SEX AND HEALTH: INCONTINENCE (INVOLUNTARY PASSAGE OF URINE)
This is regarded as an embarrassing topic by women since leakages of urine can occur in intercourse. Up to a quarter of women are said to be affected at some time in their lives. Of these two thirds pass urine on penetration and one third at orgasm. This latter observation raises the question as to whether women can really ejaculate as the G-spot enthusiasts claim, or could it just be urine? Recent research in which tampons blocked off the vaginal opening and fluid was meticulously collected from the urinary passage showed that the vast majority of women who ejaculate do not lose urine. The liquid is very like prostatic fluid.
Some cases of urine leakage are due to stress incontinence and others to so-called detrusor instability – a local muscle weakness. Both conditions exist and give trouble at other times as well as during intercourse. Some of the sufferers are utterly miserable and anxious as a result of the symptoms.
Stress incontinence-Some women leak a little urine when coughing, laughing or undertaking physical effort. The reason is that the circular muscle, at the base of the bladder, which is like a rubber band, is incompetent and when pressure rises inside the abdomen, as it does when doing these things, the muscle cannot prevent the flow of some urine from the bladder to the urethra. Various operations exist to relieve the condition. A tampon inserted before strenuous activity can prevent stress incontinence and pelvic muscle exercises can cure it.
Detrusor instability-Learning to be dry in infancy consists of establishing the control of the conscious mind over the reflex tendency of the bladder to empty when it is full. Urination then occurs only at socially convenient times and places. In detrusor instability this control is lost and the urgent and frequent passage of urine results along with symptoms of stress incontinence in some women. Bladder retraining is used to relieve the condition. The woman keeps a urinary diary for a week showing when and where she urinated. She is then taught to delay emptying her bladder by initially encouraging her to wait for half an hour between pees. Gradually she is encouraged to wait for 3 to 4 hours. Various medicinal drugs may have to be used, especially for those in this group who are incontinent at orgasm.
More generally, it seems that urination does, or can, have more significance for women then men, at least in our culture. Reasons
advanced by women to explain the situation have included the fact that the act is less ‘tidy’ in women than in men; that our culture makes female urination into a bigger secret and a greater shame than male urination; and that even in childhood girls begin to feel inferior because they are taught to pull down underclothing and crouch to urinate. Correspondence magazines such as ‘Forum’ have recently included many letters from women discussing the pleasures of standing to urinate, the delights of knicker wetting and the modifications necessary to male type urinals to make them suitable for use by women. Whilst all this may revolt some women it does suggest that, perhaps, the emotions attached to female urination are weakening-if only in a tiny sub-fraction of the population. If so more women with problems might feel able to come forward for treatment instead of putting up with them out of unnecessary shame.
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