Urinary Incontinence in Women – What You Can Do about It

You may think that if you have leakage of urine then you just have to put up with the problem, and perhaps spend a fortune on pads. This is not generally true.

Step 1: Understand Your Type of Incontinence

To get the right treatment, it’s important to figure out what kind of incontinence you have:

Stress incontinence: Leakage when you cough, sneeze, laugh, or exercise.
Urgency (urge) incontinence: A strong, sudden need to urinate, followed by leakage.
Mixed incontinence: A combination of both.

Knowing your type helps guide the best treatment. There are some simple questions to ask yourself in our types of urinary incontinence section.

What You Can Do for Stress Incontinence

Stress incontinence happens when pressure on your bladder (like from laughing or lifting) causes urine to leak. Here’s what can help:

Review Your Medications

Are you taking an alpha-blocker for high blood pressure (hypertension)? These can cause or worsen stress incontinence. Ask your doctor or healthcare provider if there’s an alternative medication instead.

Lose Excess Weight

Being overweight puts pressure on your pelvic floor. Losing weight can reduce leakage by up to 60%.

“Squeeze Before You Sneeze”

Before doing anything that might cause leakage – like coughing, sneezing, or lifting – tighten your pelvic floor muscles and hold them tight during that activity to prevent leakage. This simple trick can prevent leaks.

Do Pelvic Floor Exercises (Kegels)

These strengthen the muscles that support the bladder. When done correctly, they can reduce episodes of leakage by 50%. You’ll need to stick with them for a few months before you notice any improvement, so patience is essential.

Ideally, a continence adviser, a continence nurse specialist or physical therapist can help you learn the correct technique.
An advantage is that the muscles are invisible. You can do them anytime – on the bus, in the supermarket queue or while talking on the phone.
Once you have learned to tighten your pelvic muscles, you can squeeze them and hold when you sneeze, lift or jump. This will protect them from more damage.

How to Learn the Exercises

Stand, sit or lie down with your knees slightly apart.
Imagine trying to stop passing gas. Squeeze those back-passage muscles and lift.
You should feel a lift inside. Your stomach, buttocks, and thighs shouldn’t move.

Checking You’re Doing Then Right

Place a finger or two inside the vagina while doing the exercise. You should feel a gentle squeeze.
Use a mirror or touch the area between the vagina and anus – you should feel a lifting motion.
A common mistake is to clench your buttocks and hold your breath; if you can’t hold a conversation while doing the exercises, you’re probably doing them incorrectly. Try counting aloud as you exercise – this helps prevent breath-holding.
Avoid tightening your tummy, thigh or buttock muscles, and don’t cross your legs. Focus only on using your pelvic floor muscles.
You can ask your sexual partner if they feel a squeeze during intercourse.

Your Daily Pelvic Floor Routine

Do 5 slow contractions: Squeeze and hold for 5 seconds, then relax.
Do 5 quick contractions: Squeeze and release immediately.
Aim for 10 sets per day (that’s 50 exercises total – spread throughout the day).

Using Vaginal Cones

These are small weighted devices inserted into the vagina. You hold them in place by squeezing (tightening) your pelvic muscles. You should stand or walk with the cone in place. Start with the lightest weight and work your way up to heavier cones as your strength improves. Use for 15 minutes, twice a day. A continence specialist can help you get started.

Try Simple Supports

Inserting a super-size tampon before exercising can help support your bladder. There are also specialized vaginal devices designed for this purpose. Always follow the manufacturer’s instructions for use and hygiene.

What You Can Do for an Overactive Bladder (Urgency Incontinence)

Rule Out any Infection

Burning when you urinate? You may have a urinary tract infection (UTI). If treated, urgency incontinence and other bladder symptoms may improve or resolve completely.

Retrain Your Bladder

You can gradually teach your bladder to hold more urine and reduce the frequency of urges.

Bladder Retraining Tips

You can try the following strategies to help reduce urgency so that you will have more time to get to the bathroom:

Use mental tricks to take your mind off the urge. For example, picture a tight knot in a balloon, or challenge yourself to think of as many words as possible beginning with the letter A, then move through the alphabet. Some people find that curling their toes also helps suppress the urge.
Try slow, deep breathing. Sit down, take slow deep breaths, and focus on calming yourself until the urgency eases.
Ensure you empty your bladder fully each time you urinate. Sit down (do not hover over the toilet seat), lean forward slightly at the waist, and take your time.
Do pelvic floor muscle exercises. While these won’t stop the bladder contractions that cause urgency, stronger pelvic floor muscles can help reduce leakage.

Bladder Retraining Drill

Bladder retraining means scheduling bathroom visits at increasing intervals. Here’s how:

Days 1–2: Start by urinating every 1–2 hours.
Days 3–4: Add 15 minutes to the interval.
Then: Gradually increase the time between bathroom visits as each new interval becomes comfortable.

Manage Your Fluid Intake

Don’t over-drink or under-drink. Aim to drink about 1.5 litres (about 3 pints) of fluids per day.
Avoid caffeine (coffee, strong tea) and fizzy drinks, which irritate the bladder.

Other Lifestyle Changes

Stop smoking — Nicotine irritates the bladder. Smoking also causes coughing, which can contribute to stress incontinence.
Eat plenty of fresh fruits, vegetables, and fiber to avoid constipation. Hard stools can press on the bladder and urethra, worsening incontinence.
If you are overweight, aim to lose weight. Studies show that weight-loss programs for moderately obese women and weight-reduction surgery for morbidly obese women significantly reduce urinary incontinence (J Urol 2022;207:1096–1104).
Carry pre-moistened wipes to gently clean the vulval area after leakage and help reduce odor.

Scheduled Toileting

If you have an overactive bladder that causes urinary urgency and frequency, it’s important to follow a regular bathroom schedule. This can help prevent leakage and give you more control.

Example Schedules

Option 1:

Go to the bathroom first thing in the morning.
Go before and after every meal.
Go at bedtime.

Option 2:

Go to the bathroom first thing in the morning.
Go every 2 hours by the clock while you are awake (for example, at even or odd hours).
Go at bedtime.

Follow the schedule even if you don’t feel the urge to urinate. Waiting until you feel urgency increases the chance of leakage.

See Continence Nurse or Your Doctor

You don’t have to figure this out alone. A continence adviser or nurse specialist can help you:

Identify the type of incontinence you have.
Learn pelvic floor exercises.
Explore options like vaginal cones or other devices.
Check for underlying causes like a bladder or uterus (womb) prolapse.

You don’t need need to see a continence nurse in many areas. In the UK, contact your local Citizens Advice Bureau or check with the Bladder & Bowel Foundation.

Before Your Appointment: Prepare a Bladder Diary

Track your bladder activity for a few days on a Bladder Diary. Use a measuring jug or some type of container and note:

When and how much urine you pass
When leakage occurs
How much and when you drink fluids

You can print a chart from:

Questions Your Doctor or Nurse May Ask

When did you start having bladder trouble, when did your symptoms begin?
Are you post-menopausal?
Do you feel pain or a burning feeling during peeing (urination, pass urine)?
Do you get sudden urges to go?
Do you leak when coughing or sneezing?
How do you cope? Do you sometimes wear a pad because you are worried about leakage?
How is the problem affecting your life? Do you avoid going out or doing certain activities because of bladder control problems? Are you always on the lookout for the nearest toilet?
What medicines are you taking? Take a list with you, and include medicines you buy over the counter, as well as prescription medicines.
Have you had any pelvic surgery?

Special Tests

If the cause of your incontinence isn’t clear, your healthcare provider may refer you for urodynamic tests to measure bladder function. A small tube (1 mm in diameter) is inserted into the bladder to measure bladder capacity and pressures, and sometimes a small tube is also inserted into the rectum. These may cause some discomfort.

First published on embarrassingproblems.com
Reviewed and edited by Dr Diane K. Newman
Last updated: July 2025 by Dr Diane K. Newman

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