Is Female Ejaculation Pee? What the Science Says

Female ejaculation is not urine, but squirting mostly is, and the two are not the same thing. That distinction sits at the heart of decades of confusion. Researchers now recognize at least two separate fluid-expulsion events during sexual activity: a small-volume, milky secretion from glands near the urethra (true female ejaculation) and a larger-volume, clear expulsion from the bladder (squirting). They look different, come from different organs, and have different chemical profiles. The popular question mashes them together, and that is where the misunderstanding starts.

Two Phenomena, Not One

Until roughly 2011, scientists lumped all orgasm-related fluid expulsion under the single label “female ejaculation.” That changed as biochemical and imaging studies made it clear the fluids were coming from different places. Today the research literature treats female ejaculation and squirting as related but distinct events.¹ A third category, coital incontinence, is something else entirely and is considered a medical condition rather than a normal sexual response.

Female ejaculation in the strict sense refers to a secretion of a few milliliters of thick, whitish fluid produced by the paraurethral glands (also called Skene’s glands, or the female prostate). Squirting involves a much larger volume of transparent fluid, roughly ten milliliters or more, expelled through the urethra from the bladder.¹ Both can happen during orgasm, and in some people they happen at the same time, which is part of why the public conversation treats them as a single thing.

What Is in Squirting Fluid

The squirting fluid is, chemically, a modified form of urine. A 2015 study using pelvic ultrasound and fluid analysis in seven women who reported squirting found that before sexual stimulation, all participants’ bladders were confirmed empty. During arousal, the bladders visibly refilled. At the moment of squirting, the bladders emptied again.² That refilling-and-emptying cycle left little ambiguity about where the fluid was coming from.

The biochemistry confirmed the imaging. Urea, creatinine, and uric acid concentrations in the squirting fluid were comparable to those found in urine samples collected before and after the event.³ A systematic review and meta-analysis pooling data from multiple studies found that squirting fluid had a pooled average urea concentration around 172 mg/dL and creatinine around 30 mg/dL, with fluid-to-serum creatinine ratios greater than 1.0, all consistent with bladder-origin urine.⁴

One important qualifier: in several of the squirting participants, the expelled fluid also contained small amounts of prostate-specific antigen (PSA), a protein that does not come from the bladder. The researchers concluded that squirting is “essentially the involuntary emission of urine during sexual activity, although a marginal contribution of prostatic secretions to the emitted fluid often exists.”³ So even squirting is not purely urine in every case. The dominant component is urine, but it can be mixed with a trace of prostatic secretion.

What Is in Female Ejaculate

The fluid produced by Skene’s glands is a completely different substance. It is small in volume, typically one to five milliliters, and viscous rather than watery. Its chemical fingerprint looks nothing like urine. The meta-analysis found that female ejaculate contained an average PSA concentration of about 42.6 ng/mL, while urinary markers were minimal: urea under 5 mg/dL and creatinine under 0.1 mg/dL. The fluid-to-serum creatinine ratio was less than 0.05, essentially ruling out bladder contribution.⁴

Analysis of the ejaculate has also found prostatic acid phosphatase and glucose, components that overlap with some markers found in male seminal fluid (minus the sperm, of course). When compared to pre-coital urine from the same women, the ejaculate had significantly lower creatinine and elevated levels of prostate-derived enzymes.⁵ An earlier case study of one woman who produced both types of fluid confirmed this split: her large-volume expulsion had the chemical profile of diluted urine, while the smaller secretion had PSA concentrations in the thousands of nanograms per milliliter, comparable to prostatic fluid.⁶

The Female Prostate

The glands responsible for true female ejaculation are formally known as the paraurethral glands or Skene’s glands, though an increasing number of researchers simply call them the female prostate. That label is not metaphorical. Immunohistochemical studies have shown that these glands produce prostate-specific antigen and prostatic acid phosphatase, the same markers used clinically to identify prostate tissue in men.⁷ In one study of tissue samples, about 83% of specimens containing paraurethral glands tested positive for PSA.

Electron microscopy has revealed that the cells lining these glands look structurally like mature secretory cells in the male prostate, with the same kinds of secretory granules, Golgi complexes, and modes of releasing their products.⁸ More recent autopsy studies have mapped where these glands sit. Most of the PSA-positive structures concentrate in the last 10 to 15 millimeters of the urethra, clustered in the urethral submucosa rather than in the vaginal wall itself.⁹

The size and density of these glands vary substantially from person to person. A three-dimensional remodeling study found prostatic gland tissue encircling the urethra in 14 of 25 patients examined, with 12 of those 14 staining positive for PSA and androgen receptors.¹⁰ This anatomical variability likely explains why some people produce noticeable ejaculatory fluid during orgasm and others do not.

Coital Incontinence Is Something Else

A third type of fluid loss during sex has nothing to do with either ejaculation or squirting. Coital incontinence is an involuntary leakage of urine triggered by the physical mechanics of intercourse or by orgasmic contractions, and it is associated with pelvic floor disorders. It comes in two patterns: leakage during penetration, which in roughly 89% of cases involves stress urinary incontinence, and leakage at orgasm, where about 69% of cases involve overactive bladder contractions.⁴

The practical distinction matters. Women experiencing physiological squirting or ejaculation show no signs of stress incontinence or detrusor overactivity on clinical testing, while those with coital incontinence do. A systematic review concluded that coital incontinence is a pathological sign caused by urethral or bladder dysfunction and requires treatment, while ejaculation and squirting are normal, non-pathological sexual responses.¹¹ This is clinically significant because women who squirt are sometimes told they have incontinence and offered unnecessary interventions, while women with genuine coital incontinence sometimes dismiss it as normal squirting and miss out on effective treatment.

Why the Confusion Persists

Several things keep the “is it pee” debate alive. First, squirting fluid exits through the urethra. So does urine. For the person experiencing it, there is no obvious way to tell the difference in the moment. Second, both ejaculation and squirting can occur simultaneously, producing a fluid that is partly prostatic secretion and partly bladder-origin. Third, the volume difference between the two is dramatic enough to cause different levels of awareness: the few milliliters of female ejaculate might go unnoticed or be mistaken for vaginal lubrication, while squirting can soak bedsheets and is unmistakable.

The confusion also has cultural momentum. For decades, the default assumption in medicine was that any fluid expulsion during sex was either urine or vaginal secretion. The existence of the female prostate as a functional secretory organ was not widely accepted in clinical textbooks, even though anatomists had described it as far back as the 17th century, when Reinier De Graaf provided the first scientific description of female ejaculation and referred to the periurethral glands as the female prostate.¹² It took until 2001 for the Federative International Committee on Anatomical Terminology to officially recognize the female prostate as a distinct structure.

How Common Is It

Estimates vary depending on how the question is asked and which phenomenon the survey means. A Swedish cross-sectional study found that about 58% of women reported personal experience with ejaculation or squirting, while 6% were unsure. Among those who had never experienced it, about 29% wished to.¹³ An earlier cross-sectional study found a prevalence of about 69% for orgasm-related urethral fluid.¹⁴ Older literature suggested a lower figure, under 50%.¹⁵

Part of this range reflects how many people simply don’t notice a small amount of prostatic secretion during orgasm, especially if lubrication is already present. The Swedish study also found that women with non-heterosexual orientations were more likely to report experiencing ejaculation or squirting than heterosexual women, at about 63% compared to 52%.¹³ Whether this reflects differences in awareness, sexual practices, comfort with reporting, or anatomy remains unclear.

The Worry Factor

For many people, the real question behind “is it pee” is a practical and emotional one: should I be embarrassed? Research on this point is consistent. An international online survey found that female ejaculation had a positive impact on the sexual lives of both women and their partners.¹⁵ Still, one of the earliest motivations for studying female ejaculation scientifically was to address the anxiety women feel about potentially releasing urine during orgasm, a concern that researchers noted as far back as 1990.¹⁶

That anxiety can affect sexual function. Some people restrict arousal, avoid certain positions, or suppress orgasm to prevent fluid release. The irony is that the phenomenon itself, whether ejaculation or squirting, shows no association with pelvic floor dysfunction. People who squirt pass the same clinical tests as people who don’t, with no signs of involuntary leakage outside of sexual arousal.⁴ The bladder-filling that happens during arousal appears to be a specific physiological response, not a sign that something is wrong with the urinary tract.

Why the Bladder Fills During Arousal

One of the more puzzling findings is that the bladder rapidly refills during sexual arousal even in people who have just emptied it. Ultrasound imaging captured this happening in all study participants within a relatively short period of stimulation.² The speed of refilling suggests the kidneys may be producing urine at an accelerated rate during arousal, though the exact mechanism has not been pinned down.

Pelvic floor muscles are heavily involved in both arousal and orgasm. A systematic review found a moderate association between pelvic floor muscle strength and sexual function, and all observational studies in the review showed that these muscles were active during arousal and orgasm.¹⁷ The coordinated contraction and relaxation of these muscles during orgasm could contribute to the forceful expulsion of fluid from either the bladder or the paraurethral glands, though the exact triggering sequence remains an active research question.

A Possible Antimicrobial Function

One hypothesis about why the female prostate secretes fluid at all focuses on infection prevention. The secretion contains PSA, prostatic acid phosphatase, and glucose. Some researchers have proposed that this cocktail may have antimicrobial properties that help protect the urethra from infection during intercourse, when bacteria are most likely to be pushed toward the urethral opening.⁵ Others have suggested a reproductive angle: female ejaculatory fluids could raise the pH of the vaginal environment, which is normally quite acidic, closer to levels where sperm survive better.¹⁸ Both ideas remain hypotheses rather than established facts, but they point toward the female prostate having a functional role beyond just producing fluid that occasionally gets noticed.

What a Practitioner Should Actually Know

If you bring up fluid expulsion during sex with a doctor and get a dismissive “that’s just urine,” the response is outdated. The current evidence supports a three-category framework: ejaculation (prostatic, small-volume, not urine), squirting (bladder-origin, large-volume, mostly urine but non-pathological), and coital incontinence (pathological, associated with pelvic floor disorders).¹⁹ Each has different clinical implications. The first two do not need treatment. The third may.

For people who experience squirting and find it distressing, emptying the bladder before sex can reduce the volume but won’t necessarily stop it, since the bladder refills rapidly during arousal. For people who experience it and don’t find it distressing, the evidence suggests there is no medical reason for concern. The distinction between squirting and coital incontinence comes down to whether symptoms also occur outside of sexual arousal and whether clinical testing reveals underlying pelvic floor dysfunction. If fluid loss only happens during sexual arousal and orgasm and never when coughing, sneezing, or exercising, it is far more likely to be squirting than incontinence.¹¹

An Ancient Observation, a Modern Muddle

Descriptions of female ejaculation go back thousands of years. Chinese Taoist texts referenced it as early as the fourth century. Indian texts of the Kāmaśāstra tradition described both the fluid and the sensitive area associated with it. In Western medicine, Aristotle wrote about female fluid emission around 300 BCE, and Galen followed in the second century.¹² For most of recorded history, the phenomenon was considered real and unremarkable.

The modern confusion largely arose in the twentieth century, when female ejaculation fell out of mainstream medical acknowledgment and was recast as either myth or urinary incontinence. It was not until Ernst Gräfenberg’s 1952 paper on the role of the urethra in orgasm that the topic re-entered Western clinical discussion, and even then it remained controversial for decades. The science has caught up in the last fifteen years, but popular understanding has not. Most people still use “squirting” and “female ejaculation” interchangeably, and the internet is full of confident but wrong explanations that treat the question as having a single yes-or-no answer. The real answer requires two boxes, not one, and the contents of those boxes are chemically distinct.

1
PubMed. Female ejaculation and squirting as similar but completely different phenomena: A narrative review of current research
2
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3
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4
The Journal of Sexual Medicine. Female Ejaculation, Squirting, and Coital Incontinence: A Systematic Review and Meta-Analysis of Biochemical, Imaging, and Urodynamic Diagnostic Criteria
5
Medical Hypotheses. Does female ejaculation serve an antimicrobial purpose?
6
The Journal of Sexual Medicine. New Insights from One Case of Female Ejaculation
7
PubMed. Homology between the female paraurethral (Skene’s) glands and the prostate. Immunohistochemical demonstration
8
PubMed. Ultrastructure of the normal adult human female prostate gland (Skene’s gland)
9
The Journal of Sexual Medicine. Distribution of prostatic markers in glands of the female urethra and anterior vaginal wall—a rapid autopsy study
10
The Journal of Sexual Medicine. The Human Female Prostate—Immunohistochemical Study with Prostate‐Specific Antigen, Prostate‐Specific Alkaline Phosphatase, and Androgen Receptor and 3‐D Remodeling
11
PubMed. Female ejaculation orgasm vs. coital incontinence: a systematic review
12
PubMed. The history of female ejaculation
13
PubMed Central. Women’s experiences of female ejaculation and/or squirting: a Swedish cross-sectional study
14
The Journal of Sexual Medicine. PM-05 Prevalence and Characterization of Female Ejaculation. Cross-sectional Study
15
PubMed. International online survey: female ejaculation has a positive impact on women’s and their partners’ sexual lives
16
PubMed. Female ejaculation: perceived origins, the Grafenberg spot/area, and sexual responsiveness
17
The Journal of Sexual Medicine. Investigating the role of the pelvic floor muscles in sexual function and sexual response: a systematic review and meta-analysis
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ScienceDirect (Medical Hypotheses). Female ejaculation enhances reproductive success
19
PubMed. Differential diagnostics of female “sexual” fluids: a narrative review