A sneeze isn’t just a sneeze when your bladder won’t hold out. But accidental peeing is easily fixed, says this women’s physio. She explains the latest thinking on pelvic floor exercises – and why you’ve probably been doing them wrong all this time
Sneezing is one of the most annoying side effects of hayfever , but an astonishing number of women dread the pollen season for a different reason. A sneeze isn’t just a bit of nasal irritation, it’s a potentially embarrassing peeing incident. Think we’re making it up? Urinary Stress Incontinence – where you have trouble holding in your pee when your pelvic area is under pressure from a sneeze, a fit of giggles or coughing, running and jumping – affects millions of women, up to 35 per cent . It occurs mostly after childbirth when the pelvic floor weakens, and in menopause when low oestrogen levels can lead to thinning of the tissues in the pelvis making it harder to keep the sphincter closed, but it can affect teens as well.
Having spent 20 years diligently squeezing my mula bandha (the pelvic floor ‘root lock’) for England in yoga, I am still noticing that as I get older, it’s harder to hold it in. The fact that I have had more conversations with my friends about sex and salaries than the state of our bladders indicates that despite what the stats show, we clearly think we’re the only ones.
Why do I pee when I sneeze?
“Millions of women are affected by this problem, but so few are willing to admit to suffering them,” confirms physiotherapist Michelle Lyons, who specialises in helping women overcome pelvic floor issues.
“Leaking might be common, but there’s almost always something we can do to help. Don't believe the advertiser or indeed anyone who tells you that nothing can be done about it and wearing pads is the way forward - it is not! It's common but not acceptable. Never suffer in silence, the remedy is usually very simple.”
Caroline Telfer, a mother-of-two and personal trainer from Sussex was told by her GP that nothing could be done about ‘sneeze leaks’. “This was a devastating and humiliating blow at the time and now, I realise, quite appalling advice,” she says. “Luckily, I refused to accept that.” Through the personal training world, she discovered a pelvic floor fitness programme called Holistic Core Restore and enrolled on a course. “Within three weeks I could sneeze with confidence. It gave me tool box to apply whenever I needed it.” She loved it so much she qualified as a Holistic Core Restore instructor and helps other women regain their physical strength and confidence.
So what to do if peeing when you sneeze (or even peeing when you laugh) is affecting you? Michelle, who is also HCR’s resident wellness expert, has compiled her tips for combatting Urinary Stress Incontinence especially in hayfever season - and reveals why you may have been doing your pelvic floor exercises all wrong.
How to stop accidental urine leaks and master smart pelvic floor exercises
“The first port of call for preventing leaks is to improve the function of your pelvic floor muscles. But if you think pelvic floor exercise is only about 'squeezing' when you’re waiting at the traffic lights or cleaning your teeth, or even stopping your pee mid-stream think again, Kegels (pelvic floor exercises) have moved on a lot!" says Michelle.
DO make sure you are squeezing your pelvic floor muscles correctly
- Relax your pelvic floor muscles: take a deep breath in and as you exhale, let everything relax!
- Take another breath in and as you exhale, squeeze your anus closed as if you’re trying not to pass wind – what we’re looking for is a close and a lift up towards pubic bone - like an escalator.
- Take another breath in and as you exhale, let everything relax again. Voila, you've now performed a 21st Century Kegel!
NEVER do your PFs on the loo
“Don’t practice by stopping your pee mid-stream when you are on the loo. This is old advice and confuses your bladder! New research shows you get a better overall contraction of the entire pelvic floor if you close and lift as above focusing at anus.
“What should happen when we pee is that we sit down, relax the pelvic floor muscles and this signals the bladder muscle (the detrusor) to contract and empty the bladder. If we start contracting the pelvic floor muscles, on the other hand, that tells the bladder to stop emptying and could lead to urinary retention, incomplete emptying or possibly urinary tract infections. Sit down, relax your pelvic floor and pee! Do your PF exercises away from the loo!”
Do little and often
“Practise relaxing, contracting and then fully relaxing again. It’s better to do a couple of PF exercises every hour, which helps retrain the ‘brain-bladder connection’ rather than doing 20 reps in the morning and forgetting them for the rest of the day.”
Work them into your workout
“We know that healthy glutes are very important for a healthy, happy pelvic floor so incorporating the PF contraction when you do squats or lunges is a bit more of a functional approach. I recommend that you do them every time you go from sit to stand, so you're building them into your everyday routine.”
Make sure you ‘squeeze before you sneeze’
“When you know you are going to cough or sneeze, activate your pelvic floor quickly beforehand as above to help withstand the pressure. Close and lift around your anus to brace for impact, then relax once it’s passed.”
Don’t get constipated
“Although this might seem unrelated to bladder health, if you’re constipated this will be an added layer of stress on your pelvic floor muscles and can distract them from their mission of bladder control.”
… or dehydrated
“If you’re worried about leaking, the temptation might be to restrict your water intake, however this can actually make both your bladder leakage AND your hayfever worse! Staying well hydrated helps keep your nasal tissues healthy which is essential for hayfever management, and it helps combat constipation. If we restrict water intake, we can actually end up irritating the bladder which can make bladder control even more challenging.”
Eat peppers and pineapple
“Focus on increasing your intake of foods that contain natural anti-inflammatories and antihistamines such as cranberries, peppers and onions which contain quercetin, a flavanoid that studies have found may decrease the production and release of histamine. Instead of having a sugary treat which can make the problems worse, why not try some chilled pineapple, which contains bromelain, an enzyme which has been shown to enhance the efficacy of quercitin.”
To find a Holistic Core Restore Coach near you click here .