You feel the approaching sneeze and instinctively tense up because you know what’s coming: You’re likely going to pee when you sneeze.

You probably also leak a little when you cough, strain, or laugh, and it’s getting to be a problem. Did anyone notice? Should you avoid laughing or skip your favorite activities to prevent potential embarrassment? Of course not.

There’s a good chance that you’re dealing with stress incontinence, and you’re not alone. A few self-help techniques may help you gain control. If not, your doctor can work with you to find the right treatment.

Continue reading to learn why you pee when you sneeze and what steps you can take to fix it.

Did you know that stress incontinence is different from urgency incontinence and overactive bladder? In this case, “stress” refers to physical strain and has nothing to do with psychological stress.

Here are some other interesting fast facts about stress incontinence:

  • Stress incontinence is the most common type of incontinence and the most common one affecting younger women.
  • It’s much more common in women than in men.
  • About 1 in 3 women have stress urinary incontinence at some point.
  • Many women have both stress incontinence and urge incontinence. This is known as mixed incontinence.
  • You’re more likely to develop stress incontinence as you age, but it’s not inevitable, nor does it have to be permanent.
  • Research shows that behavioral therapy, by itself or with other treatments, is generally more effective than pharmacologic therapies alone.

Urinary incontinence is a loss of bladder control. Stress incontinence is a specific type of urinary incontinence in which you leak urine when doing something that puts pressure on your bladder and urethra.

It can happen when pelvic floor muscles or urethral sphincter muscles become weak or damaged.

The muscles and tissues of the pelvic floor help support the urethra. The urethral sphincter muscles regulate the flow of urine. When these muscles contract, they stop urine from flowing out of your bladder and into your urethra. When you decide to pee, these muscles relax and allow urine to flow again. That’s if everything is working as it should.

Weakened muscles are a little touchier. A little added pressure, say from a sneeze, can cause them to spontaneously relax. That’s when you feel a little pee escape.

Aside from a sneeze, you may also pee a bit when you:

  • cough
  • laugh
  • bend over
  • lift heavy objects
  • make sudden movements
  • exercise
  • have sex

It might not happen all the time, and it may be more of a problem when your bladder is full or close to full. It can mean leaking only a few drops of urine or enough to soak through your clothes.

Stress incontinence happens when the muscles of your urinary tract are weakened. This can be caused by:

  • Childbirth. Muscles can weaken when you give birth, particularly if it’s a vaginal delivery. Use of forceps may be a contributing factor. Stress incontinence can occur right after childbirth or several years later.
  • Hysterectomy. Surgical removal of the uterus and cervix can weaken supporting muscles.
  • Prostate surgery. Surgical removal of the prostate gland can weaken the urethral sphincter and pelvic nerves.
  • Age. Muscles can weaken a little as you age.
  • Weight. Having overweight or obesity can put added strain on pelvic muscles.
  • Injury. Damage or injury to your lower back can weaken your pelvic muscles.

Other contributing factors may include:

  • frequent coughing due to smoking
  • illnesses that cause chronic coughing
  • long-term involvement in high-impact activities like jogging or jumping

If stress incontinence is interfering with your quality of life, make an appointment to see your doctor. They’ll first rule out any underlying conditions that may be contributing to the problem, such as a urinary tract infection.

Also, follow up with your doctor if you experience chronic sneezing or coughing. Ongoing sneezing and coughing can aggravate stress incontinence and make it worse.

Lifestyle

If your episodes of peeing when you sneeze are infrequent, try these lifestyle tweaks:

  • Limit or avoid caffeine, alcohol, and carbonated drinks.
  • If you frequently strain when moving your bowels, add more fiber to your diet or seek treatment for chronic constipation.
  • If you smoke, try to quit.
  • Speak with your doctor about losing excess weight.
  • Schedule bathroom breaks to train your bladder, especially if you have mixed incontinence.

Nonsurgical treatment

Stress incontinence may be able to be resolved without surgery. Nonsurgical treatments that your doctor may suggest include:

  • regular pelvic floor exercises (Kegels) to strengthen your pelvic floor muscles
  • biofeedback in conjunction with pelvic exercises to reinforce muscle contractions
  • vaginal pessary, a device you insert into your vagina to help support your bladder
  • urethral inserts, which you insert into your urethra to prevent leakage while doing certain activities
  • estrogen creams, which may help strengthen muscles and tissues around the vagina and urethra for postmenopausal women

Surgery

If nothing else works, surgery is an option. Surgical procedures for stress incontinence include:

  • sling procedure, in which your tissue, donor tissue, or synthetic mesh is used to create a sling to support the urethra; this procedure can be performed on men and women
  • bulking agents that can be injected into tissues of the urethra to help the sphincter’s ability to close
  • colposuspension, a procedure in which the surgeon uses sutures to help support the bladder and urethra
  • a surgically implanted inflatable artificial sphincter with pump control can act as the sphincter in men

If you frequently pee when you sneeze, laugh, or strain, you may have stress incontinence. It can happen to anyone, but it’s more common in women than men.

Stress incontinence can become a quality-of-life issue, so a visit to the doctor is important. In the meantime, there are some things you can do to help strengthen your pelvic muscles and cut down on accidental peeing.

No more trying to avoid sneezing, laughing, or coughing. There are effective treatments for stress incontinence. Talk with your doctor to learn more about the treatment options that may be right for you.