Say Goodbye to Urine Leakage: Effective Tips to Stop leaking When Coughing
Are you tired of the embarrassment and inconvenience caused by urine leakage when coughing? If so, you're not alone. Incontinence particularly when coughing, is a common issue which many people struggle with. However, there's good news – there are effective strategies that can help you put an end to this once and for all. In this blog, we will go over valuable information and practical advice on how to effectively manage and stop urine leakage when coughing. From pelvic floor exercises to lifestyle modifications, we will explore a range of solutions that can make a significant difference in your daily life.
By understanding the underlying causes of incontinence when coughing and implementing the right strategies, you can regain control and confidence. Say goodbye to the frustration and embarrassment that comes with urine leakage and take the first step towards a life free from incontinence.
What is Stress Urinary Incontinence?
Stress urinary incontinence is when involuntary leaking of urine occurs with activity, movement or with large and sudden changes in intraabdominal pressure.
Coughing produces changes in intraabdominal pressure and our ability to manage the pressure is the reason leaking occurs.
There is another type of incontinence which is called urge incontinence. Here leaking occurs due to a sudden and uncontrollable urge to use the bathroom. Methods of treatment are different, so if you are experiencing more urge incontinence head to this blog to learn about the difference.
why does leaking occur with coughing?
Leaking comes down to pressure. If we can control it and manage it well, leaking will not happen.
At rest, bladder pressure low, urethral pressure is high and urine stays.
With activity, there is an increase in IAP which increases pressure on the bladder. When urethra pressure increases and is greater than the pressure from above, urine stays in
If the bladder pressure is greater than the urethra pressure, leaking will occur.
why does pressure get mismatched?
Many structures come into play when managing pressure optimally, therefore it depends on the person as to why pressure is not greater at the urethra. Treatment is not one-size-fits-all. Finding why you are not managing pressure well resulting in leaking is vital for getting rid of your symptoms and keeping them away.
Some of the common reasons for mismatched pressure:
Decrease in Strength of the Pelvic Floor Muscles
If there is not enough strength in your pelvic floor, especially the front of your pelvic floor, there will not be enough force generated to increase the pressure of the urethra to stop leaking.
Coordination of the Pelvic Floor Muscles
The contraction of the pelvic floor needs to happen at specific times to keep urine in. If the pelvic floor muscle contraction happens after the pressure increases from the bladder, leaking will still occur. The pelvic floor muscles need to contract before the increase in pressure in the bladder so they can increase pressure at the urethra. The pelvic floor can be strong and still contribute to leaking because the coordination and timing are non-optimal.
Poor Intraabdominal Pressure Management
You can have strong pelvic floor muscles and even a good ability to coordinate the contraction, however, if you can not manage intra-abdominal pressure efficiently it will be difficult to control leaking. If you continuously create a downward force into the bladder it will be difficult to match the pressure continuously resulting in leaking.
Mobility of the Pelvic Floor Muscles
Muscles need to be able to move through their range of motion to help generate force. When a pelvic floor is too tight it may not have enough mobility to contract further thereby limiting its strength and the ability to increase urethra pressure. On the other side, there can also be hypermobility within the pelvic floor, meaning it has more range of motion than normal. In this case, the pelvic floor needs to be able to generate more force to create the same tension as someone without hypermobility
Decrease in Lower Ab Strength
Our abdominals help force air out, like in a cough. How our abdominal muscles contract can make a difference as to how much pressure is being driven downward.
If our upper abdominals contract first and are stronger than our lower abdominals you will end up causing more pressure to do downward.
Another abdominal balance we commonly see is middle abdominal dominance. This essentially cuts our abdomen in half resulting in pressure getting pushed up and down.
Ideally, we want the contraction to start at the bottom and move upward to decrease excess pressure down into the bladder.
other contributing factors
Constipation
To help decrease extra pressure against our bladder, we want to make sure the other organs that are near our bladder are not contributing. If you are constipated, your rectum will be fuller for a longer period which will put excess pressure on your bladder.
Hormone Changes
A decrease in estrogen causes a reduction in the strength of our tendons and muscles. In periods when we are in an estrogen deficit state like early postpartum, when breastfeeding, perimenopause and menopause, we may see an increase or start of incontinence due to or contributing from hormone changes. The strength in our pelvic floor muscles decreases which then reduces the ability to increase urethra pressure which causes leaking.
Connective Tissue Disorders
Some disorders change the integrity of our connective tissues, like Ehlers Danlos Syndrome. When the supportive tissue strength is disrupted, it will place increased demand on other tissues which can contribute to leaking. It can also affect the integrity of the strength of the walls of the urethra making it less stable and contribute to leaking.
how pelvic floor physical helps
Pelvic floor physical therapy involves lifestyle changes, education on pressure management, manual techniques as well as mobility and strengthening exercises to help get to the root cause of your leaking making them stay gone for good! Below are some exercises to help improve leaking while coughing but getting to the root cause is the most important thing therefore getting an evaluation to determine what that is for you is important.
pelvic floor strengthening to stop urine leaking while coughing
The pelvic floor should contract non-volitionally or without you telling it to contract, therefore training it in that way is one of our preferred ways.
pelvic floor mobility exercises to stop urine leaking
One great way we like to access mobility to our pelvic floor is with breathwork. When we take a deep breath in, our diaphragm descends, our rib cage widens (the entire rib cage not just the front), our abdomen and back expand and our pelvic floor descends. On an exhale, the opposite happens. This is one reason we use breathing. It takes practice since bringing awareness to where your breath is going is different and most people are not used to it. Also, imagery goes a long way; think of your sit bones separating or someone blowing up a balloon on the inside of your pelvis with your breath in.
pelvic floor coordination exercise to stop urine leaking while coughing
One of our favorite exercises to help coordinate the pelvic floor is teaching it to activate before coughing and combining that with getting low abs to engage before your upper abs. This exercise has many different cues because it depends on what works for each person. Try some of them and see if they help.
Lower Abdominal strengthening to stop urine leaking while coughing
Having good low deep abdominal strength is vital to correctly manage intraabdominal pressure. Most people have a difficult time finding their deep low abs. Part of the difficulty is they are your deepest abdominal muscles therefore you can not touch them and tactile input can go a long way in understanding what your muscles are doing. Another reason it is harder to connect with is that they do not bring you through a range of motion, instead, they keep your torso still giving you a lot of stability to your pelvis and spine. Here is one of our favorite ways to find deep low abs. The key is making sure you feel them and it should be more than your upper abs which are near your rib cage.
lifestyle changes to stop urine leaking while coughing
There are diet and hydration changes that can be made to help decrease leaking.
Hydration, Hydration, Hydration
Many women will decrease the amount of liquid they drink hoping it will help decrease the amount they leak. However, this is not the case. Decreasing hydration makes urine more concentrated making it more irritating to your bladder and your bladder does not like irritating things! Increasing hydration dilutes urine which is less irritating to your bladder.
Bladder Irritants
Besides concentrated urine, there are also common dietary irritants to your bladder that can affect leaking. These are different for everyone while people may be extremely sensitive others may not be affected at all. Some common irritants are:
Caffeine,
alcohol,
carbonated beverages,
tomato-based foods/drinks,
acidic foods/drinks,
An easy way to tell if any are contributing to your symptoms is to track what you are eating/drinking and then your urges to go to the bathroom, any leaking that occurred, and how many times you use the bathroom. If something is irritating to your bladder you will see a change in one of those.
Decreasing Constipation
I know the issue is with leaking urine and here I am telling you constipation can contribute to leaking but it can! Your pelvis is not very big and inside are organs that stretch in size when filled. If you are constipated you are going to have a rectum that is staying more full for longer. Since there is not a lot of space in your pelvis, the rectum being full or even overly full can contribute to more pressure moving to the front of your pelvis.
Making sure you are properly hydrated as well as eating a diet that is high in fiber can help improve constipation. Straining to pass bowel movements can also be common with constipation. Straining causes an increase in downward pressure against the pelvic floor muscles which can contribute to damage over time.
Stop Straining to Pee
Whether it is because it is hard to pass urine or you are in a rush; straining to start or increase the flow of urine, increases downward pressure against the pelvic floor which can contribute to dysfunction of
Other treatments to stop urine while coughing
Pelvic floor physical therapy is not the only treatment to stop urine while coughing however it is one of the more conservative options that gives women excellent results. Here are some other treatment options:
Medicine: oral medications are usually not recommended since leaking while coughing is due to a mechanical/anatomic reasons. Topical estrogen is an option that can help improve pelvic floor strength to help improve urethra pressure.
Non-Surgical Options: There are options to help support the urethra that inserts into the vaginal canal.
A pessary, which is a silicone ring, can be inserted into the vaginal canal to help support the urethra decreasing leaking. This is commonly used for prolapse but can be used for incontinence. You must get fitted for a pessary to make sure you find the correct one for you. These can be worn for portions of a day, a whole day, or months at a time.
Vaginal inserts can help support the urethra and bladder to eliminate leaking. 2 examples
Revive Bladder support, is over the counter. . It is reusable but has a wear time of no greater than 12 hours.
Poise Imprezza, which is also over-the-counter but is not reusable. This resembles a tampon but expands once inserted to support the bladder and urethra
Surgical Options
Urethra Bulking: this is when the urethra is injected with a bulking agent to help strengthen the sides and prevent leaking. The downside of urethra bulking is that the effects diminish over time and patients may need repeat injections.
Suspension Procedures: this is when the bladder is lifted and stitched in that position.
Sling Surgery: this is when a sling is placed around the neck of the bladder to help support it and prevent leaking.
Mesh Surgery: this is when a strip of synthetic mesh is placed behind the urethra to support it.
Determining why you have incontinence is very important when considering treatment options. Inconsistent or ineffective management of abdominal pressure, which puts a downward force on the bladder and pelvic floor, can compromise the outcome of surgery. Mastering this technique is essential both before and after the procedure If you keep putting more stress on the surgery it can eventually fail as well.
We hope you learned about why leaking happens with coughing and some immediate tips and exercises you can use to help take control of your bladder! We do always recommend at least a pelvic floor physical therapy evaluation so you can determine what the root cause of your issue is versus doing any and all exercises for incontinence. If you are in the Atlanta area, give us a call or text at 678-413-5587 and we will get you back the confidence you deserve.
Dig Deeper: Uncover More Secrets to Pelvic Floor Health
Hi! We are Dr.Aimee and Dr. Lauren
We are the owners of Empower Physical Therapy and Wellness. We are pelvic floor physical therapists who specialize in helping women from pregnancy, into postpartum and through perimenopause, menopause and then beyond! We believe all women deserve to do all of the things they love without symptoms!
You can contact us via our website, email at hello@weempowerpt.com or social media!
The information provided in this blog is for educational and informational purposes only and is not intended as medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or symptoms. Never disregard professional medical advice or p in seeking it because of something you have read on this blog.
If you think you may have a medical emergency, call your doctor, go to the emergency department, or call 911 immediately. The opinions expressed in this blog are those of the author and do not necessarily reflect the views of any medical or healthcare institutions.
