Dr. Dana
For women who leak when they laugh
A friend says something funny, and you hold back the laugh. Here is why laughing pushes urine out, and how to laugh out loud again.
Laugh out loud again.
You are far from alone
In a US survey from 2015 to 2018, 61.8% of women said they had leaked in the past 12 months.[1] A laugh is one of the moments that can bring it on.
Why a laugh is harder than a sneeze
A sneeze is one push. You can time one squeeze for it. A laugh is a string of pushes, and a long laugh can last 10 seconds or more.
So a laugh asks 2 things of your pelvic floor. Speed, to close at the first burst. Stamina, to stay closed until the last one. When it tires halfway, the leak comes late in the laugh.
What helps
- Squeeze as the laugh starts. Lift your pelvic floor at the first burst, like the Knack for a sneeze. In a small study, a squeeze before a medium cough cut leakage by 98%.[3]
- Keep a gentle hold. Keep a light lift until the laugh ends, in place of a full squeeze for 10 seconds.
- Build stamina. Slow holds of 5 to 10 seconds train the hold you need. Quick flicks train the start. Guidelines list at least 3 months of pelvic floor training as the first step for stress leaks.[2]
- Sit or stand tall. Good posture helps your belly and your pelvic floor work as a team.
When it is more than a few drops
Giggle incontinence is a rare condition. The whole bladder empties during a strong laugh, and it mostly starts in the teens.[4] It needs a doctor, not exercises alone.
Try it today
Sit tall. Lift your pelvic floor as if you hold in gas and pee. Keep a light hold while you count out loud, "ha, ha, ha", for 10 seconds. Let go fully. Rest 10 seconds. Do it 3 times.
Laugh out loud again.
The Bladder leaks class trains the squeeze for sneezes and for laughs, then builds the stamina to hold it.
- A class by a urologist
- 5 to 10 minutes a day
- Week 1 is open to everyone
Quick answers
Why do I leak when I laugh?
Laughing squeezes your belly in short bursts, again and again. Each burst pushes on your bladder. If your pelvic floor does not close in time, or tires before the laugh ends, a few drops get out. Doctors call this stress incontinence.
Is it normal to pee a little when you laugh?
It is common. In a US survey from 2015 to 2018, 61.8% of women said they had leaked in the past 12 months. Common does not mean you have to live with it.
How do I stop leaking when I laugh?
Squeeze and lift your pelvic floor as the laugh starts, and keep a gentle hold until it ends. Train every day with slow holds for stamina and quick flicks for speed. Guidelines list at least 3 months of training as the first step.
What is giggle incontinence?
Giggle incontinence is a rare condition where the whole bladder empties during a strong laugh. It mostly starts in the teens. It is different from a few drops with a laugh, and it needs a doctor's visit.
Sources
- Patel UJ, Godecker AL, Giles DL, Brown HW. Updated prevalence of urinary incontinence in women: 2015-2018 national population-based survey data. Female Pelvic Med Reconstr Surg, 2022. pubmed.ncbi.nlm.nih.gov
- NICE guideline NG123. Urinary incontinence and pelvic organ prolapse in women: management, 2019. nice.org.uk
- Miller JM, Ashton-Miller JA, DeLancey JO. A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. Journal of the American Geriatrics Society, 1998. pubmed.ncbi.nlm.nih.gov
- Turner A. Giggle incontinence, not a laughing matter. Urology News, 2023. urologynews.uk.com
