If you’ve ever sneezed, laughed, or coughed and found yourself saying, “Oops, I peed a little,” you’re not alone. Stress incontinence—leaking a bit of urine when you put pressure on your bladder—is more common than you might think. And while it might feel embarrassing, the good news is that there are plenty of solutions available to help you regain control and confidence.
In this guide, we’re diving into why stress incontinence happens, how to recognize the symptoms, and, most importantly, what you can do about it. Let’s tackle the “why do I pee when I cough?” question head-on!
What is Stress Incontinence?
Stress incontinence occurs when physical movement or activity—such as coughing, sneezing, laughing, exercising, or even lifting something heavy—puts pressure on your bladder, leading to an accidental leak of urine. This is different from urge incontinence, which is that sudden, uncontrollable need to go to the bathroom right NOW.
The “stress” in stress incontinence refers to the pressure or “stress” placed on your bladder, not emotional stress (although we admit, this can cause emotional stress too!). It can happen to anyone, but it’s more common in women, especially after childbirth or as we age.
Why Do I Pee When I Cough?
To understand why you pee when you cough, it’s helpful to picture the pelvic floor as a trampoline for your internal organs. The muscles in the pelvic floor act as a supportive hammock, helping hold up the bladder, bowel, and (for women) the uterus. When these muscles are strong and healthy, they do a great job of keeping everything in place and maintaining bladder control. But when the pelvic floor weakens, it’s like having a trampoline with stretched-out springs—things just don’t bounce back as they should.
Here are a few common reasons why the pelvic floor might weaken, leading to stress incontinence:
Causes of Stress Incontinence
Pregnancy and Childbirth
Pregnancy and childbirth are some of the biggest culprits when it comes to stress incontinence. The weight of a growing baby puts pressure on the bladder, while vaginal delivery can stretch and weaken the pelvic floor muscles, sometimes damaging the nerves that control the bladder.Aging
As we age, our muscles lose strength and elasticity, and the pelvic floor is no exception. For women, estrogen levels drop during menopause, which can further weaken the muscles that help control the bladder.Weight Gain
Carrying extra weight puts added pressure on your bladder and pelvic floor, which can increase the likelihood of leaks when you cough, laugh, or sneeze.Chronic Coughing or Smoking
Constant coughing, whether from a chronic condition like asthma or from smoking, can strain your pelvic floor over time, contributing to stress incontinence.Hormonal Changes
Hormonal fluctuations, particularly the decrease in estrogen during menopause, can thin and weaken the tissues of the pelvic floor and bladder.Pelvic Surgery
Previous surgeries in the pelvic area, such as a hysterectomy, can weaken the support structures around the bladder, increasing the risk of stress incontinence.
Symptoms of Stress Incontinence
The most obvious symptom of stress incontinence is, of course, leaking urine during activities that increase pressure on your bladder. Here are some common triggers:
- Coughing
- Sneezing
- Laughing
- Exercising (especially running or jumping)
- Lifting heavy objects
- Bending over
It’s important to remember that stress incontinence can range from mild (just a few drops) to more severe (a larger amount of urine leakage). Even if it’s just a little bit, the annoyance and embarrassment can have a big impact on your daily life.
Treatment Options for Stress Incontinence
The great news is that stress incontinence is treatable! There are several approaches to managing and even eliminating symptoms, ranging from at-home exercises to advanced medical treatments. Let’s explore a few:
1. Kegel Exercises: Strengthen Those Pelvic Muscles!
Kegel exercises are the go-to first step for managing stress incontinence. By regularly contracting and relaxing the pelvic floor muscles, you can strengthen them over time, helping to reduce or even stop leaks.
Here’s how to do Kegels:
- Identify the muscles you use to stop the flow of urine (those are your pelvic floor muscles).
- Contract those muscles for a count of 5.
- Relax the muscles for a count of 5.
- Repeat 10 times in a row, several times a day.
You can do Kegels anywhere—while sitting at your desk, watching TV, or even while waiting in line at the grocery store!
2. Biofeedback with Devices Like Perifit
If you find it hard to tell whether you’re doing your Kegels correctly, you’re not alone! Biofeedback devices like Perifit can help. Perifit is a smart Kegel exerciser that connects to your phone via Bluetooth and uses games to help guide your pelvic floor exercises. It tracks your progress and lets you know when you’re getting stronger.
Think of Perifit like a personal trainer for your pelvic floor muscles—it’s fun, interactive, and can make a big difference in strengthening those muscles.
3. Emsella: The “No Effort” Option
If you’re looking for a treatment option that doesn’t require as much work on your part, Emsella might be the perfect fit. Emsella is a non-invasive, FDA-approved treatment that uses electromagnetic energy to stimulate the pelvic floor muscles.
How Does Emsella Work?
During an Emsella session, you sit fully clothed in a special chair that delivers thousands of supramaximal contractions (basically, really intense Kegel exercises) to your pelvic floor muscles. Each session lasts about 28 minutes, and it’s like doing 11,000 Kegels in that short time—without you having to do any work!
Most patients need about six sessions, spaced out over a few weeks, to see the best results. Many people notice a significant improvement in bladder control after just a few treatments.
What’s the Treatment Like?
It’s simple, comfortable, and pain-free. You’ll feel a tingling sensation and muscle contractions, but there’s no downtime or recovery period afterward. You can get right back to your normal activities immediately!
4. Weight Loss
If you’re carrying extra weight, losing even a few pounds can take some of the pressure off your bladder and pelvic floor. Maintaining a healthy weight can help reduce the frequency and severity of leaks.
5. Lifestyle Changes
Making small changes in your daily habits can also help reduce stress incontinence. Consider:
- Avoiding bladder irritants like caffeine, alcohol, and spicy foods.
- Scheduling regular bathroom breaks to avoid a full bladder.
- Doing pelvic floor-friendly exercises, such as walking or swimming, instead of high-impact activities like running.
When to See a Doctor
If stress incontinence is interfering with your quality of life or if at-home treatments aren’t helping, it might be time to see a healthcare provider. They can assess your pelvic floor muscles and recommend more advanced treatments, such as:
- Medications that can help improve bladder control.
- Surgical options like a bladder sling or urethral bulking agents, which provide extra support for the bladder and urethra.
Conclusion: Regain Control of Your Bladder
Dealing with stress incontinence, and asking yourself, “why do I pee when I cough?” doesn’t have to be your new normal. Whether you start with Kegel exercises, biofeedback tools like Perifit, or try a non-invasive treatment like Emsella, there are many ways to strengthen your pelvic floor muscles and reduce those embarrassing leaks.
