‘Is it normal to pee when I laugh’ is a question NHS GP Dr Preethi Daniel is asked most days – here she explains what can be the cause of urinary incontinence and what can be done to help with this non-laughing matter
When it comes to leaking urine when you laugh, it is absolutely no joke – except to everyone else. If you are wanting to fix the problem and want to enjoy a good old belly laugh without an unwelcome pee, having a strong pelvic floor is essential.
Would you believe there is a medical term for laughing so much until you pee? No, it’s not called great friends (although they don’t help the problem), it’s called stress incontinence, a term that covers peeing when laughing, when you sneeze, cough or run.
One way to identify your pelvic floor muscles is to think of having to hold in the biggest post-bean and onions fart you can possibly imagine
Stress incontinence is when the increase in pressure in the abdomen is greater than the bladder and pelvic muscles can handle and urine leaks out. Weight gain, pregnancy and childbirth can all be causes.
Why is this happening to me now?
Stress incontinence is common in older women, particularly after menopause, but women of any age can suffer. It is much more common after childbirth which stretches and loosens ‘everything’ down there. Being overweight makes it more likely too though sometimes it just runs in the family. Any recent major operations involving your intimate area will also put you at increased risk.
What can I do to help?
There’s a lot you can do but like many things that help your health it requires some dedicated effort.
Do you remember when everyone was talking about Kegel’s exercises? Well, you’re about to understand the hype. Your pelvic floor is a group of muscles around the vagina and anus that holds all your organs in and stabilises your spine, diaphragm and back muscles.
The best way to do Kegel’s is to do eight contractions of the muscles that stop your pee mid-flow. Another way to identify your pelvic floor muscles is to think of really having to hold in the biggest post-bean and onions fart you can possibly imagine. The group of muscles being squeezed are your pelvic floor. The best way to contract your pelvic floor is when sitting down, without moving your abdomen or buttocks or thighs squeeze your anus and vaginal muscles hard as you can for at least five seconds. Then relax for another five. Repeat this 10 times. Aim to increase from 5 to 10 second clenches as soon as you can. Try and do this 3-5 times a day. Whenever you find yourself sitting and bored. No-one needs to know.
Also try and avoid the following: sugary carbonated drinks, alcohol, chocolate, citrus fruits, spicy foods and coffee as the irritation they cause the bladder can lead to leaking.
If you are concerned, it is always recommended to visit a doctor as you need to be checked for a possible infection and there are operations that can help the worst cases.
But most important are those pelvic floor exercises. Like the gym and healthy eating, you should be keeping them up your whole life.
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Dr Preethi Daniel is an NHS GP in Hertfordshire and Clinical Director at London Doctors Clinic. She graduated from Kings College London in 2010 and has since gained extensive experience in various hospital specialties during her postgraduate medical and surgical training before becoming a GP. During her junior doctor years, she successfully published a paper on a rare condition affecting the intestines causing excessive vomiting, in GUT magazine. She has well-rounded clinical knowledge in Women’s Health, Child Health, Emergency Medicine and Mental Health. She has experience working with Herts Valleys Clinical Commissioning Group to optimise patient care pathways in the NHS. She currently teaches Community Geriatrics to UCL medical ents and mentors young people on career and interview skills for Universities. Dr Daniel also works as an NHS GP in a busy Hertfordshire practice of over 10,000 patients.