What Can I Do to Stop Peeing My Pants When I Cough? A Pelvic PT Explains.
Understand Why You Pee When You Cough and What To Do About It
If you’ve been asking yourself, “What can I do to stop peeing my pants when I cough?” — you are absolutely not alone. Leaking with coughing is incredibly common, and there are absolutely treatment options out there. Stress incontinence (also known as urinary leakage) is the technical term of “peeing when I cough”. Oftentimes, people that are dealing with stress incontinence don’t just pee when they cough, but also when they sneeze, laugh, jump, run, or do anything that requires physical exertion.
When you cough, pressure inside your abdomen increases very suddenly. Your pelvic floor is supposed to reflexively tighten to keep urine in — but if the muscles are weak, tight, delayed, or not coordinating with your breath, that pressure has nowhere to go except down onto the bladder… causing leakage
As a pelvic floor physical therapist, stress incontinence is one of the top concerns that we help patients overcome. There are various research studies that aim to quantify how many women struggle with urinary leakage and stress incontinence. Some research estimates that up to 1 in 3 women experience stress incontinence at some point — and in clinical practice, we see it even more often. This is so important because leakage is 100% treatable and can be improved or completely eliminated.
We are passionate about improving symptoms of stress incontinence or urinary leakage for two reasons:
Urinary leakage during exercise is one of the top reasons that women stop an exercise routine
Urinary leakage is a symptom, not a diagnosis.
Since this article is more about peeing when you cough, we won’t touch too much on peeing during exercise. However, as physical therapists, we are absolutely passionate about ensuring that people incorporate movement into their lives. The mental health, physical, cardiovascular, and social benefits of exercise are vast. Therefore, by missing out on exercise due to urinary leakage, you are missing out on all the other benefits of exercise!
More importantly, especially when talking about peeing when coughing, urinary leakage is a symptom, not a diagnosis. We have to investigate why the urinary leakage is happening in the first place. What exactly is causing you to leak? What part of your body isn’t doing its job? These are key questions to answer in order to ultimately stop you from peeing when coughing.
If the root cause isn’t addressed, symptoms can worsen and lead to other issues such as back pain, hip pain, bowel problems, or sexual dysfunction due to compensations
So how do we stop peeing when you cough?
Well, we have to consider the reasons that you might be leaking. The top things that pelvic PTs consider include:
Pelvic floor muscle weakness
Pelvic floor muscle tightness or poor coordination
Posture or movement dysfunction
Prolapse or postpartum changes
Hormonal changes (especially perimenopause)
Lifestyle factors such as constipation
Many of the times, people are told to do Kegel exercises (or repetitive contractions of your pelvic floor muscles). People are told to do Kegels in order to strengthen the pelvic floor muscles. The problem is, Kegels can be helpful only when the problem is pelvic floor weakness. But if the pelvic floor is tight or not coordinating, Kegels can actually make leaking with coughing worse. This is why a proper pelvic floor evaluation is important.
Therefore, in order to answer the question: “What can I do to stop peeing when I cough?” We have to get a better understanding of why you are experiencing leakage in the first place.
In general, if you are struggling with peeing when coughing, you need to find a skilled pelvic floor physical therapist that will consider all of the factors (and then some) listed above.
Taking a holistic approach that gets to the root cause of why you are experiencing your symptoms is crucial in getting your symptoms addressed. In general, treatment in pelvic floor physical therapy includes internal (inside) and external (outside) pelvic muscle treatment. This includes hands on, manual treatment, soft tissue work, exercises including strengthening and stretching, postural, movement and lifestyle modifications, and may include things like a pessary and possible hormone therapy (which would be established with another provider).
In the meantime, while waiting to get into a pelvic PT, you can try:
The “knack”: Try to engage your pelvic floor prior to coughing. Essentially, you want to squeeze it as if you are stopping the flow of urine, just prior to coughing, and holding it while coughing. Sometimes, this can help to retrain your body to engage your pelvic floor at the right time. This is a temporary strategy and unfortunately isn’t a long term solution.
Practice diaphragmatic breathing: On inhale, practice letting go of your belly. Your stomach needs to expand when you inhale, and draw in on exhale (which is the opposite of what most people do). This ensures that when you exhale (i.e. on coughing) your pelvic floor is lifting, not letting go.
We want to make sure that patients leave therapy with a tactical plan and understanding on why their symptoms might be happening in the first place.
If you’re wondering, ‘What can I do to stop peeing my pants when I cough?’ you are definitely not alone — and the good news is, this problem is treatable If you are local to the Bucks County, PA area, call us so we can see you in person at our Newtown, PA or Doylestown, PA locations. If you are not local to Bucks County, we can also see you virtually to help you problem solve your concern and get you started on the path to dry pants.
You don’t have to live with peeing when you cough. The sooner we get it addressed, the easier it is to fix. If you’re in Bucks County, schedule an in-person appointment in Newtown or Doylestown today — or join us virtually — and take the first step toward dry pants for good.
