Leaking when you cough, sneeze, laugh or jump is common after pregnancy and around menopause, but it is not something you have to live with. Here is how to strengthen your pelvic floor.
The short answer
Leaking urine when you cough, sneeze, laugh, run or lift is called stress urinary incontinence. It affects about 1 in 3 women at some point, especially after pregnancy and around menopause. Daily pelvic floor muscle exercises, done correctly for at least three months, cure or improve it for most women, and a pelvic health physiotherapist can make sure you are doing them right.
What the pelvic floor does
The pelvic floor is a sling of muscles from the pubic bone to the tailbone that supports the bladder, uterus and bowel and helps keep you continent. Pregnancy and birth, chronic coughing, constipation and straining, heavy lifting, higher body weight and falling estrogen after menopause can weaken it.
The short version
How to do pelvic floor (Kegel) exercises
- Find the muscles: imagine stopping yourself passing wind and stopping the flow of urine at the same time. Squeeze and lift inwards. Your buttocks, thighs and belly should stay relaxed, and keep breathing.
- Long holds: squeeze and hold for up to 10 seconds, then fully relax for 10 seconds. Repeat up to 10 times.
- Quick squeezes: tighten and release quickly 10 times.
- Three times a day, every day. Start lying down, then sitting, then standing.
- “The knack”: squeeze just before you cough, sneeze or lift.
Expect improvement in 3 to 6 months. Don’t practise by stopping your urine flow regularly, as this can affect bladder emptying.
Other things that help
- Treat constipation and avoid straining
- Stay well hydrated; cutting fluids makes urine more concentrated and irritating
- Cut back on caffeine, fizzy drinks and alcohol if you also have urgency
- Vaginal estrogen after menopause can help symptoms
- Pessaries, and surgery when exercises aren’t enough
When to see someone
Ask your doctor for a referral to a pelvic health physiotherapist, or book directly in BC, if leaks persist or bother you. See a doctor sooner for a sudden urge to go with leaking, burning, blood in the urine, a feeling of a bulge or heaviness in the vagina, or leaking with back pain or numbness.
Frequently asked questions
Is it normal to pee when you sneeze?
It is common, especially after childbirth and around menopause, but it is treatable and not something you have to accept.
How long do Kegels take to work?
Most women notice improvement after about 3 to 6 months of daily exercises.
How do I know if I am doing Kegels correctly?
You should feel a squeeze and lift inside without tightening your buttocks or holding your breath. A pelvic health physiotherapist can check.
Can you fix bladder leaks without surgery?
Yes. Pelvic floor exercises improve or cure stress incontinence for most women.
Build strength at home
Strong at 40+ includes pelvic-floor-friendly progressions and a 12-week home programme to build strength safely.
