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How to Stop Urine Leaking When Coughing or Sneezing
4 Min Read
Almost everyone experiences a few episodes of leaking urine while coughing or sneezing over their lifetime. I want to normalize this experience for you–especially if it happens when you have a severe illness, you may not need to do anything about it. But if you find yourself regularly noticing urine leakage when sneezing or coughing, read on for a comprehensive guide on managing and preventing stress incontinence.
Table of Contents
What is Stress Urinary Incontinence (SUI)?
There are several different types of urinary incontinence, with different causes.
- Stress incontinence refers to leakage that occurs due to excessive intra-abdominal pressure and the stress it puts on the pelvic floor. This leakage usually happens during activities like running, jumping, sneezing, coughing, laughing, lifting heavy weights, etc.
- Urge incontinence is a sense of urgency around needing to urinate and/or involuntary leakage that is caused by overactive bladder tissue
- Mixed urinary incontinence is leakage of urine caused by a combination of stress and urge urinary incontinence
- Overflow incontinence happens when your bladder is overly full, usually because the tissue making up the bladder is compressed or under-active
- Functional incontinence is leakage that occurs when there are physical or environmental barriers to toileting
A friend recently had an intense cough due to an illness. She laughed as she told me the story of getting on a video call, having a coughing fit and completely losing control of her bladder, soaking the chair she was sitting in. She knew exactly why it happened and was annoyed at the time, but remembered that she had the tools to regain better function once the illness passed. Like many people who experience stress incontinence, she is peri-menopausal and has given birth–while you don’t need to have a uterus to suffer from urine leakage while coughing, women are much more likely to experience stress urinary incontinence over their lifespan.
Stress urinary incontinence (SUI) can be incredibly frustrating since it isn’t always predictable. Understanding why stress urinary incontinence happens and how to prevent or manage it can be life-changing–you don’t have to be afraid to sneeze or cough. Of course, if you know you have a tendency to leak when you sneeze or cough, you may want to use incontinence items to absorb the urine while you learn strategies to make it less likely that the leaks will happen.
Causes of Urine Leakage When Coughing or Sneezing
The physiological reason behind urine leakage when coughing or sneezing is the increase in intra-abdominal pressure caused by the force of the sneeze or cough. To understand what intra-abdominal is, it can help to imagine the whole core system (including the pelvic floor and diaphragm) as a balloon, and picture squeezing the top of the balloon. The bottom of the balloon bulges out and down in response to the pressure from the top.
Ideally, the pelvic floor resists some of that downward pressure while also lengthening to accommodate it–you can imagine slowly straightening your arm while holding a weight. Except a sneeze is much faster, of course. If the pelvic floor muscles are unable to counteract the force of the sneeze, leaking happens.
Both pelvic floor muscle weakness/laxity and excessive tension in the pelvic floor can lead to not being able to counteract the increase in intra-abdominal pressure that happens when you cough or sneeze. If your pelvic floor muscles are too lax, there’s not enough force generated by the muscles to counteract the sneeze. On the other hand, overactive pelvic floor muscles can be so tense that they can’t contract further to withstand the load.
Factors that can contribute to overactive pelvic floor muscles include:
- Stress and trauma
- Bladder or bowel dysfunction (e.g., IBD)
- Hypermobility–this can cause you to grip your pelvic floor muscles in an attempt to find more stability
- Movement patterns and habits, including high-impact sports
Factors contributing to the weakening of pelvic floor muscles include:
- Pregnancy and childbirth
- Pelvic organ prolapse
- Weakening of tissue due to age, especially the drop in estrogen levels during perimenopause
Symptoms and Diagnosis
When is it important to seek medical advice when it comes to SUI? It comes down to frequency. If you’re noticing leakage regularly, especially if you have chronic conditions like allergies that may lead to frequent sneezing and coughing, reach out to your doctor. You’ll be able to talk through your symptoms, and your doctor may perform a physical exam, including bladder function tests. You’ll likely be checked for UTIs or other signs of infection or illness.
If you’re only noticing it occasionally (e.g., jumping on a trampoline once a year), or if you notice it when you get sick but don’t end up having issues once you’re better, working on overall core function is probably sufficient. Still, you may want to see if your doctor can refer you to a physical therapist to help you learn to better manage core and pelvic floor function. You might try a program like Restore Your Core®, since it’s designed to help you do just that.
How to Stop Urine Leaking When Coughing or Sneezing
In order to stop the leaking, you’ll have to approach the problem from multiple angles.
- Reduce consumption of bladder irritants such as caffeine and alcohol
- Learn breathing techniques and movement patterns that help you better manage intra-abdominal pressure
- Focus on the root cause of the issue: Depending on whether your pelvic floor muscles are over- or under-active, targeted exercise to increase their function may be important
- Higher body weight is correlated with an increase in the likelihood of stress urinary incontinence, but you can learn to manage intra-abdominal pressure at any size
- Smoking is also correlated with an increase in SUI
- There are medications that can be used for SUI, and your doctor will be able to tell you whether they are appropriate for your situation
- Other interventions include electrical stimulation therapy, vaginal pessaries, or urethral inserts
- Surgery is sometimes an option depending on the cause of the leakage
Tips for Managing Sudden Episodes of Urine Leakage
So you have a plan, but what do you do the next time you sneeze? First, make sure you aren’t trying to hold back the sneeze or cough–let your mouth open when you cough or sneeze and use your elbow or a tissue/handkerchief to keep droplets from spreading. Keeping your mouth open allows you to disperse some of the force. Second, notice what happens in your pelvic floor when you sneeze or cough–do you feel downward pressure? Can you find some internal resistance to that downward pressure? For some people, it can be helpful to think about performing a kegel contraction as you cough or sneeze, though ideally, in the long term, you’ll be able to contract your pelvic floor muscles reflexively without having to think about it.
Long-term Strategies
In the big picture, leaking urine when you cough or sneeze shouldn’t be something we don’t talk about openly. We need more conversations about leakage so that we can stop feeling ashamed of what amounts to a mechanical issue. Your body isn’t broken; it just needs a little help to function well. Maintaining your core function as you age and as your life stages shift is key to preventing SUI long-term.
If you notice any changes in urinary frequency or the control you have over your urinary function, see your doctor.
The information provided on this website is for educational and informational purposes only and is not intended as medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
FAQ
1. Who is most likely to experience urine leakage when coughing or sneezing?
Stress urinary incontinence, which involves leakage during activities such as coughing, sneezing, or exercising, is more common in women, particularly those who have had multiple pregnancies, given birth vaginally, or experienced hormonal changes due to menopause.
2. How effective are pelvic floor exercises in treating urine leakage when coughing or sneezing?
Pelvic floor exercises are often effective in treating stress urinary incontinence by strengthening the muscles that support the bladder and urethra. With regular practice, these exercises can improve bladder control and reduce episodes of urine leakage during coughing or sneezing.
3. What are some non-surgical treatments for stress incontinence?
Non-surgical treatments for stress urinary incontinence may include pelvic floor muscle exercises, lifestyle modifications, bladder training techniques, electrical stimulation therapy, and the use of vaginal pessaries or urethral inserts.
4. Can losing weight help reduce episodes of urine leakage when coughing or sneezing?
Yes, losing weight can help reduce episodes of urine leakage. Excess weight can put pressure on the bladder and pelvic floor muscles. At the same time, focusing on physically managing the weight of your body can help relieve some of that pressure.
5. Is surgery a viable option for treating urine leakage? If so, what does it involve?
Surgery may be considered for stress urinary incontinence when conservative treatments fail to provide sufficient relief. Surgical options include procedures to support the urethra or bladder neck, such as sling procedures or bladder neck suspension. These surgeries aim to provide additional support to the structures that control urine flow and reduce leakage.
6. How can I talk to my doctor about urine leakage without feeling embarrassed?
You can prepare for the conversation by writing down your symptoms and concerns beforehand, choosing a private setting for the discussion, and reminding yourself that seeking help is a proactive step towards improving your health and quality of life. Your doctor can offer guidance, support, and personalized treatment options to address your specific needs.