I leak when I laugh or cough: Is it normal?

First things first, if you’re leaking when you cough or sneeze or jump, whatever it may be, it’s important to know that you’re not alone! Approximately 17% of women will experience some form of incontinence in their life. But while this may be common, leaking urine while coughing or laughing is often a source of embarrassment. In some instances, it may appear out of the blue, whereas among others it can develop over time.

The technical term for the leakage of urine during an episode of laughing or coughing is termed stress incontinence.

However, even though this may seem common, that doesn’t necessarily mean that it’s normal. Since this is something that several people experience it can make it relatively easy to overlook it and seek out help for it. What’s more, is incontinence symptoms can also be a difficult concern to relay to healthcare professionals. However, we can’t stress enough the importance of seeking help and discussing your stress incontinence with a health professional to rule out any serious causes and to work towards minimizing the discomfort you may be experiencing.

Why do I leak when I laugh?

Stress urinary incontinence (SUI) is described as the involuntary leakage of urine following effort or exertion observed while you laugh, cough, or sneeze. An estimated 4 to 35% of adult women will experience episodes of SUI within their lifetime. The underlying reason why pee leaks is due to a weakness in the function of your bladder sphincter which can be traced back to a weakness in the muscles of your pelvic floor.

The sphincter

Your pelvic floor is what generally supports the sphincter function in your bladder. It’s also what keeps your organs within the pelvic floor in the optimum position. With stress incontinence, the weakened muscles of the pelvic floor are unable to support sphincter contraction. This is what ultimately results in the leakage of urine.

To add to this, the sphincter contraction might also not occur at the right time which can also result in the leaking of urine. This means any activity which increases the pressure within your abdomen may cause you to leak urine.

Jumping, lifting, sneezing, pushing oh my!

Other activities where you might observe leaks? Jumping, heavy lifting, or sneezing, just to name a few. A few other factors that can put you at risk of leaking are extra weight, having long-term constipation, or having a medical history of surgery on the pelvis. These can contribute as additional risk factors for developing SUI. To add to this, SUI is more frequent among those who have endured childbirth and the risk is twice as likely among those who have delivered vaginally versus those who have had a C-section.

Age

However, age on its own is a significant contributor to the likelihood of developing SUI. With time and a lifetime strain on the pelvic floor, the muscles start to weaken. This is why stress incontinence is largely observed in people over 40 years of age.

How is stress incontinence treated?

First off, if you notice the leaking of urine during activities such as laughing or coughing, we encourage you to get yourself checked with a health care professional as this is the primary sign of underlying SUI.

We promise none of this is to scare you! Experiencing an occasional leak of urine doesn’t directly imply that you are dealing with stress incontinence. However, it’s when these symptoms begin to bother or affect your daily functioning that you should consider having it checked out.

Visiting with a doctor about SUI

When you meet with a doctor to discuss your SUI symptoms, the doctor will conduct a comprehensive examination to understand what the underlying cause of SUI is. Once the underlying cause has been detected, you will both decide on a treatment plan that is suitable for your specific needs.

Treatment options

A chief manner in which stress incontinence is managed is through behavioral techniques such as pelvic floor muscle training. A physical therapist will guide you on how to perform pelvic floor exercises, such as Kegel exercises, which will enhance the strength of your pelvic floor over time.

Other methods such as electrical stimulation, vaginal cone therapy, or insertion of vaginal pessaries might be employed if your physician feels that it might reduce symptoms of SUI.

If these treatment options don’t have the desired effect and you continue experiencing SUI symptoms, surgery may be the next step. Approximately 20% of people with stress incontinence require surgery.

How do I stop pee from leaking when I laugh or cough?

But there’s some good news! Stress incontinence is easily managed, especially when diagnosed in its early stages.

Some simple steps you can take to stop leaking when laughing or coughing include :

  • Monitoring your fluid consumption. While you shouldn’t be dehydrating yourself, consider moderating the amount of fluid you consume, especially if a bathroom is inaccessible.
  • Regulate your bathroom breaks. The more frequently you empty your bladder, the less likely you are to leak urine during moments of pressure.
  • Consider a few lifestyle changes. Caffeine and alcohol can increase your urine output. They can also irritate your bladder prompting urine leakage. Cut back as much as possible.
  • Mindful exercising is also crucial. Lifting heavy weights and strength training increase the pressure put on your pelvic floor. It can further weaken your pelvic floor muscles. Consider aerobic exercises such as pilates which assist with strengthening your pelvic floor.
  • Maintain a healthy weight. Extra weight puts additional pressure on the pelvic floor and with long durations, this causes the pelvic floor to weaken. Talk to your doctor about your ideal weight and get some evidence-based tips for weight-loss strategies.
  • Have a doctor look into conditions like chronic cough or constipation. Conditions that increase your need to bear down can also weaken your pelvic floor, indirectly impacting bladder sphincter control.

Stress incontinence can also be one of the symptoms of pelvic organ prolapse, diabetes, and even infection. This is why early signs of possible incontinence should always receive medical attention to prevent worsening of both symptoms and pelvic floor function.

Article written by
Michelle Frank, Medical Doctor
Director: Health & Wellness at Naima

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