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

So you leaked a bit. Here’s what to do about it.

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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 pee a little accidentally, are not so great. This unwelcome surprise is called stress incontinence.

What is stress incontinence?

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.

Urinary leakage can occur if the urethral wall, urethral sphincter, or pelvic floor muscles are weak. You have a higher chance of stress incontinence if you:

  • Have been pregnant or given birth, especially after a vaginal delivery
  • Have gone through menopause
  • Are overweight
  • Have diabetes

Some women do regain bladder control within a couple months after having a baby. However, it’s fairly common to have some stress incontinence for several years after childbirth. One study found that 29 percent of first-time mothers still had incontinence four years after delivery.

What are treatments to avoid or manage accidents?

Treatments for stress incontinence usually include lifestyle or behavior changes. In more serious cases, medication and surgery are also an option.

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

1. Empty your bladder often.

Stress incontinence is less likely when you don't have a full bladder. It’s also important to urinate when you first feel the urge, so don’t hold it. This may help reduce the amount of urine that leaks.

2. Do Kegel exercises.

Kegels may help to strengthen your pelvic floor muscles. This way, they are better able to close the urethra in moments of stress, such as exercising, coughing, or sneezing. Here’s how to do a Kegel exercise — and also how NOT to do a Kegel exercise.

3. 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.

When is surgery helpful?

If lifestyle modifications don’t help, surgery is an option for stress incontinence. In this surgery, doctors place a sling under the urethra. The sling helps shut the urethra, which helps prevent leakage.

While leaking urine is common — especially as people age — you don't have to just put up with it. There are a number of things that you and your doctor can do that may help. Talk to your doctor if you experience stress incontinence often, or if it's getting in the way of your daily living.