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Pee with Sneezing = Stressful Cold and Flu Season

Cold and flu season can be very stressful for many reasons. The kids have to stay home from school AGAIN, so you miss even more work. You can’t attend fun family or friend gatherings. It’s just one germ after another. Then YOU get sick. Sneezing, coughing, blowing your nose, vomiting. So much repetitive increase in intra-abdominal pressure that might lead to peeing your pants. How embarrassing! And it’s embarrassing whether you actually pee with sneezing or if you always just cross your legs when sneezing. (I hate to be the bearer of bad news, but when you cross your legs when sneezing, most people – or at least women – will know why…)

The good news is there are a lot of things that can be done to fix peeing with sneezing! No one needs that added stress to an already stressful cold and flu season. Let’s dive into a few reasons why you might pee with sneezing and what can be done about it!

pee with sneezing

Why Do I Pee with Sneezing?

Peeing with sneezing is a form of stress urinary incontinence. Stress urinary incontinence is an involuntary leaking of urine during moments of increased intra-abdominal pressure through pressure or force. This form of leaking occurs without an urge. Stress incontinence most commonly occurs with sneezing, coughing, running, jumping, or lifting.

Pelvic Floor Tightness or Weakness

Many things can contribute to stress incontinence, and a big contributing factor is often an issue with the pelvic floor muscles themselves. Pelvic floor weakness, tightness, or poor coordination can all cause you to pee with sneezing. Addressing any dysfunction in the pelvic floor muscles can make a HUGE difference!

How do I know if my pelvic floor muscles are tight or weak? Because many of the symptoms of pelvic floor weakness and tightness overlap, the only way to truly know how these muscles are functioning is through a pelvic floor exam by a physical therapist. However, here are some common symptoms usually only associated with pelvic floor tightness:

  • History of back, hip, glute, or tailbone pain
  • Difficulty relaxing to start your urine stream
  • Chronic constipation
  • Incomplete emptying of bladder or bowels
  • Urinary urgency or frequency
  • Discomfort with intercourse, tampon or cup insertion, or gynecologic exams

Fix Your Pelvic Floor Tightness

If your pelvic floor muscles are too tight, you’re going to work on RELAXING them. Below are 2 of my favorite exercises to help the pelvic floor muscles relax.

Fix Your Pelvic Floor Weakness

If your pelvic floor muscles are weak, you are going to work on strengthening the pelvic floor muscles as well as all the surrounding muscles (abdominals, glutes, hips, inner thighs, etc). Below is a description on how to properly do a Kegel (= pelvic floor contraction). In order to stop pee with sneezing, you should work on a maximal but shorter Kegel. For example, do 3 sets of 5 maximal Kegels.

Fix Your Pelvic Floor Coordination = The Knack

If you have good strength and mobility of your pelvic floor muscles (or even if you don’t), sometimes coordination or timing of the pelvic floor activation is the issue. Our pelvic floor muscles mainly activate in response to changes in our intra-abdominal pressure or activity without us purposefully contracting them.

If you pee with sneezing, your pelvic floor muscles may not be activating at the right time. In order to fix that, you need to remind them when to contract! There is a great strategy called “the Knack” that is very helpful in this situation. When you feel a sneeze coming on, do a Kegel just prior to that sneeze. (This is super effective and a helpful tip that you’ll want to remember this winter!) Ideally over time your muscles will learn they need to be more active in that situation and will contract on their own.

Poor Posture

Did you know that your posture GREATLY affects the pressure in your abdomen? Anytime that we are slouched forward (like with an aggressive sneeze – because let’s be real, lots of us do not have dainty sneezes…), more pressure is placed downward onto your pelvic floor. This makes it that much harder for our pelvic floor muscles to counteract pressure, and you’ll be more likely to pee with sneezing. All of our core muscles work incredibly more efficiently when our ribcage is stacked on top of our pelvis. So when you feel that sneeze coming on, instead of doubling over, bring your arm up to your mouth and try to remain in a good posture.

End Peeing with Sneezing

Leaking any amount of urine at any time with any activity is NOT NORMAL, and it is FIXABLE! So if you pee with sneezing, now is the time to do something about it! Don’t suffer through another cold and flu season wondering if anyone saw you cross your legs or carrying extra underwear or pads everywhere you go. Give these tips a try so you can have a more enjoyable cold! (Ok, maybe a less stressful cold is a better way to describe it.) If you’re still experiencing peeing with sneezing after trying these tips, reach out! As a pelvic floor physical therapist, this is what I’m here to help with!

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