Why Do Women Leak Urine? 2 Types of Incontinence (And How to Actually Fix Them)
Bladder Health Mini Series
Part One:
Part Two:
Part Three: How to Stop Recurrent UTIs From Coming Back
Part Four: How to Pee Correctly (Yes, There's a Right Way!)
Running to find bathrooms before it's too late. Leaking during workouts. Avoiding jumping and running with your kids. Racing to make it to the toilet when that sudden urge hits. Living with urinary leakage affects everything from your exercise to your daily activities to your relationships, and can even your affect your sleep.
Some women have had bladder problems since childhood, for some it started during pregnancy, for others it started after delivery.
Even though 1 in 3 women experience bladder leaking, this isn't something you need to accept. Although leaking is common, it's not "normal". And it's definitely NOT just "part of being a mom."
You can have a life where you don't worry about where the closest bathroom is, or wet your pants on the way to the bathroom. You can exercise without pads. You can sleep through the night without multiple bathroom trips. You can be confident in your bladder and your pelvic floor can be strong again. Let's look at why leaking happens, the two types of incontinence, and most importantly, what you can do about it.
Stress Incontinence: leaking with exercise, movement, and increased pressure
Leaking with coughing, sneezing, laughing, exercise or movement is medically known as stress incontinence. Stress incontinence is the result of core muscles that don't properly manage pressure increases in your abdomen. Coughing, laughing, sneezing, and exercise all increase the pressure in your abdomen. Anytime the pressure increases in your abdomen, your core muscles (pelvic floor, abdominals, and diaphragm) should reflexively activate in a way that supports your bladder and urethra. When your core muscles are dysfunctional, or not working properly, and they do not support your bladder and urethra during a pressure increase, leaking can result.
Many women stop exercising, doing activities they love, and playing with their kids because of stress incontinence. They stop high impact exercise classes, they stop certain activities that used to relieve stress because they don't want to wet their pants. They stop running, jumping rope, and they stop playing on the trampoline with their kids. They get anxious when they have to cough or sneeze because they are worried it might trigger an accident.
The root cause? Core and pelvic floor muscles that aren't coordinating properly to handle normal daily increases in abdominal pressure. Every time you move, breathe, cough, talk, or laugh, these muscles should work together automatically to support your bladder. When this coordination is off, leaking occurs and it can make you feel insecure and embarrassed, and lead to avoidance of important normal daily activities that are necessary for your health and well being.
If this sounds like you, don't worry- you don't have to live like this. There is a simple fix. Read on to learn more.
Urge Incontinence: leaking with urgency
Leaking with urgency on the way to the bathroom is medically known as urge incontinence. Urge incontinence strikes with an intense, sudden need to urinate. The urge feels impossible to control, often leading to leaks before reaching the bathroom. Women with urge incontinence often limit their water and fluid intake thinking if they drink less, they will pee less and leak less. They often try to control their urgency and leaking through restriction of fluids, which only makes their problem worse. This type of incontinence forces you to map out every bathroom location. You might wake up multiple times at night because of the need to pee. Social events, car trips, and meetings become sources of anxiety.
Urge incontinence is caused by two major factors: 1) pelvic floor muscle spasm, and 2) bladder irritation. I'll explain both causes in more detail and how they are related.
Pelvic floor muscle spasm is when your pelvic floor muscles are too tight. Increased tension in your pelvic floor muscles can make you feel like you have to pee when your bladder isn't even full. This dysfunctional tension in your pelvic floor muscles also makes them weak- so when you get that urge to pee and start rushing to the bathroom, your pelvic floor muscles fail and you wet your pants.
Bladder irritation is caused by urine that is too concentrated. Concentrated urine comes from dehydration (not drinking enough water) and/or a high intake of bladder irritants, like caffeine, carbonation, artificial sweeteners and highly acidic substances like coffee, diet sodas, OJ, lemonade and tomato sauce. When your bladder is irritated from highly concentrated urine, this will make your pelvic floor muscles tense up, and lead to that sensation of urgency that is sudden, overwhelming and completely out of your control.
Women with urge incontinence usually stop drinking water because they think that will help them pee and leak less. But in fact this makes their urgency worse and their pelvic floor muscles even tighter and weaker. So they end up getting stuck in a vicious cycle of severe urgency, chronic dehydration, and not making it to the bathroom in time- and have no idea how to end it.
If this sounds like you, don't worry. You can regain control of your bladder with a simple protocol.
The Real Cause of Bladder Leaking
Leaking happens when your core muscles are not working together as a team. Your diaphragm, deep abdominal muscles, and pelvic floor should coordinate automatically to support your bladder (and all of your other organs) with every breath you take and every movement you do. When this coordination breaks down, your bladder loses its support system, and various types of leaking can result.
Did you know that your breathing pattern directly affects this core muscle coordination? Your breathing is what triggers reflexive activation or your core muscles. Your breathing mechanics will either TURN ON or TURN OFF your core muscles. If you're breathing incorrectly, holding your breath during activities, or stuck in a cycle of anxiety, this will directly impact the ability of your core and pelvic floor muscles to support your bladder. Add concentrated urine to this, and you've got a real problem.
Pelvic floor muscle spasm, core muscle dysfunction, and bladder irritation are the real causes of leaking. And the good news is, all of those causes can be fixed. But first, let's talk about what will not fix leaking, and can in fact make it worse.
What NOT to do if you are Leaking
Often women who leak are told to do kegels. The truth is, kegels dont fix anything. In fact, kegels make leaking worse! See, leaking comes from pelvic floor muscles that are too tight and don't coordinate their movement with the other core muscles. Kegels isolate the pelvic floor, which is not functional at all because the pelvic floor NEVER activates alone. Kegels also make pelvic floor muscle spasm worse- repetitively squeezing a muscle that is already too tight, will only make it tighter and even more dysfunctional.
Women who leak also often restrict their water intake. They stop drinking water as a way to control their urgency and leaking. The reality is, this only makes their bladder more irritated by the concentrated urine, which in turn causes more pelvic floor muscle dysfunction and more leaking.
So if you have stress or urge incontinence, don't do kegels and don't restrict your water intake.
I know what you're thinking: If kegels and limiting fluids wont help my leaking, then what will??
How to Stop Bladder Leaks
Leaking stops when the core muscles start functioning properly, and when the bladder is regularly filled with dilute urine. Simple as that.
The first thing I do when I a patient comes to me for leaking is ensure they are adequately hydrated, that they are not drinking more than a cup of coffee a day, and certainly not drinking diet sodas or over-doing it on acidic beverages and food. Ensuring the bladder is regularly filled with dilute urine has a calming effect on the bladder- reducing urgency, and helping ensure the pelvic floor muscles are are not spasming because of irritation.
The second thing I do is teach her simple breathing drills to do throughout her day, in the face of urgency, and when she has to cough/laugh/sneeze or exercise. These breathing drills immediately start to sync up her core muscles and properly coordinate their activation so that they support the bladder with every breath she takes. In addition to these breathing drills, I also teach her hypopressive breathing, which is a gentle yet powerful method that stabilizes the bladder, heals the pelvic floor and trains the core muscles function as they were meant- to automatically support the organs with every breath and every movement and every sensation.
When you restore optimal core muscle function through breath training, and achieve adequate hydration, bladder issues resolve quickly and leaking stops for good.
See your core muscles need to work automatically - no conscious squeezing required. You should not have to think about turning on your core and pelvic floor muscles before your sneeze, cough or move. They should automatically activate on their own! Through specific breathing exercises and practicing subconscious movement patterns, you can retrain your core and pelvic floor muscles to activate on their own, and when they should.
Breathing is the gateway to the subconscious nervous system. In order to stop bladder issues and leaking- you need to train in the subconscious nervous system! You are not voluntarily leaking on purpose! It's a problem outside of your conscious control. You can't heal an involuntary subconscious problem through the voluntary nervous system. Thats why kegels don't work. In order to stop leaking for good, you must train your core muscles through the subconscious nervous system by triggering their proper activation via reflexes elicited by breathing. Proper breathing sets the foundation for a healthy bladder.
Living with bladder leaks isn't your new normal.
While bladder leaking affects many women, it's a clear signal that your core and pelvic floor need attention. When you restore proper coordination between your diaphragm, deep abdominals, and pelvic floor- bladder control returns automatically with every breath you take.
Ready to stop planning your life around your bladder? The Core Recovery Method® teaches you how to rebuild proper core muscle function, without relying on kegels or complex exercises. This proven online program guides you through the exact process I use with my private clients to resolve bladder issues once and for all.
The Core Recovery Method® is designed by a busy mom, for busy moms, who need quick and effective solutions. You'll learn:
- How to retrain your core muscles to support your bladder automatically
- Breathing techniques that heal and strengthen your pelvic floor
- Simple exercises that fit into your daily routine and produce results fast
- Detailed guidance on proper bladder hygiene to ensure you stay dry, calm and confident.
