Achoo… and oops! With fall comes the return of colds, and with them a minor discomfort we rarely talk about: urinary leakage when coughing or sneezing.

Is this normal? It’s common, yes. But it’s not normal—it’s a sign that your pelvic floor needs a little help.

And the good news is, it’s very easy to strengthen.

Please read this first: This article is for informational purposes only and is not a substitute for medical advice. If you experience urinary incontinence, talk to your primary care physician, gynecologist, urologist, or midwife.

This type of leakage has a name: stress urinary incontinence

According to the French National Health Insurance, stress urinary incontinence is the involuntary leakage of urine—not preceded by the urge to urinate—that occurs during even minimal physical exertion, such as coughing, sneezing, laughing, jumping, or carrying a load…

It differs from urge incontinence, in which leakage occurs after a sudden, urgent urge to urinate.

→ The two types can also occur together; this is referred to as mixed incontinence.

25 to 45% of women

Key statistic: According to the urology department at Bordeaux University Hospital, 25 to 40% of women report having urinary incontinence.

7 to 8% of men

Key statistic: Men are also affected: the French national health insurance system estimates that 7 to 8% of men aged 65 suffer from this condition.

→ In France, at least 2.6 million people over the age of 65 are affected.

And these figures are likely underestimated: the French national health insurance system points out that few people dare to seek medical care.

Why does coughing cause leakage?

When you cough or sneeze, the pressure in your abdomen increases suddenly. This pressure pushes against the bladder. Normally, the perineum and the urinary sphincter contract at the same time to “lock” the opening and hold in the urine.

If the perineum is weakened or does not contract quickly enough, it cannot withstand the pressure: a few drops leak out. And during a cold or bronchitis, with repeated coughing fits, the perineum is under even greater strain.

According to the Bordeaux University Hospital, several factors can weaken the perineum: age, pregnancies and vaginal deliveries, menopause, being overweight, smoking, chronic coughing, or repeated straining. In men, prostate surgery is also a common cause.

The first-line treatment: pelvic floor rehabilitation

Here’s the good news from this article: perineal rehabilitation is the first-line treatment recommended for urinary incontinence, according to the French National Health Insurance.

For stress incontinence, the Bordeaux University Hospital confirms that it is recommended as the first-line treatment.

In practice, it is performed by a physical therapist or a midwife. It helps to:

→ strengthen the pelvic floor muscles so they can better withstand pressure;
→ learn to contract the pelvic floor at the right moment—just before coughing, sneezing, or lifting a heavy object.
Physical therapists often refer to this as “pelvic floor locking”;
→ adopt the right habits in daily life: posture, physical activity, and lifestyle.

Depending on your needs, the therapist may use biofeedback—which allows you to visualize the contraction of your muscles on a screen—or electrostimulation.

Both techniques are used with a rehabilitation probe connected to a device: a vaginal probe for women, and an anal probe for both men and women.

Our expertise: At Sugar International, our line of rehabilitation catheters was designed by a therapist specializing in urogynecology. For 30 years, we have been supporting physical therapists and midwives who help their patients—both women and men—regain their continence.

Our Tips for Staying Dry This Winter

While you wait for your appointment, a few simple habits can help:

⇒ Treat your cough: a cough that lasts more than a few weeks should be brought to your doctor’s attention.
⇒ Avoid constipation, which also puts strain on the pelvic floor. The French National Health Insurance recommends a healthy diet to prevent constipation, as well as maintaining a healthy weight.
⇒ Don’t strain when urinating: let your bladder empty naturally.
⇒ If you’ve already learned how to squeeze your pelvic floor with a professional, remember to contract it before every sneeze or coughing fit.

To conclude

Leakage when coughing or sneezing is common in both women and men.

But it’s not inevitable, nor is it something you have to accept in silence.

Pelvic floor rehabilitation is the first-line treatment, and it yields excellent results. So this winter, don’t be afraid to talk to your doctor about it! 🤧💙

⇒ For more information, (re)read our Pink October article “Perineal rehabilitation: process, steps, and techniques ⬈.”