How to Stop Peeing When I Cough
Ever coughed, sneezed, or laughed — and felt that little leak?
If so, you’re not alone. Many women experience leakage with coughing, sneezing, or physical activity, especially after pregnancy or during hormonal changes. But while this is common, it’s not something you have to live with — and it’s absolutely treatable with the right approach.
At Rome Physical Therapy, we help women understand why this happens and what to do to fix it, not just manage it.
What’s Really Happening When You Leak — It’s Called Stress Incontinence
When you leak urine during a cough, sneeze, laugh, or jump, it’s called stress urinary incontinence.
This happens when pressure inside your abdomen increases (like during a cough) and that pressure isn’t managed well by your core and pelvic floor system.
There are a few common reasons this can happen:
Urethral sphincter weakness – the muscles that close off the urethra aren’t strong or coordinated enough to stay shut under pressure.
Urethral hypermobility – the urethra moves more than it should due to loss of support from surrounding tissues.
Levator ani weakness – the deeper pelvic floor muscles aren’t providing enough lift and stability to the pelvic organs.
Poor pressure management – the diaphragm, abs, and pelvic floor aren’t working together to balance pressure during breathing, movement, or coughing.
Bladder association with coughing – over time, your bladder can start reacting to the anticipation of a cough or sneeze, contracting even before the pressure hits.
Each of these issues requires a different approach — which is why cookie-cutter “just do Kegels” advice rarely solves the problem.
Why It’s More Than Just Kegels
If you’ve been told to “do more Kegels” to fix leaking, you’re not alone — and it’s one of the most common misconceptions we see.
The truth is: Kegels only address one small part of the pelvic floor system — strength. But leaking with a cough isn’t always about weakness. Sometimes the pelvic floor is too tight, too slow to respond, or out of sync with your breathing and core.
When that happens, simply tightening your muscles over and over doesn’t teach your body how to coordinate and manage pressure — which is the key to stopping leaks.
At Rome Physical Therapy, we focus on restoring coordination, timing, and breath mechanics, not just strength. Because your pelvic floor needs to contract, relax, and respond automatically when you cough or move — not stay clenched all day.
How the Pelvic Floor and Core Work Together
Your pelvic floor muscles act like a supportive hammock at the base of your pelvis. They help control the urethra, support your organs, and stabilize your core.
When you cough, intra-abdominal pressure rises quickly. If your pelvic floor and deep core don’t reflexively activate together, urine can leak.
Through pelvic floor physical therapy, we retrain that automatic response — helping your body manage pressure the right way again.
The Mind-Body Connection
Pelvic floor therapy is about more than exercise — it’s about awareness and connection.
Many women have a disconnect between their brain and pelvic floor after pregnancy, childbirth, or surgery. By teaching you how to breathe, move, and recruit your core and pelvic floor together, we rebuild that connection so your muscles respond naturally and efficiently.
This is what allows you to stop leaks for good — not just temporarily.
What You Can Start Doing Today
Here are a few steps you can begin right now:
Connect your breath and core.
Try exhaling as you cough or lift something heavy — this helps your pelvic floor engage reflexively.Avoid “holding your breath.”
Holding your breath increases pressure downward onto your pelvic floor. Keep your breath flowing.Don’t overdo Kegels.
Strength without coordination doesn’t solve the problem. You want a pelvic floor that can relax and respond quickly when needed.Be mindful of posture.
Sitting or standing tall with relaxed ribs allows your diaphragm and pelvic floor to move in sync.Seek help early.
If leakage happens, its a check engine light for your pelvic floor muscles that something is a little off. A pelvic floor physical therapist can evaluate exactly which muscles or pressure patterns are contributing.
How Pelvic Floor Therapy Helps
During an evaluation at Rome Physical Therapy, we’ll assess:
How your pelvic floor muscles contract and relax
How your body manages pressure during movements like coughing or lifting
How your breath and posture influence your pelvic control
We’ll then guide you through a personalized plan to retrain your pelvic floor, core, and breathing patterns so your body responds automatically again — not just when you think about it.
Our goal isn’t just to stop leaks — it’s to help you feel confident, strong, and reconnected to your body.
When to Reach Out
If you’re leaking when you cough, sneeze, laugh, jump, or run — or if you’ve been avoiding certain activities because of it — it’s time to reach out.
Whether you’re months or years postpartum, it’s never too late to retrain your body and restore control.
✨ Ready to stop peeing when you cough?
Our pelvic floor specialists at Rome Physical Therapy can help you understand your body, retrain your system, and prevent issues long term.
Let’s get you back to moving confidently — without leaks.
👉 Book your evaluation at Rome Physical Therapy
We proudly serve the Charleston, South Carolina area, including Mount Pleasant, Summerville, and West Ashley.