Leaking When You Laugh? An Expert Explains Stress Urinary Incontinence

Oops, there’s that trickle again.

If you “leak” more than occasionally or often find yourself in a frantic dash for the ladies’ room, you may have stress urinary incontinence. It’s an involuntary loss of urine when you laugh, sneeze, cough, exercise, or generate other pressure on the bladder.

And yes, it’s okay to talk about it!

In years past, many women found leakage an embarrassing subject to broach with their physicians or with anyone else. But the taboo has been lifted.

Today’s healthcare practitioners know female stress incontinence is treatable, and women are sharing their stories and asking the right questions.

Thanks in large part to doors opened on social media, pelvic floor physical therapists are excited to educate the public: stress incontinence is not an unavoidable “badge of honor” that comes with pregnancy. And it’s no longer inevitable that you’ll spring a leak if you jog, chase a pickleball, or play with your kids.

Pelvic floor dysfunction can be helped.

What Is Stress Urinary Incontinence?

For some women, the phrase “stress incontinence” conjures the thought of emotional or psychological stress and begs the question, “Can stress cause urinary incontinence?”

In this case, stress incontinence refers to a physical stressor. An act as simple as taking a jog, lifting a loaded trash bag, or even sneezing may trigger a leak.

In basic terms, it’s a pressure management issue.

Your core muscles consist of the pelvic floor, diaphragm, transversus abdominis, and lumbar multifidi — deep stabilizers that wrap around your lower abdomen and pelvis to brace your spine and support pelvic stability. The pelvic floor and diaphragm move synergistically, like a piston in an engine, lowering and rising together in a perfect system of pressure management.

If that rhythm becomes dysregulated, any exertional “stress” (a cough, a sneeze, a jump, etc.) may cause urine to leak.

What Causes Stress Incontinence?

The pelvic floor is a muscle group, just like our quads, biceps, or rotator cuffs. Any overused muscle can stiffen, ache, and temporarily lose some functionality; if underused, the muscle weakens and becomes less efficient.

Over time, major physical changes and events in a woman’s lifecycle — pregnancy, childbirth, menopause, and aging — can alter or weaken pelvic floor muscles and contribute to stress urinary incontinence.

Excessive weight gain, pelvic surgery, certain medications, smoking, or underlying medical conditions like urinary tract infections can affect the pelvic floor and trigger leakiness.

When to Consult a Physical Therapist

Half of all females experience stress urinary incontinence, says the University of North Carolina’s Department of Urology. With a population of roughly 5.5 million women, this means many females in our state are already affected or may experience leaks in the future.

Bladder leakage problems can hurt your lifestyle. You may worry about spotting or odor in public, or grow tired of wearing bladder control liners (and black pants).

If you notice recurring leakage issues, reach out to your PCP to discuss your options.

I sometimes see patients who’ve tried to improve their stress incontinence with strengthening exercises or other recommendations posted by social media “influencers.” Yet they still leak, sometimes worse, and accompanied by pain.

To help them, I first conduct a full internal exam and evaluation to determine if they have tight, overactive, or fatigued pelvic floor muscles that require lengthening, stretching, and relaxation… or weaker muscles that lack endurance and need a strengthening program.

And in every case, we incorporate the essential practice of diaphragmatic breathing. Let your belly rise and the rib cage expand fully.

Muscles must always lengthen before they can contract. Lengthening the diaphragm and pelvic floor muscles sets the stage for better bladder control.

Laugh Without Leaking

If you suffer from leakage, rest assured: you’re not destined to live with stress incontinence forever.

At Signature Healthcare, we help women (and men) successfully conquer bladder leakage, restore their confidence, and improve their lives. You’ll notice a change quickly.

Ready to laugh without leaking? We’d love to hear from you.