Giggling at a good joke is no laughing matter when a leak of pee escapes into your underwear.
It can be uncomfortable and embarrassing and make you wonder: why do I pee when I cough or laugh?
The condition is known as stress incontinence and you’re not alone. Studies have found that incontinence affects twice as many women as men.1 It’s also more common as we get older, affecting up to 52% of women by the time we reach the 70-74 age group.2
Let’s look into why many of us pee when we cough or laugh.
The loss of bladder control is called urinary incontinence, and there are two types that most commonly affect women: stress incontinence and urge incontinence (or overactive bladder).1
Incontinence affects twice as many women as men, which may be because of the different life journeys we follow that often include pregnancy and childbirth, and finally menopause. While it can be more common as we age, it does not have to be a normal part of aging, and it can be treated.1
Stress urinary incontinence is the condition of peeing with physical movement or activity, which includes coughing and laughing, but can also happen when you’re jumping, running or lifting heavy objects. The physical strain puts pressure or stress on your bladder, hence the name stress incontinence, which in turn causes you to leak urine. Stress incontinence is not related to psychological stress, but it is more common among women.3
Urge incontinence or overactive bladder (OAB) is when your bladder muscle contracts and creates a sudden urge to urinate before you can get to the bathroom.3
What Causes Stress Incontinence?
This annoying and sometimes embarrassing condition happens when the muscles weaken in your pelvic floor and those that control urine, known as the urinary sphincter. When the bladder fills with urine, it expands. Usually the muscles in the tube that carries urine, the urethra, keep it closed as the bladder expands. That helps you get to a bathroom before releasing urine.3
But when the muscles get weak, any sort of force puts pressure on your bladder and makes it leak. That includes sneezing, coughing, bending over, lifting or laughing hard.3
The issue can get worse as we get older, when incontinence is associated with other factors, like chronic conditions such as diabetes and stroke, or even difficulty with mobility. There could also be age-related changes in the lower urinary tract and urinary tract infection.4
Add that to a woman’s life course of having children and the hormonal changes of menopause, and incontinence can be more prevalent as we age. Some numbers estimate as many as one in three women will experience stress urinary incontinence at some point.5
What Can I Do About Stress Incontinence?
If you have the symptoms of stress incontinence, seek diagnosis and advice from a doctor. Then you can embark on a treatment plan that may include some of the tips below. You can also look to these strategies to prevent incontinence:
- Perform pelvic floor exercises, known as Kegels, in which you contract, hold and then release your pelvic floor muscles.5
- Do other exercises, such as yoga, to strengthen your core and pelvic floor muscles.
- Eat high-fibre foods and drink plenty of water to prevent constipation, which can make incontinence worse.5
- Quit smoking.5
- Maintain a healthy weight.5
- Manage conditions like diabetes and high blood pressure.5
- Use the restroom at set times, known as timed voiding or bladder training.5
In some instances, your doctor may suggest other treatment options. A vaginal pessary, for instance, is a device that supports the bladder and urethra.5 In some cases, surgery is performed to make a sling or mesh under the urethra to support it.5
You can also take steps to minimize the impact of incontinence as you seek treatment. Being prepared may help you feel more comfortable to go out, so you can maintain connection with family and friends and feel confident at work. For instance, do research on a new destination to find restrooms nearby. Take pads or even a change of clothes with you. And be upfront with your partner to gain support for your condition, especially if it’s impacting your sex life.3
Finding a Doctor
Incontinence is not a normal part of aging, so it’s important to remember that treatments are available to cure or significantly reduce the effects of stress incontinence on your life.3
Use our Physician Finder to find a doctor near you with expertise in women’s health, who is willing to work with you to determine the best way to treat your incontinence.3