Leaking urine when you cough, laugh, jump or run is common, especially in women, and it is not a routine part of being a woman or getting older. An estimated half of all women experience urinary incontinence, the accidental loss or leaking of urine. Bladder control problems can greatly affect your quality of life, and an exercise class is the kind of activity you may be too embarrassed or afraid to take part in because of them.
Is leaking when you jump or cough a bladder problem?
Leaking urine during everyday activities, such as lifting, bending, coughing or exercising, is among the signs and symptoms of urinary incontinence, one of the most common bladder control problems. Urinary incontinence is a condition that may be related to another health problem or a life event, such as pregnancy or prostate problems.
There are several types of urinary incontinence, and each type has different symptoms and causes. These are three of them:
| Type | When urine leaks |
|---|---|
| Stress incontinence | When stress or pressure on your bladder makes you leak, which could be due to coughing, sneezing, laughing, lifting something heavy or physical activity. |
| Urge, or urgency, incontinence | When a strong need to urinate comes on and some urine leaks out before you can make it to the toilet. |
| Mixed incontinence | More than one type, usually stress and urge incontinence together. |
A health care provider can work out which type you have, using tools that may include a medical history with questions about your symptoms, a physical exam, urine or blood tests, and bladder function tests. Urinary incontinence can range from a minor problem to something that greatly affects your daily life, and it can get better with proper treatment. The sooner you raise it with a health care professional, the sooner incontinence may improve.
Why urine leaks when you move
Movement pushes on your bladder: stress incontinence occurs when coughing, sneezing, laughing or physical activity puts pressure on the bladder and causes urine to leak. The pelvic floor muscles stretch like a hammock from the front to the back of your pelvis and support the bladder, rectum and uterus. Weak pelvic floor muscles can make it hard for your bladder to hold urine in when that pressure arrives.
In women, pregnancy and childbirth, trauma or injury such as sexual assault, pelvic organ prolapse and menopause can each lead to stress incontinence by weakening the pelvic floor muscles. Surgery and getting older are among the other things that can weaken pelvic floor muscles.
A chronic, or long-lasting, cough is one of the health problems that can lead to urinary incontinence, along with diabetes and overweight or obesity, among others. Smoking raises your chances of developing stress incontinence, because smoking causes long-lasting coughing. Constipation can make urinary tract health worse and can lead to incontinence, so check whether what you have counts as constipation (see Two bowel movements a week: constipation, or just eating less?). Physical inactivity is one of the lifestyle factors that make women and men more likely to experience urinary incontinence.
Staying active while you still leak
Staying active while you still leak is good for you: physical activity is important for overall health and may prevent further bladder control problems, even though running, jumping or brisk walking may cause some people with incontinence to leak. Until you find a treatment that is right for you, or for extra peace of mind, incontinence briefs and pads absorb leaks and control odor, and they may give you the confidence to get moving again.
Walking, swimming, biking and dancing are among the activities that can improve your health. If you are concerned about not having a bathroom nearby during physical activity, choose a place with restrooms close by, such as a shopping mall, community park or local gym. You may be able to reduce leaks by being physically active and keeping a healthy weight.
The exercise for leaking, and how long before anything changes
Kegel exercises, also called pelvic floor muscle training, strengthen the muscles that hold urine in: you squeeze, hold and relax your pelvic floor muscles. They can help both women and men, but in some cases they may not be a good option, so check with your own doctor, a nurse or a pelvic floor therapist before you begin.
Many people have trouble finding the right muscles, so start there. Imagine you are trying to stop passing gas and squeeze the muscles you would use; a pulling feeling in your vaginal or rectal area means you have found them. Stopping your urine midstream is another way to find them at first, though not a way to exercise, because stopping your bladder from emptying completely could increase your risk for a bladder infection.
Keep your stomach, thighs and other muscles relaxed while you squeeze. Squeezing the wrong muscles can put more pressure on your bladder, making it easier to leak urine.
The exercise can be done in different ways, in how many seconds you hold the squeeze and how many repetitions you do, so a doctor or a pelvic floor therapist can give you a plan that meets your needs. Until you have one, follow one of these two routines rather than mixing them:
| Step | NIDDK | MedlinePlus |
|---|---|---|
| The hold | Try to hold the squeeze for 3 seconds, then release and fully relax. | Hold tight for 3 to 5 seconds, then relax for 3 to 5 seconds. |
| Each time | Try to work up to 10 to 15 repetitions. | Repeat 10 times. |
| How often | At least three times a day. | 3 times a day, in the morning, afternoon and night. |
| Position | Try to use all three every day: lying down, sitting and standing. | Sitting or lying down, with your bladder empty. |
| First change | You may not feel your bladder control improve until after 3 to 6 weeks. | You should have fewer symptoms after 4 to 6 weeks. It may take several months for incontinence to lessen. |
On either timeline, a week of squeezing with no change is early. Once you are doing the full routine, keep doing the exercises, but do not increase how many you do, since overdoing them can lead to straining when you urinate or move your bowels. The exercises help only while you keep them up: incontinence will return if you stop, and once you start, you may need to do them for the rest of your life. In women, doing Kegel exercises incorrectly or with too much force may cause the vaginal muscles to tighten too much, which can cause pain during sex.
What helps besides the exercises
Besides the exercises, weight plays a part: overweight and obesity raise your chances of developing urinary incontinence, and losing weight can help you have fewer leaks, and avoiding weight gain may prevent urinary incontinence. Depending on the type of incontinence you have, the doctor treating it may suggest lifestyle changes first, and if they are not working for you, may prescribe medicine, a medical device, a bulking agent or, as a last resort, surgery.
When to see a doctor about leaking, and how soon
See your own doctor about the leaking itself, because leaking urine is one of the symptoms of a bladder problem to see a health care professional about, as are others such as trouble urinating, waking to use the bathroom and pelvic pain. Tell them about the class too, since bladder control problems that make it difficult for you to be active are something to talk over at that visit. Health care professionals, especially gynecologists, urologists and geriatricians, often talk with people about bladder control problems.
At that visit, ask whether you are squeezing the right muscles. The doctor, a nurse or a pelvic floor therapist can let you know if you are doing the exercises correctly, and can examine you while you do them. You may be referred to a physical therapist who specializes in pelvic floor exercises. The doctor may ask you to keep a bladder diary for a few days before your appointment, recording how much and when you drink, when and how much you urinate, and whether you leak urine.
Some signs need care sooner than a booked visit:
| Sign | Who to contact, and how fast |
|---|---|
| You suddenly lose control over urine and also have any of these: difficulty talking or walking; sudden weakness, numbness or tingling in an arm or leg; loss of vision; loss of consciousness or confusion; loss of bowel control. | Call 911 or your local emergency number, or go to an emergency room. If you cannot wait, call 911 so the emergency team comes to you right away. |
| See a health care professional right away, because these symptoms can signal a serious health problem. Your own doctor's office is one place to phone; if it is not open, your call may be forwarded to a nurse or other provider on call, who can tell you what to do. |
NicoCares patients can also tell their care team about the leaking, and about the class it has cost them, in Spruce, the messaging app where the team answers. Replies in Spruce carry no set time, so every sign in the table above goes to a health care professional you can reach right away, or to emergency care, as the table sorts them, and never into a message.
