Any number of things might run through your mind during sex—and hopefully most of them are some version of, This is amazing! But every now and then—in addition to random thoughts like, “Did I remember to turn the oven off?”—you’ll realize that, crap, you feel like you need to pee. Mood killer, amirite? But what is your body really trying to tell you when that happens?

Sure, sometimes you just need to excuse yourself for a quick bathroom break while doing the deed. But sometimes that “need to pee” sensation might actually indicate that you’re about to have an orgasm accompanied by squirting or ejaculation. And other times, it’s possible the alarm bells from your bladder are warning you of a problem. So, how do you tell the difference? Unfortunately, it’s complicated.

The science of squirting is limited—and controversial. But it’s important to know that sprinkles (or, hey, even gushes) of fluids during sex isn’t bad! “Sex can be messy and [releasing] fluids during sex is normal and can be a sign of arousal, like with ejaculation or squirting,” says Adrienne Ton, a certified nurse practitioner and director of clinical operations at TBD Health.

Meet the experts: Adrienne Ton, APRN-CNP, is a certified nurse practitioner and director of clinical operations at TBD Health.

Susie Gronski, PT, DPT, is a certified pelvic rehabilitation practitioner, AASECT-certified sexuality educator, and founder of Dr. Susie Gronski, Inc, a pelvic and sexual health clinic for men.

Alyssa Dweck, MD, FACOG, is a practicing gynecologist and co-author of three books, including The Complete A to Z for Your V.

Lainie Givens, OTR/L, is a licensed occupational therapist specializing in pelvic health at Dr. Susie Gronski, Inc.

Ahead, experts explain the mind-blowing things bodies do in bed so you can set your mind at ease, including how to know if you’re actually about to pee or are having an orgasm.

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Is it possible for vagina owners to pee during sex?

Yes, it is possible to pee during sex. But that doesn’t mean the fluid coming out of you is necessarily urine.

There are some underlying health issues that can cause an intense urge to urinate, or even leakage, during intercourse. According to the National Institutes of Health, nearly one quarter of women in the United States are affected by one or more pelvic floor disorders, leading to incontinence (a.k.a loss of bladder control), general discomfort, and/or a need for reduced activity.

But if you’re experiencing incontinence, it’s probably not happening only during sex. People with medical conditions “might experience incontinence at other [times when there’s] pressure on the pelvic floor and bladder, such as coughing, sneezing, or laughing,” says Ton.

If you’re pretty sure the fluid you’re experiencing during sex is pee, there’s still more to sleuthing to do. First, you need to figure out which type of coital incontinence you tend to experience. There are two types: incontinence during penetration and incontinence during orgasm, according to certified pelvic rehabilitation practitioner Susie Gronski, PT. “Incontinence during penetration is most commonly associated with stress urinary incontinence (SUI),” she says. And it’s SUI that’s often associated with weak pelvic floor muscles.

Although most easy-to-find advice suggests performing kegels to strengthen pelvic floor muscles, it’s also common to suffer from a pelvic floor that’s holding too much tension. And both being too weak or too tight can lead to that need-to-pee feeling. So before taking on a new exercise routine to try to fix the issue, it’s important to be examined and diagnosed by a professional first.

As for incontinence during orgasm, Gronski says that this form is less common than incontinence during penetration. It’s usually caused by an overactive bladder. And because this type of incontinence lines up with orgasm, it can be tricky to distinguish from squirting.

What about penis owners?

Yep, folks with penises can pee during sex, too—though it’s much less common.

When that happens, it’s called climacturia (a.k.a urinating during ejaculation) and may be a symptom of medical procedures involving the prostate, such as a prostatectomy. “During a prostatectomy, the internal urethral sphincter, which is at the bladder neck, is removed. The internal urethral sphincter and external urethral sphincter (located at the apex of the prostate) are intimately involved in urinary control,” says Gronski. She also points out that some medications “like Tamsulosin (Flomax) or Terazosin (a medication used to treat enlarged prostate symptoms and high blood pressure)” can relax the muscles of the prostate and bladder, causing the same effect.

If you’re someone with a penis who experiences incontinence and you’re looking for some ways to mitigate the issue during sex, Gronski offers the following suggestions:

  • Empty your bladder beforehand.
  • Use a penis ring to prevent urine flow from the urethra.
  • Explore pelvic floor muscle training.
  • Wear a condom during sex.
  • Consider getting an artificial urethral sphincter or urethral sling through surgery.

But if these are new symptoms, it’s important to check with a doctor to make sure nothing serious is going on before trying any at-home remedies.

Is squirt pee?

Short answer: No. Longer answer: There’s no consensus among scientists and doctors about what exactly is coming out of vaginas before, during, and after orgasm.

In fact, some experts are now saying there’s more than one type of fluid associated with sexual arousal and female orgasm. In a 2022 review published in Clinical Anatomy, researchers posited that female ejaculation and squirting “are similar but etiologically different phenomena.”

How are they different, exactly? Well, female ejaculation is when fluid is released in response to arousal or climax from the paraurethral glands (a.k.a the Skene’s glands, which are located on the front wall of the vagina and typically secrete mucus-containing fluids during sex to assist with lubrication), says Gronski. “In ejaculation, the fluid is typically going to be a little white-thick discharge,” she adds.

Squirting, on the other hand, is more rare than female ejaculation, and “tends to happen more during high arousal or climax (orgasm) and includes fluid that is similar to urine that comes from the urethra (where urine typically comes out),” Gronski says. This explains why the act of squirting may feel like you’re peeing.

It’s also worth noting that orgasm and ejaculation are separate biological processes (even in people with penises). Meaning, you can have one without the other. Or you can have both, but at different times. For folks with penises, they usually happen so close to the same time you can’t tell the difference. But for people with vaginas, it’s not uncommon for squirting to happen first—sometimes more than once—before orgasm. And that time lag can create additional confusion, or fuel the assumption that the fluid is actually pee.

If you’re looking for a more definitive answer for what your body is expelling, Gronski recommends administering a sniff test—for science! (Goggles and gloves are optional.) As she points out: “The smell of urine is just plain obvious.” But for an even closer examination, “place a towel underneath your bum and notice the color,” Gronski suggests. “If it’s yellow and smells like urine, you’ve got your answer.” If not, you’ve probably just squirted for the first time (congrats!).

When trying to figure out if it’s squirt or pee, color and smell aren’t the only distinguishing characteristics to look out for, says Ton. “You might be able to tell by the type of fluid or the amount of fluid that comes out. White is more likely to be from ejaculation. A lot of clear fluid during orgasm (even after you’ve emptied your bladder before sex) is more likely to be [a result of] squirting.”

Ultimately, what matters the most during sex is that you’re having fun and experiencing pleasure. If you’re really worried about possibly peeing while getting down and dirty (no pun intended), just throw down a towel beforehand to set your mind at ease about post-coital cleanup.

Why do I feel like I have to pee? And what can I do about it?

There are a number of things that might contribute to the feeling that you need to run to the bathroom, says Alyssa Dweck, MD, a practicing gynecologist in New York. Chief among them? You had to pee before sex and didn’t realize it until you were already getting hot and heavy.

Dweck says that pressure on the bladder—whether it’s from thrusting or because you decided to try a more creative sex position—can make you realize you need to pee.

Vaginal dryness, as well as sensitivity to a lubricant or condom, might also cause irritation and swelling around the urethra, and subsequently lead to the urge to pee, adds Dweck. To figure out what the root cause is, Dweck recommends eliminating potential irritants, then reintroducing them one at a time to see if symptoms resolve or worsen. (Just don’t eliminate the condom! Instead, try experimenting with different brands.)

Want even more tips to pee-proof your sexcapades? Pelvic health occupational therapist Lainie Givens offers the following suggestions:

  • Empty your bladder before you have sex.
  • Reduce bladder irritants such as alcohol, caffeine, nicotine, and carbonated beverages at least two hours before engaging in sex.
  • Consider changing positions to reduce the amount of pressure on the bladder—like laying on your side, being on top, or having a partner penetrate or enter you from behind.
  • Consider shallow penetration as opposed to deep penetration—which may put more pressure on the bladder.
  • If you really have to pee during sex and it’s distracting you from being in the moment, pause to use the bathroom, and resume sex afterwards.

But if you think squirting or ejaculation is behind your urinary urgency, you might just want to get wet and wild, says Dweck. “Some women opt for water play—such as sex in the shower or bath—so it’s masked.”

Try out these shower sex positions during your next steamy (get it?) sesh:

preview for Shower Sex Positions Attempted by Real People

If your goal is to squirt, you could throw some toys in the mix to stimulate your G-spot or try different positions. (Sex therapist and sexologist Alex Robboy previously told Women’s Health that woman-on-top positions are ideal for achieving female orgasm.)

Should I be worried about my health if I always have to pee during sex?

It depends.

If you constantly feel like you need to pee during sex (or you’re always experiencing leakage), then you might be dealing with an underlying health issue, like a urinary tract infection (UTI). Dweck says urgency, the frequent need to urinate—plus, a burning sensation when you do—and symptoms that worsen during sex are all hallmarks of a UTI. A fever, blood in your urine, back pain, a foul smell, and chills are also signs that it’s time to see a doc. Some of these symptoms may also be signs of an STI, making it doubly important to make that doctor's appointment.

It might also be time to double-check the medicine cabinet—and read the fine print. Ton points out that some medications are diuretics, which means they cause you to urinate more frequently. Other life and bodily changes can also cause incontinence or increased urgency, including pregnancy, childbirth, or menopause.

The bottom line: It’s always a good idea to check with your doctor if you’re worried about your health and what your body is doing. Once medical causes are ruled out, it’s time to embrace all the amazing things your body can do, and all the sensations it can feel, even if, at times, sex gets messy enough to require a raincoat.

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Stella Harris
Freelance Writer

Stella Harris is a certified intimacy educator, professional coach, trained mediator, and the author of Tongue Tied: Untangling Communication in Sex, Kink, and Relationships and The Ultimate Guide to Threesomes. Her freelance career is never dull; highlights include being sent to a strip club with a press pass, appearing on the evening news to discuss the importance of sex education in schools, and speaking as an authority on banana slug mating habits. In her free time, she curls up with scary books and horror movies.  

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Caroline Shannon-Karasik is a writer and mental health advocate based in Pittsburgh, PA. In addition to Women's Health, her work has appeared in several print and online publications, including The Cut, Tonic, Narratively, Good Housekeeping, Redbook, and DAME. She is currently writing a collection of essays.