4 Reasons You Might Accidentally Pee and What To Do About It

Some people experience urinary incontinence—or the loss of bladder control which makes them accidentally pee.

People with urinary incontinence may worry they'll wet themselves every time they cough, run, or lift a heavy bag of groceries—this type of incontinence is called stress incontinence. Luckily, there are effective ways to treat incontinence.

What Is Urinary Incontinence?

You can blame urinary incontinence, at least in part, on your pelvic floor muscles—the trampoline-like tissue that stretches from the pubic bone to the tailbone and includes the urethral sphincter (that thing you clench when you hold in pee).

If these muscles are weak, they may have trouble holding urine in—mainly when pressure is applied to the bladder through coughing, sneezing, laughing, or physical activity.

What Causes You to Accidentally Pee?

Weak pelvic floor muscles cause urinary incontinence, but how do your pelvic floor muscles become weak in the first place? Some life events and health problems can lead to weak pelvic floor muscles that can cause incontinence. Here are a few factors that might cause this vital muscle group to lose strength.

Menopause

The primary culprit may be estrogen or a lack thereof. If you've noticed that after your period stops, you've been experiencing incontinence, then menopause may be the cause. After menopause, your body has low levels of estrogen. Researchers suspect a lack of estrogen weakens your urethra, leading to incontinence.

If you're going through menopause, likely, you're also an older adult, and as you age, your muscles become weaker over time, and you won't be able to hold as much urine.

Pregnancy and Childbirth

About 40% of people will experience urinary incontinence during pregnancy. This is because the fetus can push down on the bladder, urethra, and pelvic floor muscles, which can cause them to become weaker; during labor, the muscles and nerves that control the bladder can become damaged, making them weaker.

Usually, after pregnancy and delivery, the muscles will heal over time. But for some people, the problem may last longer. In one study, 75% of people experiencing urinary incontinence three months postpartum were still experiencing it 12 years after giving birth.

Another study found that people between 40 and 64 were more likely to report incontinence if they had experienced pregnancy and childbirth. These effects were more pronounced for people who gave birth vaginally compared to those who had a C-section.

Weight

Any pressure applied to the bladder can weaken the muscles over time. Weight from the abdomen can apply pressure to the bladder and the muscles surrounding it. If you want to lose weight to help with incontinence, talk to a healthcare professional about weight loss strategies.

Exercise

Some research found that doing strenuous exercise on a regular basis may cause or worsen pelvic organ prolapse—when the muscles that support the pelvic organs become weak—which can lead to incontinence.

What's the Treatment for Incontinence?

The first line of treatment is pelvic floor strengthening—something all women, even those who have never experienced stress urinary incontinence—should be doing.

It's a good idea to do your initial pelvic floor training with a physical therapist (PT), who can assess your muscles' strength and identify any underlying problems, like scar tissue. PTs also have access to training tools, like biofeedback, that can assist women who are having trouble performing the exercises correctly.

How To Do Kegel Exercises

Pelvic floor exercises, also called Kegels, are a common treatment option for people who are experiencing incontinence. Kegel exercises can be described as pretending you have to urinate and then holding it.

Find the Right Muscles

Before you do Kegel exercises, you have to find the right muscles. Here's how: When you're urinating, start to go and then stop. You'll be able to feel the muscles get tight—those are your pelvic floor muscles.

If you are having trouble finding the muscles that way, you can insert a finger into your vagina, tighten the muscles as if holding in urine and then let go. This will help you feel the muscles.

Steps for At-home Kegels Exercises

Now that you've found the proper muscles, you can start doing Kegel exercises. Here are the steps to doing Kegel exercises at home:

1. Make sure your bladder is empty.
2. Sit or lie down.
3. Tighten your pelvic floor muscles for 3–5 seconds.
4. Relax the muscles for 3–5 seconds.
5. Repeat 10 times in the morning, afternoon, and night.

Keep in mind that you shouldn't clench your abs, thighs, or butt, and you shouldn't do the exercises while you're peeing, as this can damage the bladder. Also, avoid using too much force since this can lead to pain during sex. Your symptoms should improve in four to six weeks.

Are There Other Incontinence Treatments?

Aside from Kegels and other pelvic floor exercises, there are other options you can try as well. Discuss your options with a healthcare provider who can guide you through the best treatment plan.

Bladder Training

You can try to stretch your bladder by allowing it to hold more urine for a longer time. You can do this by having a schedule for when you urinate and holding it in until you are scheduled to urinate. A healthcare provider can help you make a schedule that works for you.

Surgery

If you're still struggling, your healthcare provider may recommend sling surgery, a common, minimally invasive procedure.

This type of surgery is when a strip of material, usually synthetic mesh, is inserted between the vagina and urethra. If you have a penis, the strip of mesh will be placed under the urethra.

Give It Time

Be patient. It can take up to six weeks to strengthen your pelvic floor and an ongoing effort to keep the muscles in shape. But it's worth putting in the work.

When you need motivation, consider this: A strong pelvic floor can also intensify orgasms.

Products That Can Help

In the meantime, certain products can offer peace of mind until you regain control.

Absorbent Underwear

These sorts of panties contain a multilayer crotch that is designed to wick urine (so you don't feel damp if you dribble) and absorb liquid (so it doesn't seep through your clothes).

Urethral Inserts

These soft, plastic balloons are inserted into your urethra, providing a temporary seal that stops urine from leaking. You need to take them out to pee (and then replace them with a new sterile insert to avoid infection), so it's probably best when the risk of leakage is high, like when attending a HIIT class.

Vaginal Inserts

You insert a device into your vagina like a tampon, but it's nonabsorbent and shaped more like an hourglass to prevent leakage by lifting and supporting your urethra.

A Quick Review

Stress incontinence is a common condition caused by menopause, pregnancy and childbirth, exercise, and weight gain. This type of incontinence puts pressure on the bladder and the muscles that control it, weakening them.

You can use Kegel exercises to strengthen your pelvic floor. If your symptoms haven't improved in six weeks, ask your healthcare provider for other treatment options like surgery or bladder training.

As you try treatment options, various products can make you more comfortable.