 7 days a week.

For any physical hurdles you may be struggling to overcome when being intimate, always speak to your doctor.