Peeing When You Laugh Is Common. It Isn't Normal.
Excerpt: Crossing your legs before a sneeze and keeping a liner in every purse shouldn't be your routine. Dr. Martin Pakideh explains why leaking happens, the different types and the treatments that work.
In this article
Why it happens
Not all leaking is the same
A quick self-check
What treatment looks like
Frequently asked questions
At some point, a lot of women develop a quiet little routine. Cross your legs before you sneeze. Skip the trampoline. Keep a liner in every purse. Laugh, but not too hard.
If that sounds familiar, you're in very good company. Urinary leakage affects millions of women, and many wait years before mentioning it to a doctor. Some never do.
Here's the message I wish every woman heard: common does not mean normal. And it definitely doesn't mean untreatable.
Why it happens
Your bladder is held in place and kept closed by a team effort: pelvic floor muscles, ligaments and the tissue that supports your urethra. When that support weakens, pressure wins and urine escapes.
The usual suspects:
Pregnancy and vaginal childbirth, which stretch and strain the pelvic floor
Menopause, when falling estrogen thins the supporting tissue
Aging, which gradually weakens muscle and connective tissue
High-impact exercise, like running and jumping, over many years
Chronic coughing, constipation or heavy lifting, which push down on the pelvic floor
Extra weight, which adds constant pressure on the bladder
Not all leaking is the same
Knowing which type you have is the first step to fixing it. MedlinePlus describes these main types:
Stress incontinence: leaking with a cough, sneeze, laugh, jump or lift
Urge incontinence: a sudden, intense need to go, and not making it in time
Mixed incontinence: a combination of both, which is very common
The treatments are different. A sling, for example, works well for stress leakage but isn't designed to fix urgency. That's why a proper evaluation matters. At Monroe OBGYN, that can include urodynamic testing, a simple in-office test that shows how your bladder fills and empties.
A quick self-check
Ask yourself:
Do I leak when I cough, sneeze or laugh?
Do I plan my outings around where the bathrooms are?
Have I stopped exercising, dancing or playing with my kids because of leaking?
Do I wear a pad or liner "just in case" every day?
Do I get up more than once a night to urinate?
If you answered yes to any of these, it's worth a conversation with your gynecologist.
What treatment looks like
Most women start simple, and many do great without surgery.
Pelvic floor physical therapy to strengthen the right muscles the right way
Bladder training and lifestyle changes, like managing fluids, caffeine and constipation
Vaginal estrogen after menopause, to strengthen thinning tissue
A pessary, a small removable device that supports the bladder
Medication for urgency symptoms
A midurethral sling, a short outpatient procedure for stress leakage. I explain how it works in Whoopi Goldberg Made Bladder Leakage Ads Famous.
At Monroe OBGYN, I'll help you figure out which type of leakage you have and which options make sense for your life.
You shouldn't have to plan your life around a bathroom. Leaking is one of the most treatable problems I see, and the hardest part is usually just bringing it up.
Ready to stop leaking? Book a visit at Monroe OBGYN or call (734) 242-2022.
Frequently asked questions
Is it normal to leak a little after having a baby? It's common in the first weeks and months after delivery, and it often improves with time and pelvic floor exercises. If it's still happening a few months later, it's worth getting checked.
Do Kegels really work? They can, when they're done correctly. Many women squeeze the wrong muscles. A pelvic floor physical therapist can teach you the right technique, which makes a big difference.
Will cutting back on water help? Not usually. Drinking too little can irritate the bladder and make urgency worse. Cutting back on caffeine, carbonated drinks and alcohol often helps more.
Is it embarrassing to bring this up at my appointment? Not at all. We talk about bladder leakage every day. You can mention it when you book, or just say "I've been leaking" at your visit, and we'll take it from there.
References
MedlinePlus, U.S. National Library of Medicine. Urinary Incontinence.
About the author: Dr. Martin Pakideh, DO, is a board-certified OB-GYN at Monroe OBGYN specializing in robotic and minimally invasive gynecologic surgery, pelvic reconstructive surgery and urinary incontinence treatment. He has trained surgeons from hospitals across Michigan in advanced robotic techniques.
This post is for general education and isn't medical advice. Talk to your own doctor about your situation.
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