“Don’t make me laugh or I’ll wet myself…!”
How many times have you heard yourself say this? For some women however, this is more reality than humour. Giggle incontinence is where you leak urine when you laugh or giggle. It’s more common in young girls and often results in quite a lot of urine escaping rather than just a few dribbles. As you can imagine, this type of leakage causes huge amounts of distress and can often completely ruin a girl’s social life.
What causes giggle incontinence?
We’re not sure exactly what makes the bladder react in this way but it is thought to be linked to an over-active bladder. This is where the bladder is too sensitive and responds to any stimulus (physical or emotional) by making you wee. It’s different to stress incontinence although if you have this condition then laughing can also make you leak urine.
It can run in families and can also be linked to a condition called narcolepsy where you feel exceptionally sleepy or suddenly drop off to sleep without warning.
Can it be treated?
Treatment of giggle incontinence usually starts with increasing your awareness of your pelvic floor muscles and how to activate them in order to close the sphincter (a tight ring of muscle) at the base of your bladder. Biofeedback has been shown to be useful here. A small probe is inserted into your vagina and connected to the Peritone. As you tighten and relax your muscles, it then gives a reading on the screen. This helps you to understand what the muscles feel like when they are tightening around the base of the bladder and what they feel like when they are relaxing. Over time you can then learn to develop an awareness of when the leaking is going to occur and tighten your muscles to stop it happening. Performing kegel (or pelvic floor) exercises every day can then help to prevent the incontinence from returning.
Other treatments used for an over-active or weak bladder (characterised by frequent urination) will also help. Cutting out fizzy drinks and caffeine and trying to slowly increase the amount that you drink (so that the urine filling your bladder isn’t too concentrated) can help to stop it emptying when you start to laugh.
What if these treatments don’t work?
In some cases, over-active bladder medication (prescribed by your doctor) is necessary but most cases can be managed with pelvic exercises and biofeedback alone. Most girls will eventually out-grow the problem but effective treatment can make it resolve sooner rather than later.
What about stress incontinence?
If your pelvic floor is weak then laughing (which raises the pressure inside your tummy) can press on the bladder and cause urine to escape. This is slightly different to giggle incontinence and can be helped by strengthening your pelvic floor muscles. Read our articles on the The Pelvic Floor and How to do a Pelvic Floor Exercise to learn more about this sort of weakness and how to treat it.
By Alison Bourne MA (Cantab) BSc MCSP ACPWH