So you're crushing intervals during HIIT class, showing burpees who's boss, and jump-roping with the best of them when—oops—a little something leaked out. Nope, that's not sweat, that's definitely a tiny bit of pee. (This is just one of the very real thoughts you definitely have during HIIT class.)
Whether it's double unders, jump squats, sprints, or jumping jacks that get you, you're far from alone if you experience the occasional bladder leakage mid-workout. An estimated 15 million women in the U.S. experience stress urinary incontinence (SUI). That's when you pee a little while exercising, coughing, sneezing, etc., according to the National Association for Continence (NAFC).
No, this "stress" has nothing to do with the ~emotional~ stress you experience when your boss is being an A-hole or your calendar looks like Rachel's from Glee. In this case, stress refers to intra-abdominal pressure pushing on your bladder, says Elizabeth Kavaler, M.D., a urogynecologist at Total Urology Care of New York. Basically, if there's enough pressure on your bladder—whether it's from bending, lifting, sneezing, coughing, or intense exercise—and your pelvic floor muscles aren't super strong, a little urine can squirt out.
But why do some women have this issue while others happily crank away at SoulCycle without a squirt in sight? The overall underlying cause is a weak sphincter muscle (that holds the urethra closed) and/or weak pelvic floor (the muscles supporting your bladder, uterus, and bowel), according to the NAFC. Those can become weak for a variety of reasons, the most common being aging and pregnancy/childbirth, says Alyssa Dweck, M.D., a New York City–based gynecologist and author of The Complete A to Z for Your V. In fact, SUI affects anywhere from 24 to 45 percent of women over the age of 30, according to the journal American Family Physician. Other causes include pelvic surgery (like a hysterectomy), a genetic predisposition, and chronic pressure on the bladder—from things like chronic coughing, constipation, and even being overweight, says Dr. Kavaler. Also on the list? Repeated heavy lifting or high-impact sports, according to the NAFC.
Some great news: A little leakage now doesn't mean adult diapers are in your near future. "It's usually not progressive, so it doesn't mean that when you have children it'll get worse," says Dr. Kavaler. In even better news, your best bet to reduce your risk of SUI is free and easy, and you've probably already heard of it—yep, kegels. Dr. Kavaler recommends three sets of 10 to 15 kegels throughout your day. (Here's how to do kegels the right way.) You can even grab a newfangled kegel tracker if you want to take your pelvic floor training to the next level. Just know that they aren't necessarily going to work magic and it may take a few weeks to notice improvements, says Dr. Dweck. (Bonus: They also make sex even better.)
If you're concerned about your leakage sitch, just mention it to your gyno. She can help you figure out whether it's NBD, if strengthening your pelvic floor muscles will help, or if you should see a specialist (like a gynourologist or even a pelvic floor physical therapist), says Dr. Kavaler. And, PSA: If this issue suddenly appeared along with a more frequent urge to go or with bloody urine, there's a chance it's not SUI and is just a urinary tract infection (UTI), says Dr. Dweck.
You can kegel your day away, but a certain amount of bladder leakage during deadlifts may just be your workout destiny. Stock up on some black leggings and Icon Pee-Proof Underwear (made by THINX, the revolutionary period panties brand), and embrace some of the less glamorous parts of getting fit.