Women who leak urine when they sneeze, cough, or laugh may have a condition called stress incontinence. Learn more.

You’re walking down the street when you feel a sneeze attack coming on. And with each hearty “achoo,” you leak a little bit of urine. You wonder: Is this normal?

Why Do I Pee When I Sneeze?

If you leak urine — a little or a lot — when you laugh, cough, or sneeze, you have a type of urinary incontinence. It’s common, especially in women as they get older. But it’s not an inevitable part of aging.

There are many things you can do to improve urinary incontinence.

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What Is Urinary Incontinence?

Urinary incontinence means that you leak urine when you don’t want to. There are two kinds of urinary incontinence:

  • Urgency incontinence. Also called overactive bladder, urgency incontinence happens when the bladder spasms and squeezes uncontrollably. The main symptom is a strong, sudden “gotta go” urge.
  • Stress incontinence. The word stress refers to physical pressure on the pelvic floor — like sneezing or coughing — not mental stress.

Some women have both urgency and stress incontinence.

What Is Stress Incontinence?

Stress incontinence happens when there’s sudden pressure on the bladder and urethra. The pressure makes the sphincter muscles (which hold in urine) open for a moment.

These leaks are most likely to happen when you laugh, cough, sneeze, or exercise. Even gentle movements like standing up or bending over can trigger a leak. You may even pee a bit when you have sex.

The amount of urine leaked can be a few drops, or it can be enough to soak through your clothing.

Stress Incontinence in Women

Both men and women can suffer from stress incontinence, but it’s much more common in women.

According to the Urology Care Foundation, about 1 in 3 women will suffer from stress incontinence at some point in their lives. And half of women age 65 and older find that they leak urine.

What Causes Stress Incontinence in Women?

A weak pelvic floor causes stress incontinence in women. The muscles of the pelvic floor can get stretched or damaged. When that happens, they can’t support the urethra to regulate the flow of urine.

Risk factors for stress incontinence in women include:

  • Pregnancy.
  • Childbirth.
  • Being over age 65.
  • Menopause.
  • Being overweight.
  • Having chronic constipation.
  • Smoking.
  • Chronic coughing.
  • Pelvic surgery (i.e., a hysterectomy).

Treatment for Stress Incontinence

There are ways to reduce stress incontinence in women. Many are home remedies with minimal expense.

Lifestyle treatments for stress incontinence in women

Your doctor may recommend the following home treatments:

  • Do pelvic floor exercises. Kegel exercises can strengthen the muscles of your pelvic floor. To do Kegels, tighten and release muscles that hold back urine. Gradually increase the length of the contractions and the number of repetitions.
  • Lose weight. Being overweight can weaken the pelvic floor and increase leaks. Your doctor can recommend a healthy eating and exercise plan.
  • Quit smoking. Chronic coughing from smoking weakens the pelvic floor, making leaks more likely.
  • Improve your bowel movements. Being constipated puts pressure on your urinary tract and pelvic floor. That can make stress incontinence in women worse. Eat plenty of fiber, get regular exercise, and drink 6 to 8 glasses of water each day to ward off constipation.
  • Reduce caffeine and alcohol. Both are diuretics that increase urine output.
  • Cut back on high-impact exercise. Nix running and cardio workouts with lots of jumping. Instead, opt for lower-impact activities like walking, yoga, cycling, or swimming.

Medical treatments for stress incontinence in women

If lifestyle changes don’t help, your doctor may recommend one or more of the following treatments for stress incontinence:

  • Vaginal pessary. This flexible device sits inside the vagina, supporting the bladder and urethra above it so they can work better. Your doctor will fit the pessary and show you how to insert it.
  • Estrogen creams. These can help strengthen the muscles and tissue in the urethra and vaginal areas.
  • Surgery. Surgery may be an option to help correct stress incontinence. In urethral sling surgery, a small strip of material is placed under the urethra to support it.

NHS, Non-surgical Treatment, Urinary Incontinence, Link

Urology Care Foundation, What is Stress Urinary Incontinence? Link

U.S. Department of Health and Human Services, Office on Women's Health, Urinary Incontinence, Link

National Institute of Diabetes and Digestive and Kidney Diseases, Bladder Control Problems (Urinary Incontinence), Link

About Urology

The UPMC Department of Urology offers a wide variety of specialized care for diseases of the male and female urinary tract and the male reproductive organs, including erectile dysfunction, kidney stones, urinary incontinence, prostate cancer, and more. We have a multifaceted team of physicians and researchers working together to provide the best care to both children and adults. Our team is nationally renowned for expertise in highly specialized technologies and minimally invasive surgical techniques. To find a provider near you, visit our website.