Leaking When You Cough or Sneeze?

‘Tis the season… cold and flu season that is, and it’s a season when even the best pelvic floor can be challenged by a barrage of coughing and sneezing fits. Yes, your best bet is to train your pelvic floor to withstand the increased pressure caused by a cough/sneeze (that’s what makes you pee - a type of incontinence we call stress incontinence), but if you’re looking for a quick fix, we’ve got some of those for you as well!

Apply external pressure:

A cough or a sneeze can create a lot of downward pressure on the pelvic floor. In an ideal world, your pelvic floor would be able to rise to the challenge (literally and metaphorically), meeting pressure with pressure. But a lot of people are living in a less than ideal world, so it can be helpful to apply some external pressure to help your pelvic floor. One way to do that is to take your hand and place it at your perineum (the space between your genitals and rectum) and apply some upwards pressure there. You’ll want to do this when you feel a cough or sneeze coming on.

The Knack:

The beloved knack, a favorite of pelvic floor therapists everywhere, and for good reason! The knack is when you anticipate a sneeze/cough and do a pelvic floor contraction (kegel) right before that happens. Of course, timing is of the essence here. It works best when you can anticipate the sneeze/cough, and less well when you’re already in the middle of an episode. It also requires you to know what your pelvic floor is doing when you’re contracting it, which is why the knack is best trained for under the guidance of a pelvic floor PT.

Listen to your bladder:

Leaking when you cough or sneeze is ultimately an issue of whether your pelvic floor can handle the pressure of the cough or sneeze. Training your pelvic floor for this kind of impact is great, but if your bladder is too full there’s a limit to how much pressure your muscles will be able to handle. We are DEFINITELY not saying to limit your fluid intake (never!) but we are saying to make sure you listen to your bladder cues. You want to be emptying every 2-4 hours - any longer than that and chances are your bladder is going to be quite full, creating a lot of increased pressure on the pelvic floor so that when that sneeze or cough does come, your pelvic floor might struggle to respond. 

While we love these tips for short term fixes, we want to stress that if you are leaking while coughing/sneezing, you really should be seen by a pelvic floor PT who can get to the bottom of why you are leaking.