Stress Urinary Incontinence (SUI)

A nude figure holds up a half-cut citrus fruit (that resembles a vulva). White droplets fall from the fruit/vulva. The background is a dark pink and the figure drawing is light pink Illustration by Nerea Ubeda from Pussypedia

The following text uses the word “pussy*” as defined by Pussypedia.

It also references the Body Mass Index (BMI), a concept that Our Bodies Ourselves Today does not support; you may read more in our Core Values & Guiding Principles on how we address Fat Politics.

by Annemarie Everett, PT, DPT, WCS

What’s Going On?

Stress Urinary Incontinence (SUI) is “the involuntary loss of urine on effort or physical exertion (e.g. sporting activities).”1 In general, this means a little bit of pee comes out of your urethra (pee hole) when you’re coughing, sneezing, laughing, jumping, running, or lifting something heavy.

During a pelvic floor muscle contraction (squeezing), the “urethral closing pressure”—the strength of your connective tissue combined with the strength of your muscle contractions—increases. At the same time, the pelvic floor pushes back against downward motion. The contraction of the pelvic floor muscles also stops the contraction of the bladder (which pushes pee out).2  Basically, you squeeze your pelvic floor muscle and it keeps your pee in.

SUI is caused when one force is stronger than the other: when pressure on the bladder is stronger than the muscles that tighten to keep the pee in.1

How Common is This?

Prevalence of SUI ranges from 29-75% of people with pussies (about 3.5% of those 20-29 years old and up to 38% of those age 80 and above).3 The odds of having SUI are 2.3 times higher in people experiencing obesity than those within the range of standard body mass index (BMI).4 People with pussies who do high-impact activity such as running or jumping experience significantly higher rates of SUI than those who do not.5

Research is unclear about the impact of pregnancy and the mode of delivery (vaginal birth or cesarean) on the risk of SUI, but there is evidence that having one vaginal delivery significantly increases the risk of SUI when compared to cesarean delivery.5 Between 30-50% of pregnant people experience SUI during pregnancy.2

What Can I do to Take Care of my Pussy*?

The first line non-aggressive treatment for SUI is pelvic floor muscle training (PFMT), as endorsed by the Cochrane Review, American Academy of Family Physicians, the International Continence Society, and other organizations. High quality studies support supervised pelvic floor muscle training for at least three months as the first line recommendation for SUI.6

PFMT is the contracting and relaxing of the pelvic floor muscles to make them stronger. PFMT helps the pelvic floor muscles support the bladder against downward pressure so that it’s easier to keep your pee hole closed and prevent pee from leaking out.

For those with SUI, squeezing your pelvic floor muscle before and during a cough or sneeze helps reduce and prevent pee leakage.



1. Haylen R, de Ridder D, Freeman R, Swift SE, Berghmans B, Lee J, et al. “An International Urogynecological Association (IUGA)/International Continence Society (ICS) Joint Report on the Terminology of Female Pelvic Floor Dysfunction.” Neurourology and Urodynamics. 29(1). (2010): 4-20. <>.


2. Hojberg KE et al. “Urinary incontinence: prevalence and risk factors at 16 weeks of gestation.” British Journal of Obstetrics and Gynaecology. 106(8). (1999): 842-50. <>.


3. Wu JM, Vaughan CP, Goode PS, Redden DT, Burgio KL, Richter HE, Markland, AD. “Prevalence and trends of symptomatic pelvic floor disorders in U.S. women.” Obstetrics & Gynecology. 123(1). (2014): 141-8. <>.


4. Dallosso HM, McGrother CW, Matthews RJ, Donaldson MM, Leicestershire MRC Incontinence Study Group. “The association of diet and other lifestyle factors with overactive bladder and stress incontinence: a longitudinal study in women.” BJU International. 92(1). (2003): 69-77. <>.


5. Lasak AM et al. “The Role of Pelvic Floor Muscle Training in the Conservative and Surgical Management of Female Stress Urinary Incontinence: Does the Strength of the Pelvic Floor Muscles Matter?” PM&R Journal. S1934-1482(18). (2018): 30232-6. <>.


6. National Collaborating Centre for Women’s and Children’s Health (UK). “Urinary Incontinence in Women: The Management of Urinary Incontinence in Women.” London: Royal College of Obstetricians and Gynaecologists. 2013. (NICE Clinical Guidelines, No. 171.) <>.


This article was previously published in Pussypedia and is reposted with permission.