Is It Normal to Pee a Little When I Cough or Sneeze?

Some surprises, like when your spouse makes you breakfast in bed or when the barista randomly gives you a latte on the house, are great. Other surprises, like when you have a sneeze attack and then, er, pee yourself a bit … are not so great.

Peeing in your pants a little, while embarrassing, is totally normal. It’s called stress incontinence when the bladder leaks urine while under increased pressure, like when you exercise, lift something heavy, sneeze, or even when you’re having sex.

Stress incontinence can occur if the urethral wall, urethral sphincter, or pelvic floor muscles are weak. Women who’ve been pregnant, given birth, gone through menopause, or are overweight or have diabetes are at an increased risk for stress incontinence. “It’s very common to have a leaking of urine after you have a vaginal delivery,” says Jennifer Wu, MD, an ob-gyn at Lenox Hill Hospital. “This is because the pelvic supports have had some stress.”

While some women regain bladder control within a couple months after having a baby, it’s not uncommon to have some stress urinary incontinence for several years after childbirth. One study found that 29% of first-time mothers still had incontinence four years after delivery. “Patients may report that with any sort of increased pressure, like coughing or sneezing, they leak a little bit, even after years of having a baby,” says Dr. Wu.

Treatments for Stress Incontinence

Treatments for stress incontinence usually include lifestyle or behavior changes, and in more serious cases, surgery. “Before talking about surgery, we talk with patients about behavioral modifications and also medications that can help with the leaking of urine,” says Dr. Wu.

Here are some lifestyle tweaks that may help reduce stress incontinence:  

Empty your bladder often. “A patient may want to try to keep their bladder as empty as possible, especially emptying right before exercise,” says Dr. Wu. It’s also important to urinate when you first feel the urge—don’t hold it. This may help reduce the amount of urine that leaks.

Do Kegel exercises. “[Kegels] help to strengthen the [pelvic floor] muscles so they’re better able to close the urethra in moments of stress, such as coughing or sneezing, says Dr. Wu. Here’s how to do a Kegel exercise—and also how NOT to do a Kegel exercise.

Drink the right amount of fluid. If you drink large amounts of fluid, you may find that cutting back will reduce your leakage. However, if you don’t drink enough fluid, your urine may become concentrated, which can irritate your bladder and increase the urgency to urinate. Here’s how to drink the right amount of water for your body.

If lifestyle modifications don’t help, surgery is an option for stress incontinence. “There’s surgery where we place a sling under the urethra, so when a patient coughs it helps to shut the urethra so [they] don’t leak,” says Dr. Wu.

“Many women think that urinary incontinence is just a part of the process of getting older, but they don’t realize that there are different things we can do to help them,” says Dr. Wu. “We don’t want it to impact their daily lives where they’re avoiding exercise, we really can help them with surgery and medications.”