When I have sex and I am about to have an orgasm, I end up peeing. It's not just a little leakage, but a lot, enough to wet the bed. We have to use a towel. What is wrong with me?

K.S.

You are not alone. Many, many women experience incontinence associated with intercourse. It may be from mechanical reasons -- the penis strikes against a dropped bladder, leading to leakage -- or it may be due to bladder spasms associated with orgasm. Some women lose muscle control throughout their bodies when they orgasm, and this can affect the muscles around the urethra as well, producing incontinence.

First, you need an exam by your gynecologist or a urologist to make sure there is no underlying infection or abnormality causing urinary incontinence. If you also leak in other circumstances, be sure to tell the doctor. If you are having bladder spasms, there are medications available to quiet down the bladder muscle. If your bladder has dropped, trying positions that do not put so much pressure on the bladder may be helpful.

Some women are able to avoid intercourse-related incontinence by emptying the bladder right before having sex. If the bladder is empty, there will be minimal leakage, if any.