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Women in fitness class laughing whilst exercising

Why am I leaking during exercise?

29 Feb 2024 • 6 min read

Stretch, squat, and – what was that?

More than one in five women know this feeling.1 So why aren’t we told about it?

Stress urinary incontinence (SUI) can make exercise intimidating. But there are ways to hit the gym with confidence...

Leaking is often down to stress incontinence (also responsible for leaks when you sneeze or cough).2

"Stress” in this context means the pressure put on your bladder, not mental stress. It’s usually due to weakness in the muscles that hold pee in, such as in your urethra and pelvic floor.3

High-impact exercise and lifting puts strain on your pelvic floor.4 So you can guess what happens next...

Who experiences it?

Anyone!

But exercise incontinence affects twice as many women than men.5 Pregnancy, childbirth, and menopause can all play a part. Also, the female urethra is shorter than the male urethra, so there’s less muscle to hold in your pee.6

You might associate “leaking” with older people, but stress incontinence (the type that happens during exercise) is actually most likely to affect younger women.6

Of course, people of any gender and any age can experience it. You might be more likely to leak if: 
  • you’ve got a certain medical condition, like diabetes
  • you’ve had a surgery affecting your pelvic muscles (e.g. a hysterectomy) or your prostate gland 8,2 
  • you’re overweight
  • you’ve recently had a UTI
  • you experience lower back pain 9

There’s also evidence to suggest that it’s more common in women who are physically active.9 But, ironically, regular exercise is also a good way to help reduce incontinence.10 So, it’s not about avoiding exercise – just doing what works for you...

Tips on strengthening your pelvic floor

See your GP if you’re experiencing urinary incontinence.

They may recommend pelvic floor exercises (also called Kegels), which help to strengthen the muscles that hold in your pee. They can be done by people of any gender.

Not only do pelvic floor exercises help manage incontinence, but they may help prevent it.3 Plus, they can make sex feel better.11

Nobody can see when you’re doing Kegels, so you could add them into your gym routine just like any other exercise.

Kegels: How-to

Try to imagine yourself stopping from peeing: these are the muscles to work on. 
  1. Make sure you’re relaxed and your bladder is empty. You can stand, sit, or lie down. 
  2. Squeeze your pelvic floor muscles up to 10 times, holding each squeeze for 10 seconds. Try not to tense your body or hold your breath.
  3. Relax for 10 seconds between each rep.
As you get the hang of it and strengthen your muscles, you can work up to doing sets of 10 Kegels, three times a day.12 You shouldn’t do more than six sets per day.11

You can also switch up the speed of your squeezes, holding them for longer, or practicing quick ones. But it’s best to master the basics first. 

It might take a few months to see results. Keep doing them, even if you feel like your leaking’s improved.

Which exercises can make incontinence worse?

Everyone’s different, and maybe you’ve found out your “danger zones” the hard way.

Generally, leaks happen during exercise that puts strain on your bladder and pelvic floor muscles. These can include: 2,4,13 
  • running 
  • lifting weights 
  • trampolining 
  • squats 
  • sit-ups and crunches

Changes you can make in the gym

You shouldn’t have to say goodbye to your usual workouts, but there are changes you can make while you work on your pelvic floor. You could try: 13,4,14 
  • lower-intensity exercise, such as brisk walking instead of running 
  • strengthening exercises like pilates 
  • doing push-ups and planks on your knees, or reducing your hold time 
  • using lighter weights 
  • taking care not to hold your breath while you exercise 
  • using seated equipment or sitting on an exercise ball
Continue to drink enough water while you exercise, otherwise you’ll risk becoming dehydrated.

You might also want to use products like incontinence pads or absorbent pants. The NHS states that you can occasionally use tampons, which put pressure on the bladder and may help reduce leaks. However, this is not a permanent solution and isn’t recommended by the National Institute of Health and Care Excellence (NICE).15

Changes you can make at home

1. Try pelvic floor products

Just like the equipment you’d find at the gym, there are products designed to help “work out” your pelvic floor.

You can insert a small, specially made weight into your vagina to help strengthen the muscles while you do Kegel exercises. The Intimina Laselle is a 38g weight, coated in medical-grade silicone, which gently adds weight to the pelvic floor muscles while you squeeze them.

The Intimina KegelSmart™ is another pelvic weight trainer, this time with added tech. It registers your pelvic strength and automatically sets an exercise level according to your needs.

Using a simple vibration pattern, it designs a daily 5-minute program that’s smartest and safest for you.

2. Reduce caffeine and alcohol

Caffeine and alcohol are both diuretics, which make you pee more.4 Reducing your intake may help you need to go less frequently or less urgently.

3. Stop smoking 

Smoking makes you cough, which puts strain on your pelvic floor muscles.10

4. Avoid constipation

Straining too hard on the toilet can weaken your pelvic floor.7 You can help prevent constipation by: 16 
  • drinking 6-8 glasses of water per day 
  • eating plenty of fruit, veg, and fibre-rich foods 
  • staying active throughout the day 
  • going to the toilet when you need to, rather than holding it in

The final say

Leaking is very common and not something to be ashamed of. It’s not just “part of being a woman” or “part of getting older”, and it’s not something you should have to deal with alone

If pelvic floor exercises and lifestyle changes aren’t working, your GP might recommend other treatments like medication or surgery.

Handpicked content

Disclaimer

 

Sources

1. Royal College of Obstetricians & Gynaecologists. RCOG calling for action to reduce number of women living with poor pelvic floor health [Internet]. RCOG; 2023. Available from: https://www.rcog.org.uk/news/rcog-calling-for-action-to-reduce-number-of-women-living-with-poor-pelvic-floor-health/
2. NHS Inform. Urinary incontinence [Internet]. NHS Inform; [reviewed 2024 Jan 9]. Available from: https://www.nhsinform.scot/illnesses-and-conditions/kidneys-bladder-and-prostate/urinary-incontinence/
3. NHS. Urinary incontinence – Overview [Internet]. NHS; [reviewed 2023 Jun 15]. Available from: https://www.nhs.uk/conditions/urinary-incontinence/
4. NHS. 10 ways to stop leaks – Urinary incontinence [Internet]. NHS; [reviewed 2023 Jun 15]. Available from: https://www.nhs.uk/conditions/urinary-incontinence/10-ways-to-stop-leaks/
5. Incontinence UK. How Incontinence Affects Men & Women Differently [Internet]. Incontinence UK; 2022. Available from: https://www.incontinenceuk.co.uk/news/how-incontinence-affects-men-and-women-differently
6. National Institutes of Health: Office of Research on Women’s Health. Urinary Incontinence [Internet]. National Institutes of Health: Office of Research on Women’s Health; 2019. Available from: https://orwh.od.nih.gov/research/maternal-morbidity-and-mortality/information-for-women/urinary-incontinence
7. Pelvic Obstetric & Gynaecological Physiotherapy (POGP). The Pelvic Floor Muscles: A Guide for Women [Internet]. POGP; 2015. Available from: https://www.iow.nhs.uk/Downloads/Pelvic%20Floor%20Physiotherapy/Pelvic%20Floor%20Exercise%20for%20women.pdf
8. NHS. Incontinence – Causes [Internet]. NHS; [reviewed 2023 Jun 15]. Available from: https://www.nhs.uk/conditions/urinary-incontinence/causes/
9. Chisholm L, Delpe S, Priest T, Reynolds WS. Physical Activity and Stress Incontinence in Women [Internet]. Curr Bladder Dysfunct Rep. [Internet]. 2019 Jul 1 [cited 2024 Feb 22]; 14(3) 174-179. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6711374/
10. Bladder & Bowel UK. What you need to know about stress incontinence [Internet]. Bladder & Bowel UK; 2023. Available from: https://www.bbuk.org.uk/what-you-need-to-know-about-stress-incontinence/
11. NHS. What are pelvic floor exercises? [Internet]. NHS; [reviewed 2023 Nov 22]. Available from: https://www.nhs.uk/common-health-questions/lifestyle/what-are-pelvic-floor-exercises/
12. National Association for Continence (NAFC). Kegel Exercises [Internet]. NAFC. Available from: https://nafc.org/kegel-exercises/
13. Continence Foundation of Australia. How to exercise without wetting yourself [Internet]. Continence Foundation of Australia; 2019. Available from: https://www.continence.org.au/news/how-exercise-without-wetting-yourself
14. NHS. Physical activity guidelines for adults aged 19 to 64 [Internet]. NHS; [reviewed 2021 Aug 4]. Available from: https://www.nhs.uk/live-well/exercise/physical-activity-guidelines-for-adults-aged-19-to-64/
15. NHS. Incontinence products – Urinary incontinence [Internet]. NHS; [reviewed 2023 Jun 15]. Available from: https://www.nhs.uk/conditions/urinary-incontinence/incontinence-products/
16. NHS. Constipation [Internet]. NHS; [reviewed 2023 Oct 26]. Available from: https://www.nhs.uk/conditions/constipation/
 
heeral-patel-bio

Heeral Patel

Reviewer

Health & Science Editor

Biomedical Sciences

Graduating from Cardiff University in Biomedical Sciences, I pursued a career related to health and medicine. Landing me my first job in pharmaceutical market research, from listening to patient stories my interest in health and wellbeing grew, leading me to work in publishing and editing content for medical education and women’s health journals. Now I am here as part of the Science team to create science and health editorial guidelines and content reviews so we can help the business with their mission of being science-led!

Something I am passionate about:
Exercise! I’m not a regular gym go-er, but I am an advocate for moving your body in some form or another, whether that’s a long walk or dancing! It’s really helped with my mental well-being, and I love getting 10,000 steps in!
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