My bladder leaks when I cough

Coughing, sneezing, laughing, lifting, or exercise can raise pressure inside the abdomen. If the pelvic-floor muscles and urethral support do not close firmly at that moment, urine can escape. Pregnancy, birth, menopause, changes in pelvic support, constipation, and repeated coughing can contribute. A pelvic organ prolapse can also affect bladder control, so mention vaginal pressure or a bulge to a clinician.

Keep a brief diary of drinks, toilet trips, leakage triggers, urgency, and night-time symptoms. This helps separate stress leakage from urgency or another bladder problem.

Arrange an assessment if leakage is recurring or limiting activity. A clinician may check your urine, ask about pregnancy and birth history, and assess pelvic-floor function. [Pelvic Floor Exercises](/treatments/pelvic-floor-and-rehabilitation/pelvic-floor-exercises/) and supervised [Pelvic Floor Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/pelvic-floor-physiotherapy/) can improve coordination and strength. If symptoms began after birth, [Postnatal Physiotherapy](/treatments/pelvic-floor-and-rehabilitation/postnatal-physiotherapy/) may be suitable.

Avoid straining with constipation, treat an ongoing cough with medical guidance, and do not drastically restrict fluids. [Bladder Training](/treatments/pelvic-floor-and-rehabilitation/bladder-training/) may help when urgency is also present. Persistent stress leakage can be discussed with a specialist; a [Mid-Urethral Sling](/treatments/gynaecological-surgery/mid-urethral-sling/) is one possible surgical option.

Seek prompt advice for burning urine, blood in the urine, fever, back or side pain, difficulty emptying your bladder, new leg weakness, or loss of bowel control. Arrange review if leakage starts suddenly, follows an operation, or comes with a vaginal bulge. These features can point to infection, nerve problems, prolapse, or another issue needing targeted care.

Ask which type of incontinence you have, whether your pelvic floor is tightening correctly, and whether a urine test or bladder diary would help. Ask how long to try physiotherapy, how to modify exercise safely, and when specialist or surgical treatment should be considered.