Everything Incontinence

Understanding Stress Incontinence and Urine Leakage


It’s Okay if You Pee When You Cough — Why Urine Leakage Happens

Breaking Down Why Some Adults Pee When They Cough

As men and women age, or when women become pregnant, the body goes through many unexpected changes, such as sudden urinary incontinence issues. If you’re wondering, “Why do I pee when I cough?” you’re not alone. This issue is very common, especially among women and older adults. As the body ages, the pelvic muscles get weaker, and it’s especially prevalent among aging women who have given birth vaginally. Although it’s a sensitive issue, it’s very common. Peeing when you cough (stress incontinence) is the most common type of incontinence, and it can be treated. 

Here, we’ll explain some of the causes, treatments, and ways you can make yourself or your loved one more comfortable and confident, so they can get back to enjoying life.

Understanding the Basics of Urinary Incontinence

Nearly 40% of adult women experience stress incontinence, and that number increases in middle-aged and older demographics. While the rate is lower for men, this type of incontinence can affect anyone. 

Urinary incontinence is characterized by urine leakage. There are several categories of urinary incontinence, including urge incontinence (aka overactive bladder), overflow incontinence, and stress incontinence, which we will focus on below. Stress urinary incontinence (SUI), aka “the leaky valve,” is the reason you pee when you cough, sneeze, or jump up and down. Stress incontinence is the most common type of urinary incontinence. 

The Anatomy and Physiology of Urinary Control

Stress incontinence occurs when the muscles of the pelvic floor and bladder are weakened. These include muscles that support the urethra: the pelvic floor muscles and muscles that support the urinary sphincter. As the bladder fills with urine, it expands. Normally, valve-like muscles in the urethra stay closed as the bladder expands to keep leaks from happening until you can reach the toilet. 

However, when those muscles weaken, anything that puts force on the abdomen and pelvic floor muscles will pressurize the bladder, like sneezing, coughing, jumping up and down, or laughing. As a result, there’s less bladder control and a sudden release of urine.

Causes of Stress Incontinence 

You know urine leaks often happen because of weakened pelvic floor muscles. But what causes that weakness? What are the risk factors to know about? 

Stress Incontinence After Childbirth

There are many factors, but the most common cause is childbirth. Women who have given vaginal birth are at a significantly higher risk of stress incontinence. This is because when the body is stretched during childbirth, the pelvic floor muscles get loose and nerves can become damaged, thin, and weakened. 

Stress Incontinence and Age

As the body ages, hormones affect the elasticity and firmness of the pelvic floor muscles. This causes the muscles to grow weaker, which can cause both stress incontinence and urge incontinence.

Stress Incontinence and Obesity

Those who are overweight or obese are at a higher risk of stress incontinence due to excess weight sitting on the abdomen and pelvic organs, pressurizing the bladder even more. This further weakens the pelvic floor and leads to urine leakage.

Urine Leakage After Prostate Surgery

Although stress incontinence is more common in women, men experience it too. Treatment for prostate cancer usually involves surgery, which weakens the urinary sphincter and can lead many men to experience trouble with leaking urine.

Stress Incontinence in Menopause

During and after menopause, women experience significant fluctuations in their hormones. The sharp decline in estrogen levels during this period causes the tissues that support the urethra to weaken, which can contribute to urine leakage.

Injury or Illness-Related Incontinence

There are many other factors that may contribute to stress incontinence. Nerve injuries that affect the pelvic region or lower back can impact bladder control, while pelvic organ prolapse — when organs like the uterus, bladder, or vagina drop — weakens the tissues in the pelvis and causes incontinence. Other chronic conditions, like coughing, can put constant stress on the bladder muscles, leading to leakage. 

How Doctors Diagnose Stress Incontinence

To diagnose stress incontinence, a physician will look at your medical history and then conduct a series of tests and a physical examination to confirm the diagnosis. Some of the procedures you may experience during incontinence diagnosis include:

  • A “cough test” to check for leakage

  • A urine test — urinalysis — to check for urinary tract infection (UTI) or abnormalities in the urine

  • A bladder stress test, in which you may be asked to get up and down while straining to see if this causes leakage

  • Pelvic ultrasound to check on the pelvic organs and muscles

  • A cystoscopy, in which a camera is inserted in the urethra to see inside the bladder

  • A bladder diary, which you may be asked to keep, to make note of how frequently you urinate

The Impact On Your Daily Life

Urinary incontinence issues can stop people from going out, doing physical activities, hanging out with friends, or getting physically intimate with a partner. It’s important to note that stress incontinence is the most common form of incontinence, and it’s nothing to be ashamed of. Empowering yourself with exercises to improve your condition, as well as products to avoid embarrassing accidents in public, will help you feel like yourself again and regain your quality of life. 

When to See a Healthcare Professional for Stress Incontinence

It’s hard to know at what point you need to see a specialist for urinary incontinence. But if you feel that it is impacting your overall quality of life, damaging relationships, or causing you to avoid activities and hobbies you once loved, it’s worth seeking medical advice from a healthcare professional. 

You can start by seeing your primary care physician, who will conduct a basic physical examination and may perform a urinalysis or other testing. That doctor may refer you to a specialist such as a urologist for further diagnostics and treatment. Often, women will start the process with their gynecologist, and may be referred to a urogynecologist who specializes in urinary incontinence and pelvic issues in women. You may also be recommended to see a physical therapist, who will help you learn exercises to strengthen your pelvic floor.

Management and Treatment Options

Luckily, stress incontinence is completely manageable, with both medical and at-home  treatment options. 

Non-Surgical Treatments for Stress Incontinence

The following are the most common forms of non-surgical treatment for stress urinary incontinence:

  • Pelvic floor therapy: The first best step is to do pelvic floor exercises, such as kegels, to help strengthen the muscles around the urethra. 

  • Vaginal cones: These tools are a great and easy way to strengthen the pelvic floor muscles and are available in different sizes to fit your body. 

  • Incontinence products: While you’re working on strengthening the pelvic floor, it’s important to still live your life worry-free. Using helpful pads, liners, and underwear will keep you dry and embarrassment-free so you can live your life as you normally would.

  • Cut out or limit alcohol and coffee: These bladder stimulants can irritate the bladder and cause more of a need to go to the bathroom as they are diuretics. 

  • Eat more fiber to limit constipation: Straining to go puts more stress on the bladder, so make sure you’re eating enough fiber and healthy foods to stay regular.

  • Quit smoking: Smoking causes chronic coughing, which can worsen stress incontinence.

  • Lose weight: Obesity impacts continence, and extra weight on the bladder and pelvic floor can result in an increased amount of urine leakage when under stress. Getting to a healthy weight can relieve some of these symptoms.

Surgical Treatment Options

While most urologists and gynecologists will try non-surgical avenues before resorting to surgical procedures, it may be necessary in severe cases. If surgery is recommended to treat your incontinence or a medical condition that is contributing to it, your physician may suggest the following procedures:

  • Mid-urethral slings: A sling is placed under the urethra to give it extra support.

  • Colposuspension: Surgery that lifts the bladder neck and secures it to the pelvic bone.

  • Artificial urinary sphincter: An implant is placed around the urethral sphincter with a pump in the scrotum. The implant is inflated to help control urine flow.

  • Urethral bulking: These injections add bulk to the urethra to help it close. The injections may be synthetic or could be the patient’s own fat. 

Get Quick Relief with the Knack Technique

Similar to Kegel exercises, the Knack technique is an exercise that strengthens the pelvic floor. The difference is that the Knack technique is employed in the midst of a coughing, sneezing, or laughing episode. 

To perform this exercise, as soon as you feel a sneeze or cough coming on, quickly contract your pelvic floor muscles. Use your strength to squeeze them upward and inward. Hold this contraction tightly while the stress event is happening. Once the event has passed, relax your pelvic muscles.

You can practice the Knack technique by forcing small coughs and squeezing your muscles for different periods of time. Practice while sitting and standing, until it becomes a reflex.

Choosing the Right Products for Stress Incontinence

Navigating stress incontinence requires finding the right support. Below are the top adult diapers and incontinence pads to help manage this condition.

Adult Diapers

Incontinence Pads

  • Dry Direct Overnight Bladder Control Pads: As a top-rated product for overnight use within underwear, this pad offers a contoured shape with up to twice the absorbency of retail pads.

  • Poise Pads Ultimate Coverage: These pads provide superior protection and comfort for women seeking reassurance, featuring an absorbent core to lock away wetness and a longer, thinner, contoured design.

How Parentgiving Can Help 

Peeing when you cough can feel frustrating, embarrassing, and disempowering. However, there are many solutions and products to make you feel more secure. Parentgiving has a wide selection of premium products, such as leak-proof underwear and pads, to help support your body. Explore all of our incontinence products and feel more empowered today.


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