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Peezing Your Way Through Winter

Peezing: sneezing and peeing your pants at the same time.

While the word peezing may be funny, the situation and reality of it is all too real and embarrassing for many women. Peeing when sneezing, coughing, and laughing is known as stress incontinence and although common (especially among postpartum women), it is in no way normal! I repeat, peeing yourself when laughing at a joke is NOT normal.

Just to get a better picture of how much pressure is placed on the pelvic floor with coughing or sneezing take the following as an example. A case study was performed to see the difference of internal pressure when performing various exercise activities.

The following was recorded, where cmH2O is amplitude of pressure.

- Abdominal curl up (approx. 25 cmH2O)

- Full sit up (approx. 50 cmH2O)

- Lifting and carrying 18.2 kg (approx. 80 cmH2O)

- Running at 9.66 km/h (approx. 80cmH2O)

- Jumping (approx. 80 cmH2O)

- Coughing (approx. 145 cmH2O)

The muscles of the pelvic floor have a lot of responsibility such as holding back urine throughout the day as well as maintaining everything in position in your pelvis. A sneeze or cough, whether it's a built up sneeze, a small cough, or one that catches you off guard is a blast of energy that has downward force (aka pressure and stress) on your bladder and pelvic floor. Even more so when you are struck with a cold and coughing/sneezing non-stop, it causes constant pressure and stress on the pelvic floor muscles causing for fatigue and ultimately failure of the pelvic floor muscles to contract on time (or at all!). This is the reason why often times I see patient's symptoms worsen during or immediately after an illness.

Whether or not we sense a cough or sneeze coming on, our pelvic floor's job is to time the contraction perfectly to avoid any accidents. Often with someone with stress incontinence, the timing is off and the pelvic floor will contract after the sneeze or cough has occurred, causing a leak to happen.