Why Do I Pee When I Cough?—the Surprising Cause of Common Urine Leaks

TEAM KNIX / YOUR BODY

This article was medically reviewed by Dr. Navya Mysore and updated on March 8, 2024

Peeing a little bit when you cough or laugh, or during exercise is not unheard of. So odds are you're not alone in asking yourself, "Why do I pee when I cough?" Indeed, this kind of urinary incontinence in women can affect us for four main reasons:

  1. You already needed to pee, and your ability to ‘hold it in’ is compromised when you have a sudden physical exertion. In this case, make sure you heed the need to pee in a timely fashion should take care of the problem. If this is a one time event, don't worry about it. Just try not to hold your urine in for long periods. If you notice, however, this is a recurring problem, you may be experiencing stress incontinence which we describe below.
  2. You’re experiencing temporary incontinence. This can be caused by many things, which we’ll dive deeper into in the next section.
  3. However, if this is less a one-off accident and more a pattern that keeps happening, you may be experiencing a form of incontinence called “stress incontinence.”
  4. You have “mixed incontinence,” which is a combination of stress incontinence and urge incontinence. Urge incontinence usually manifests as a sudden urge to urinate, which may result in urinary leakage.

What Would Cause *Temporary* Incontinence?

Urinary incontinence can be brought on temporarily for a number of reasons. Most of the causes of temporary urinary incontinence in women are not medically concerning.

Causes of temporary urinary incontinence include eating hot and spicy foods or drinking too much liquid (water, coffee/tea, alcohol). If this applies to you, it should pass in a relatively short time.

In this instance, there’s no need to worry—though you may want to pay increased attention to how much liquid you’re consuming in one day and the foods you’re eating, especially if they're irritating foods. 

Temporary urinary incontinence can also be a side effect of certain medications. Your doctor or pharmacist will usually caution you if this is the case with a medication you’ve been prescribed. If it gets too much, you can work with your doctor to explore alternative treatments.

One cause of temporary incontinence that does warrant a visit to your doctor is a urinary tract infection (UTI). Other symptoms of a UTI include a burning sensation when urinating, urgency and/or blood in your urine, and pelvic pain.

Stress Urinary Incontinence (SUI) Explained

It might surprise you to know there are different kinds of incontinence. You can read about all 5 types of urinary incontinence here.

But if you are peeing when you cough and it’s happening more frequently, it’s likely you have stress urinary incontinence. 

Stress urinary incontinence (also known as stress incontinence) has nothing to do with emotional stress but is about physical exertion. This can be the obvious physical exertion of doing exercise.

But it can also include bodily functions and involuntary reactions like coughing, sneezing, and even laughing, which cause an involuntary release of urine.

In fact, stress incontinence can occur during any of the following:

  • Coughing or sneezing
  • Laughing
  • Bending over
  • Lifting heavy objects
  • Exercise
  • Have sex

When you cough, for example, there’s a lot of exertion: Your abdominal muscles, diaphragm, and intercostal muscles push the air out of your lungs, and your vocal cords, your throat, and even eyelids muscles play a role.

In other words, your body is working! With all that bodily stress, weaker muscles can “falter” in those moments, and that can cause a small amount of urine to leak.

But why would the muscles in your urethra and bladder be weakened? The pelvic floor muscles are just like any other muscle: They can be weak, injured, or damaged which can cause you to develop stress incontinence. 

Causes of Stress Incontinence in Women

Damage to the pelvic floor muscles or the muscles of the bladder and urethra can happen to women due to childbirth or trauma from surgery (e.g., hysterectomy), and this is often a reason women develop stress incontinence or urge incontinence (urgency urinary incontinence).

Weakened muscles can happen because of aging (menopause) and lack of exercise. This is one of the reasons why pelvic floor exercises (exercising the pelvic floor muscles) come up so often in relation to urinary incontinence.

Additional factors that increase the risk of developing stress incontinence include:

  • Age
  • Being overweight
  • Smoking
  • Family history
  • Other diseases (e.g., diabetes, MS, Parkinson’s Disease)
  • Having been through pregnancy and childbirth
  • Having undergone certain pelvic surgeries (e.g., hysterectomy)

Lifestyle Changes You Can Make to Manage Stress Incontinence

50% of people who experience incontinence do not seek help. But whether incontinence is temporary or persistent, there are lifestyle changes you can make to treat and manage your stress incontinence and have an excellent quality of life.

Reduce the Risk of Stress Incontinence by Reducing Risk Factors 

If you want another reason to quit smoking, reduce alcohol consumption or maintain a healthy weight, here it is. Of course, you can do these things for myriad medical reasons, and while they don’t come with guaranteed health outcomes, you will help to reduce the risk of stress incontinence (along with many other diseases and conditions).

Strengthen Your Pelvic Floor Muscles With Kegel Exercises

These exercises strengthen the weakened pelvic floor muscles, which support the bladder, uterus, small intestine, and rectum. There’s no reason to wait to start doing pelvic floor exercises—but no matter what age you start to do them, they can help!

Don’t think of pelvic floor exercises just as something to do if/when incontinence occurs. Doing them when healthy can have myriad benefits, both present and preventative:

  • Helps prevent urinary incontinence
  • Preventing involuntary gas or fecal incontinence
  • Improve symptoms of prolapse
  • Orgasm improvement
  • Maintaining overall pelvic floor strength
  • Improve your other workouts, like running or weight training

To learn more about how to do pelvic floor exercises, read this.

Try Products Like Leakproof Underwear 

Experiencing incontinence can often cause some embarrassment. It even prevents some people from participating in events and outings, leading to isolation, depression, and shame. While you explore treatment options with your doctor, you can also explore products to help you stay active and social. Leakproof Underwear comes with different absorbency levels, including Zones+ Ultra Leakproof which features targeted protection and coverage zones for light bladder leaks. 

While lifestyle changes are easy to make, we don’t suggest those changes replace medical advice. 

When to Seek Medical Advice for Stress Incontinence

It is never a good idea to use “Dr. Google” to self-diagnose, so we definitely recommend booking some time to discuss your experience of incontinence with your healthcare provider.

During your visit, they may want to conduct a complete pelvic examination and study your medical history to better understand possible causes that might point to certain treatment options.  

They will be able to confirm whether you do indeed have stress incontinence or if it could be mixed urinary incontinence.

When you do take the time to talk to your doctor, it always helps to be prepared. Write down the questions you want to ask and anticipate the questions they might ask you.

These are some of the questions your doctor may ask about your experiences of urinary incontinence:

  • How long have you been experiencing these symptoms?
  • Have your symptoms been continuous or occasional? Have they worsened over time?
  • How often do you need to urinate?
  • When (time of day or night) do you leak urine?
  • Is it difficult for you to empty your bladder?
  • Have you noticed any blood in your urine?
  • Do you have any urgency before having to urinate? Do you feel like you do not completely empty your bladder?
  • General lifestyle questions: surgeries, pregnancies and types of deliveries, smoking, diet, alcohol, caffeine consumption, exercise, etc.

And here are some questions you might ask your doctor:

  • What type of incontinence do I have?
  • What is causing my urinary incontinence?
  • What tests should I expect?
  • Should I make lifestyle changes, like:
    • Bladder diary
    • Kegel exercises
    • Timed bathroom breaks
    • Diet changes, etc.
  • What treatment(s) do you suggest for me and why?
  • Without treatment, what will happen?
  • What are the side effects or risks associated with this treatment plan?

Incontinence is not an easy thing to experience, but there are treatment options and lifestyle changes that can make it easier to live with incontinence. 

Stress Incontinence Treatments You Might Explore with Your Doctor

As you explore treatments for stress incontinence with your doctor, some combinations of the following may be discussed.

Pelvic Floor Therapy & Biofeedback

Kegel exercises are something you can do yourself as part of general health and fitness, but your doctor may recommend you see a pelvic floor physical therapist who can assess the strength of your pelvic floor and help you to rehabilitate it. They can teach you how Kegel exercises strengthen your pelvic floor muscles and sphincter, as well as how to do them. Just like any exercise regime, Kegel exercises require consistent practice to have effect.

Biofeedback can also be used along with Kegel exercises to increase effectiveness. This involves the use of pressure sensors or electrical stimulation to reinforce certain muscle contractions. This would usually be offered as part of a pelvic floor therapy program to help address stress incontinence and strengthen the pelvic floor muscles.

Fluid Consumption & Bladder Training

Your healthcare professional may also recommend making changes to the fluids you consume and when you consume them to help control bladder leakage.

Of course, it’s important to stay hydrated, but they may suggest cutting back on caffeinated, carbonated beverages and/or alcohol. If these simple changes have a positive effect, then it may be something you incorporate day to day.

In addition to curtailing certain beverages, your doctor may advise bladder training. This involves taking bathroom breaks at regularly timed intervals. By ensuring your bladder is emptied frequently, you minimize the chances of leakages.

Over time, the time between breaks can be increased, especially if you are also strengthening the pelvic floor with Kegel exercises and other pelvic floor exercises. This course of action might be especially effective for those with mixed incontinence.

Devices & Surgery

Devices that can be used to control stress incontinence and bladder leakage include vaginal pessaries and urethral inserts.

Finally, under certain circumstances, you may need surgery. Your doctor might explore surgery options for stress incontinence. These will usually help strengthen the bladder neck or improve closure of the sphincter. 

Surgeries can include sling procedures, pelvic organ prolapse surgery, or bladder neck suspension. Surgery for stress incontinence often offers a more long-term solution to involuntary urinary incontinence.

However, as with any surgery, there are risks to consider and your health care provider will often suggest exploring other options before you undergo surgery.

Sources:

https://www.hopkinsmedicine.org/health/conditions-and-diseases/urinary-incontinence/urinary-incontinence-in-women 

https://www.niddk.nih.gov/health-information/urologic-diseases/bladder-control-problems/symptoms-causes 

https://www.health.harvard.edu/bladder-and-bowel/types-of-urinary-incontinence 

https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074 

We hope you found this post informative—but remember: we’re not doctors and this post is not medical advice! While all posts are fact-checked and well researched, we always recommend you chat with your doctor about any questions or concerns you might have regarding a medical condition.

We’re here to support and educate, but never with the aim of disregarding professional medical advice you’ve been given. Phew, now that that’s out of the way, you can go on living unapologetically free.