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Why Do I Pee When I Cough?

Have you ever experienced urine leakage when you cough or sneeze suddenly? What about when you work out? Or laugh at a friend’s funny joke? This is a common problem for many women and can be a disruption to day-to-day life. (Not to mention embarrassing!). At NAFC, we hear this complaint from women all the time: I pee when I cough. How can I stop urine leakage when coughing? This article will explore why the leaks happen, and a cool trick to avoid them.

 

First, why do you pee when you cough?

The most common reason that women experience bladder leakage when they cough is stress incontinence and a weakened pelvic floor. Stress incontinence is a condition that occurs when urine leaks from the bladder during moments of physical stress, such as sneezing, laughing, working out, or, you guessed it, coughing. 

When the muscles of the pelvic floor (the hammock-like structure that supports the bladder, among other organs) become weakened, it can make it harder for women to “hold it in” when they have to go. Add physical pressure onto that, like a cough, sneeze, or a laugh, and you have a recipe for a bladder leak.  

Stress incontinence is especially common in women due to the many changes that occur to a woman’s body over her lifetime. Things like pregnancy and childbirth, and changing hormones during menopause can all affect the pelvic floor, making it weaker than it used to be. 

Luckily, there are many things you can do to treat stress incontinence. But, an easy trick to stop peeing when you cough or sneeze is an exercise technique commonly referred to as “the knack”. 

 

What is “The Knack”?

The Knack is a counter-bracing technique that allows you to brace your pelvic floor muscles when you’re about to place pressure on them. It sounds fancy, but really, the knack is just a timed Kegel contraction. Basically, when you feel a laugh, cough, or sneeze coming on, you quickly perform a Kegel contraction and hold it until the moment has passed and your pelvic floor is no longer experiencing so much pressure. This helps control bladder leaks by closing the urethra. 

If you find that you pee when you cough, laugh, sneeze, or workout, this exercise is for you. 

 

Who is the knack for?

Women who experience bladder leaks.

The knack is a useful exercise for anyone experiencing bladder leaks. If you experience incontinence when laughing, sneezing, or working out, (and yes, if you pee when you cough!) you can probably benefit from the knack.

Women with a pelvic organ prolapse

A prolapse is a condition where the pelvic floor has become weakened to the point that it’s unable to support one or more of the pelvic floor organs (the bladder, bowel, or uterus). When this happens, one or more of the organs collapses into the pelvic canal. There are many different stages of severity of a pelvic organ prolapse ranging from mild to severe, and symptoms can vary widely but may include bladder leaks, or a feeling of pressure or heaviness in the pelvis. Women who experience symptoms from pelvic organ prolapse can use the knack to protect against pressure on the pelvic floor.

 

When To Do The Knack?

You can do the knack any time you sense pressure coming to your pelvic floor. This may include: 

  • Coughing
  • Sneezing
  • Working out/lifting
  • Standing from a sitting position
  • Pushing
 

How Do You Do “The Knack” Exercise?

The knack is basically a timed Kegel, that’s done any time you anticipate pressure on the pelvic floor. So, to do the knack, you simply have to follow the instructions to do a Kegel.

  1. When you feel a cough or sneeze coming on, lift and squeeze your pelvic floor muscles.
  2. Contract the muscles for the urethra, vagina, and anus all at once.
  3. Hold the contraction throughout the cough (sneeze, workout, etc.)
  4. Once the pressure has passed (you’ve stopped coughing, sneezing, laughing, etc.) release your pelvic floor muscles and allow them to return to a neutral state. 

Mastering the Kegel exercise can be tricky, and may take some time to get it right. Many women do Kegels incorrectly and activate the wrong muscles. If you find you’re having trouble, consider seeing a physical therapist specializing in pelvic floor therapy to help guide you. 

Watch the video below to learn how to properly do a Kegel. Then start incorporating the knack to help prevent leaks when you cough, sneeze or laugh. 

 

Learn More about your pelvic floor

NAFC offers a comprehensive guide to your pelvic floor in our Pelvic Floor Health Center.

Learn about ways to keep your pelvic floor strong and healthy, download exercise sheets, watch videos, and learn about tools to help support and strengthen your pelivc floor. 

You can also sign up for a FREE 6-Week Pelvic Health Training Guide to improve your pelvic floor health.

This program will walk you through the ins and outs of your pelvic floor, talk to you about common problems that can occur, and show you ways to address them. Sign up for this FREE program for a healthier pelvic floor!

 

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