How can I prevent leaks during sex?

Q:

The last time my husband and I were intimate, I peed a little, which was mortifying! I’ve been avoiding sex since then because I’m worried it’ll happen again. Is there anything I can do to make sure it doesn’t?

A:

If it makes you feel better, this is a common concern among my patients. During intercourse, you may experience pressure on your bladder or urethra, which can trigger the urge to urinate. And if there’s fluid in your bladder, leaks can result.

The best ways to prevent coital leakage are to empty your bladder before sex and to do Kegel exercises regularly to strengthen your pelvic floor muscles. Limiting or avoiding bladder-irritating foods and drinks (such as caffeine, chocolate and alcohol) may also help, and shedding any extra pounds you may be carrying can also decrease pressure on the bladder. But if these steps don’t solve the problem, you may want to see a urogynecologist to discuss other options, such as pelvic floor physical therapy or medications.

Q Now that I’m going through perimenopause,

I’m getting migraines more frequently. What can I do about

them?

A Migraines are surprisingly common at this stage. In one study, the risk of suffering more than 10 migraines a month increased by 60% during perimenopause. To blame: estrogen flux.

For some women, oral contraceptives provide relief, so I tell my perimenopausal patients with migraines who are taking them to skip the placebo pills and keep taking the active pills, which stabilize estrogen to help prevent the pain. And since certain medications, like beta blockers and some antidepressants, can help prevent migraine flare-ups, ask your doctor if one is right for you. If you prefer a natural remedy, supplementing with 400 mg. of magnesium a day reduces the blood-vessel inflammation linked to the headaches. In one study, regular intake of the mineral reduced migraine frequency by 42%.