Stress Urinary Incontinence - Leaking with exercise or sneezing?

Stress Urinary Incontinence (SUI) is when you are experiencing urinary leakage with an increase in intra-abdominal pressure such as when you sneeze, cough, laugh, jump or run.

 SUI can be caused by several factors including:

  • Weak pelvic floor muscles: The pelvic floor muscles play a crucial role in supporting the bladder and the urethra.  If these muscles are weak or have poor coordination, they may not be able to withstand the increased pressure on the bladder during coughing/exercise, leading to leakage.
  • Pregnancy and childbirth: The hormonal changes and increased pressure on the pelvic floor during pregnancy, as well as the stretching and potential trauma to the pelvic floor muscles during childbirth, can contribute to weakened pelvic floor muscles and fascia, causing SUI.
  • Aging: As we age, the muscles and tissues in the pelvic area may naturally weaken, reducing their ability to support the bladder properly. This can make individuals more susceptible to urinary leakage during activities that put pressure on the pelvic floor, such as coughing.
  • Menopause and a drop in oestrogen: during menopause, the body undergoes significant hormonal changes, including a decrease in estrogen levels. This reduction in estrogen can have an impact on the pelvic floor muscles and contribute to stress urinary incontinence (SUI)
  • Chronic coughing: Conditions like chronic bronchitis, asthma, or persistent coughing due to smoking or respiratory issues can put repetitive strain on the pelvic floor muscles over time, potentially leading to SUI.
  • Obesity: Excess weight can put additional pressure on the pelvic floor muscles, causing them to weaken and result in urinary leakage during activities that increase intra-abdominal pressure, including coughing.

What are the treatment options?

If you are experiencing leakage with activities like jumping or coughing, then its always best to see a health care profession, so that you can get an individualised program, however often first line treatment for SUI is pelvic floor muscle training. Pelvic Floor Muscle Training (PFMT) over at least a 12 week period is really effective in treating SUI and aims to achieve the following:


  • Strengthening pelvic floor muscles: Regular exercises targeting the pelvic floor muscles can strengthen them over time. Stronger pelvic floor muscles provide better support to the bladder and urethra, helping to prevent leakage during activities that increase intra-abdominal pressure.
  • Improved muscle coordination: Pelvic floor muscle training also focuses on improving the coordination and control of these muscles. By learning how to properly contract and relax the pelvic floor muscles, individuals can enhance their ability to maintain continence during sudden increases in intra-abdominal pressure, such as coughing or sneezing.
  • Enhanced muscle tone and endurance: Pelvic floor muscle training can increase the tone and endurance of the pelvic floor muscles. This can be particularly beneficial for individuals with weak or fatigued muscles, as it helps them sustain muscle contractions for longer periods, reducing the likelihood of urine leakage.

There are different ways to train and strengthen the pelvic floor and some of the following may be part of a well-rounded strengthening program:

  • Performing “Kegal” exercises every day
  • Using vaginal weights to improve endurance and tone faster
  • Completing functional exercises that strengthen the glutes, adductors, core and hip rotators
  • Learn how to “knack” which is a pelvic floor squeeze prior to coughing and sneezing

To find a pelvic floor clinician near you, head to our clinician locator


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