Updated: Jan 29
One of the most common reasons that people reach out to me is that they find that they're wetting themselves when they cough or sneeze. If you're in this boat, I assure you, you're in good company. The sneeze-pee is super common during pregnancy and postpartum.
The good news is that there is A LOT you can do to minimize or eliminate these leaks. Before we get into the nitty gritty, let me take a sec to answer this frequent question:
Why do I pee when I cough or sneeze?
When you do any physical activity or when you cough, sneeze or laugh, you create pressure in your abdomen (--> intra-abdominal pressure or IAP). IAP pushes out against your inner core muscles- your pelvic floor, abdominals and diaphragm.
Normally, IAP is a good thing. IAP is a tool your body uses to stabilize your torso during all kinds of activity.
Coughing or sneezing can create sharp spikes in IAP. If you are pregnant, early postpartum or managing a prolapse you may not yet have the pelvic floor strength, coordination OR reflexive function to respond effectively to those spikes in pressure. If you can't manage spikes in IAP, you may experience uncomfortable downward pressure into your pelvic floor or you might wet your pants.
Now for the reason you're really here:
How do I stop peeing when I cough or sneeze?
My first tip is your long term strategy. If you want to kick the sneeze pee for good, invest a little time here:
1) Retrain your breath. Continence (the ability to hold your urine) directly relates to how well your inner core muscles (diaphragm, pelvic floor and innermost abdominals) are operating. Your breath drives your inner core function. Pregnancy throws a kink in both your breathing pattern and core function and the result is leaks and other pelvic floor dysfunction. Retraining your breath is easier than you think and takes less time than you might imagine.
Fortunately for you, I've created a number of resources to help you DIY your breathing and core function. The No B.S. Guide to Breathing is an excellent place to start.
Tips 2-5 are great temporary solutions to help keep you dry NOW if you feel a sneeze or cough coming.
2) If possible, take a big inhale and pre-contract your pelvic floor (kegel) before you cough (or sneeze).
3) Try and get taller by coughing into a raised elbow, rather than contracting or flexing around your middle. Taking a tall posture may put the pieces of your inner core in a good position to best manage the pressure.
4) Take a slight bend or hinge at your hips before you cough. I personally find this to be super helpful. Similarly to getting tall, taking a hinge at the hips (not flexing at the spine!) can put your core into an optimal position to fire in a coordinated and reflexive manner.
5) Sit down before you cough. Sitting provides physical support to your perineum.
6) Keep in mind that following a cold, an increase in pelvic floor symptoms (heaviness, pressure, that icky feeling like a tampon is falling out) is predictable and temporary. These are not an indication that you’ve experienced a lasting change to anything in your pelvic floor. Your symptoms should resolve with rest and time.
Have you tried these or know of any other good tricks? I'd love to hear from you!
Keep your panties dry for good.
Download a copy of The No B.S. Guide to Breathing.👇🏽👇🏽
My mission is to make sure that having a baby is not a reason why you can’t do all the things.
Contact me if you have questions about exercise or pelvic health pertaining to pregnancy or postpartum. I also offer personal training services and consultations to folks locally (Seattle, Bellevue, Redmond, Kirkland) and online.