Cumming or peeing? Squirting, female ejaculation, and coital incontinence explained 

By: Dr. Janelle Howell, DPT, WCS 

In the bedroom...it's three types of Vagina CEO's that absolutely can't be discreet: the screamers, the sprayers and the squirters! Which one are you?

And if you're following me on Instagram, you know that I'm all the way here for being loud, unapologetic, and noisy during freaky time because it activates your pelvic floor muscles and enriches your potential for pleasure...but that's a topic for a different blog. Let's talk about the sprayers and the squirters!

The sprayers are those who lose urine during sexual activity. This is referred to as coital incontinence in the medical community. The two forms are penetrative incontinence (PI) and orgasmic incontinence(OI) according to literature. Both are typically due to stress incontinence in which someone loses urine when there is pressure exerted on the bladder, like let's say with coughing, running, sneezing, or jumping. When the pelvic floor is unable to exceed the amount of pressure above the bladder when this pressure happens, then pee comes out. All forms of urinary incontinence can be treated, and the most non-invasive form of treatment is pelvic physical therapy. When urine is escaping from the bladder during orgasm or penetration, the fluid will likely be yellow, have a stronger odor, and be a large amount of fluid. You may or may not feel like you're going to pee and it may not be accompanied by a feeling of intense pleasure and approaching climax. Remember, if you are losing urine during any type of activity outside of toileting-this can signal pelvic floor dysfunction and it's best to work on it with a professional if you're able. 1 in 3 Vagina CEO's have urinary incontinence so you're not alone and there is nothing to be ashamed of. It can happen to anyone regardless of age or fitness level.

But if you know you're not peeing during sexy time...what about squirting? The female body is capable of expelling so many different bodily fluids during sexual activity that's worth understanding and distinguishing. 

Squirting, female ejaculation, and urinary incontinence all expel different fluids from the genitalia during sexual activity, according to this study. All three of them are different from each other. Female ejaculation is not squirting, and squirting is not female ejaculation. Coital incontinence, which is involuntary urinary leakage during either penetration or orgasms, is also not the same as squirting.

The way you can know the difference is by its color, its consistency, and its amount. Squirting typically expels larger amounts of fluid that come out of the urethra with more force. The bladder is the only organ that can expel this amount of fluid, but according to the most recent literature, this fluid that comes out with squirting is not the same as urine because it differs in the concentration of urea and creatinine (even though it comes from the bladder). So if you're squirting or curious about squirting in the future, just know that it should resemble watered-down urine, look clear in consistency, and be fairly odorless. Squirting typically happens around the same time as an orgasm, but it does not have to happen with an orgasm. Nor, does squirting signify an explosive orgasm or superiority to orgasms that other people have without squirting. And while some naturally and easily squirt, there are those who do not currently squirt. Some go their whole lives without squirting and live extremely satisfying sex lives, having multiple orgasms and strong orgasms. There are also those who, for years, never squirted but then begin squirted at a different stage in their life. Squirting alone does not dictate your orgasm satisfaction, your sexual satisfaction, or your sexual capabilities.

But, regardless of whether you do it or do not do it, is nothing to be ashamed of. Just as men and everyone with male genitalia should not be ashamed to expel semen when they have an orgasm.

There's also a rise in the interest of people who want to learn how to squirt. This is not bad. It's absolutely acceptable if someone wants to push the limits of their sexual capabilities or performance. Wanting to do new and exciting things is great! Yet, we should be able to strive for new and exotic forms of pleasure without being ungrateful or dismissive of the current level of pleasure that we already have-especially if we have a happy, fulfilling, and satisfying sex life already. If you do squirt currently, remember that squirting is an involuntary liquid expulsion that happens naturally with sexual excitement and stimulation. 

True squirting should not be forced. You should not feel like you have to hold your breath to do it. You should not feel like you are bearing down or pushing out to make this happen. 

Any liquid that comes from the genitalia should ALWAYS be natural and easy. Any time you find yourself pushing out, bearing down, or straining to expel anything from the pelvis, this puts your pelvic floor at risk for weakening, strain, and excess pressure-which could lead to pelvic floor dysfunction.

Technically, all who have female genitalia are capable of squirting, but that does not mean it will happen to everyone. 

Our anatomy, our clitoral vaginal distance, sex positioning, penetrative strategies, and even pre-sex activities can all impact one's likelihood of squirting. Even aspects that we typically overlook will impact our ability not just to squirt but also to ejaculate. 

Pain and poor arousal are some of the biggest barriers to all pleasurable and orgasmic activities. 

There's help for the pain you feel! No matter where you are in the world, if you want to work with me to treat your painful sex, you can find more info about that here. You can also ask your doctor for a referral to pelvic physical therapy and sexual medicine. Or, if you're in the United States, use this directory to find a pelvic physical therapist near you. Painful sex is not something to ignore, and it is treatable. It can block your path to pleasure, fulfillment, and even healthy sexual relationships with people you really care about. So we need to be able to enjoy sex without pain, but we also should support our bodies in desiring sex! Poor arousal is a barrier to peak sexual fulfillment because if your labia, clitoris, and vaginal wall are not getting engorged with blood, then your nerves are not as sensitive, and the clitoral erection may not be sufficient enough to bring you to orgasm. Your sex drive, your ability to become aroused, and find what arouses you, and keep you aroused will be key to bringing you to orgasm and maybe even squirting. And it's important to discuss low libido with your doctor if it concerns you. To take your sexuality to the next level, you need to learn and understand how the pelvic floor, nutrition, and your mindset contribute to your level of drive and libido. You can do this with me in my next masterclass. We'll be diving into why low sex drive happens and how we can ramp it back up again by way of our pelvic floor, nutrition, and even our thought patterns! 

Now, let's set it straight about female ejaculation!

Female ejaculation is a fluid that is typically creamy, milky, and thicker than the fluid accompanied during squirting. The amount may also be so small that it goes unnoticed, according to this study here. This fluid typically is released during orgasm and comes from the skene glands, which are synonymous with the male prostate. This fluid also has prostate-specific antigen in it and secretes an anti-bacterial substance which may protect the urethra and help prevent urinary tract infections. It may or may not happen to everyone, but it is not typically a fluid that gets forcefully expelled. So squirting is not ejaculating, and if you do ejaculate, it won't be getting sprayed across the room! Sorry. 

So all three: squirting, ejaculation, and coital incontinence, are all distinct and different fluids that are frequently expelled during sex.

Wherever you fall along the spectrum of a squirter, sprayer, screamer-or none...know that your body is infinitely miraculous, complex, and high functioning! You deserve the best from your body, especially in the area of health and wellness. Never let anyone convince you that sexuality is not an integral part of our health and that health is not also sexual. Your body is your home, and you deserve to feel good in the home you live in. It's your birthright and your territory. Claim it!