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Do you pee when you exercise? Believe me, you are not the only one. But it is a subject not brought up because of embarrassment or fear of TMI. Reading on the internet, people dismiss it as common, don’t worry about it, or, OMG! That’s not normal, you need to get that checked! Meanwhile, women everywhere are stuck between shame and misinformation, and that helps no one. So, let’s see if we can get this issue in the light, and get it untangled. Keep in mind, I am not a doctor, and nothing I say should be construed as medical advice. However, my goal is to arm you with information, so when you do talk to your doctor, you have confidence and choices. Ready? Let’s go!
So what is this phenomenon of confusion? The technical term is stress induced incontinence. Laughter, sneezing, coughing, exercise can all make this flare up. Another kind of incontinence is called urge incontinence, which is a separate issue, and is not the focus of this article.
How to tame this monster? Well, there are several options. I will go through them from least invasive, to most (surgery.) First off there is always the tip I keep finding that tells you to go multiple times before you start to be sure your bladder is empty.. Sounds good, right? It may even help somewhat. However, did you know that you could be training your bladder to signal that it needs to be emptied when it is not full by using this method? As an athlete who drinks tons of water, I truly don’t want to go to the bathroom more than I have to.
Another “tip” that I keep finding is the one to restrict liquid intake. Do not do this! One, you need to stay properly hydrated to perform. Being dehydrated can be very dangerous. Also, restricting fluids can set you up for urinary tract infections.
So where are we at now? Ahh, yes kegel exercises. That is probably one of the first things everyone thinks of when addressing this issue. Do them and it is a cureall! Sigh. If only it were so simple. For one thing, studies have shown that most people perform these exercises incorrectly, even though they may think and even insist they are doing them right. Also, if your pelvic floor muscles are already too tight, that can cause leakage as well.
Still, kegels can help tremendously if you are consistent and do them correctly. Here is a step by step:
https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/kegel-exercises/art-20045283
Ok, so we’re working our kegels, but what about other options? There are a few.
Pessaries
A product called Impressa, by Poise
Urethral bulking
Slings
Sooo, what exactly is a pessary? It is a soft, flexible, device inserted into your vagina to support your bladder, vagina, uterus, and/or rectum. There are a few different types. Like anything else, there are considerations. There could be irritation, sexual considerations (with a gelhorn pessary you can’t have sex), and sizing issues. For a more in depth discussion, read this:
https://www.webmd.com/urinary-incontinence-oab/what-are-vaginal-pessaries
https://images.app.goo.gl/u9HzzRmgTMrLqepQ6
These are some pictures of various types of pessaries
There is also a product called Impressa, by Poise, which may be a bit simpler to use than a pessary. These are a little like tampons. Start with the sizing kit- it has three different sizes for you to find the degree of support you need. They can be worn for up to 12 hours. These are also easier to access: you don’t need to go to the doctor to get these. They are available at CVS, Amazon, and poise.com.
https://www.poise.com/en-us/products/impressa/detail/sizing-kit
Next time we will touch on urethral bulking and surgery.