Why Sex Can Hurt Even When Everything Looks "Normal"

You're halfway through a workout. Maybe it's a box jump, a heavy lift, a sprint, or even just a big laugh during your fitness class. Then it happens. A small leak of urine. Many people brush it off as "normal after having kids" or assume it's simply the price of staying active. Others stop running, avoid jumping, or give up the sports they love altogether. Here's the truth: Leaking during exercise is common—but it isn't normal, and it isn't something you should have to accept. More importantly, it doesn't always mean you have a weak pelvic floor. Why do I leak urine when I exercise? Exercise places extra pressure on your bladder and pelvic floor. Every time you jump, run, cough, lift, or land, the pressure inside your abdomen increases. Your pelvic floor needs to respond at exactly the right time to help support your bladder and keep you dry. If that system isn't working efficiently, urine leakage can occur. This is known as stress urinary incontinence—the leakage of urine during activities that increase pressure on the bladder. Does leaking mean my pelvic floor is weak? Not always. This is one of the biggest misconceptions we see. While reduced pelvic floor strength can contribute to bladder leakage, it's only one piece of the puzzle. Your pelvic floor may also be: lacking coordination or timing unable to relax properly between contractions working too hard and becoming fatigued struggling to manage pressure during exercise affected by previous pregnancy, childbirth, surgery or hormonal changes. Think of it like your calf muscles. Even if they're strong, they won't help you run efficiently if they don't contract at the right time or coordinate with the rest of your body. The pelvic floor works the same way. Why does it only happen during certain exercises? You might notice leakage when you: run jump skip lift heavy weights do burpees sneeze during a workout play netball, basketball or tennis trampoline with your kids. These activities create higher forces through your body, meaning your pelvic floor needs to react more quickly and effectively. Leaking during high-impact exercise doesn't necessarily mean you'll leak during everyday activities. I only leak a little—is that okay? Even a few drops matter. Small leaks are often dismissed because they're manageable, but they can be an early sign that your pelvic floor or pressure management system isn't functioning as efficiently as it could. Addressing symptoms early is often easier than waiting until they become more frequent or start affecting your lifestyle. What if I've never had children? You don't need to have been pregnant to experience bladder leakage. We also see leakage in: runners gym-goers dancers gymnasts CrossFit athletes women going through perimenopause or menopause men after prostate surgery people with chronic coughs or constipation. Pelvic floor dysfunction can affect anyone. Should I stop exercising? In most cases, no. Exercise is incredibly important for your physical and mental health, and the goal isn't to avoid movement—it's to understand why you're leaking and address the underlying cause. Sometimes small changes to technique, breathing, exercise selection or training load can make a significant difference while you're working on improving pelvic floor function. How can a pelvic floor physiotherapist help? A pelvic floor assessment looks far beyond whether you can do a Kegel. Your physiotherapist may assess: pelvic floor muscle strength muscle relaxation and coordination breathing patterns pressure management movement during exercise lifting technique bowel and bladder habits lifestyle factors contributing to symptoms. Treatment is tailored to your body and goals and may include: pelvic floor muscle training (when appropriate) learning how to coordinate your pelvic floor with movement breathing and pressure management strategies progressive return to impact activities exercise modifications while symptoms improve education to help you train with confidence. The aim isn't simply to stop the leaking—it's to help you return to the activities you enjoy without fear or embarrassment. When should you seek help? It's worth booking an assessment if you: leak during running, jumping or lifting wear a pad to exercise "just in case" avoid certain workouts because of leakage notice your symptoms are becoming more frequent feel pressure or heaviness during exercise have tried Kegels without improvement. You don't have to wait until the problem becomes severe. Frequently Asked Questions Is it normal to leak urine when exercising? No. Although it's common, leaking urine during exercise isn't considered a normal part of ageing, childbirth or fitness. It's a sign that your bladder and pelvic floor would benefit from assessment. Can pelvic floor exercises stop bladder leakage? For many people, pelvic floor muscle training is an effective treatment. However, not everyone with bladder leakage needs strengthening exercises. Some people require training to improve coordination, relaxation or pressure management instead. Can I keep exercising if I leak? In most cases, yes. Staying active is important. A pelvic floor physiotherapist can help identify why you're leaking and guide you on how to continue exercising safely while addressing the underlying issue. The Bottom Line Leaking during exercise isn't something you should ignore—or simply accept because you've had children or are getting older. Whether it's a few drops during a jog or enough to make you avoid your favourite workout, there's usually a reason it's happening, and effective treatment is available. The first step is understanding why you're leaking. From there, a personalised assessment can help you build the strength, coordination and confidence to move freely again. You shouldn't have to choose between staying active and staying dry. If bladder leakage is holding you back, book an assessment with one of our pelvic health physiotherapists and let us help you get back to exercising with confidence.

Hormone therapy can bring many positive changes, but it can also influence how your body feels and functions, including your pelvic health. Changes to bladder, bowel, sexual health and pelvic pain can occur as your body adapts to different hormone levels. For people taking testosterone, lower oestrogen levels can affect the tissues of the vagina and vulva, sometimes causing dryness, irritation, discomfort with penetration or changes in bladder function. Some people may also experience increased pelvic floor muscle tension, which can contribute to pelvic pain, bowel or bladder concerns, or discomfort during intimacy. For people taking oestrogen, changes in sexual function can occur as the body adjusts to treatment. This may include changes in libido, arousal, erections or ejaculation. After gender affirming surgery, pelvic health physiotherapy can also support recovery by helping with pelvic floor function, bladder and bowel health, scar management and vaginal dilation where appropriate. These changes do not happen to everyone, but if something feels different, uncomfortable or is affecting your daily life, it is worth paying attention to. Pelvic health physiotherapy can help you understand what may be contributing to your symptoms and provide practical strategies to improve comfort and function. Your body is constantly changing, and hormone therapy is one part of that picture. Understanding those changes can help you feel more informed and confident in looking after your pelvic health.

Encopresis is when a child regularly soils their underwear after the age they would usually be toilet trained. For many children, this happens because of long-term constipation, stool withholding, or reduced awareness of the body’s signals that tell them they need to do a poo. When stool builds up in the bowel over time, the rectum can stretch and become less sensitive. This means children may not feel the urge to go, and softer stool can leak around the blockage without them realising. This can be frustrating and upsetting for both children and parents, but it is very common and treatable. Pelvic health physiotherapy can play an important role in helping children manage encopresis by improving bowel habits, supporting healthy toileting routines, and helping the bowel return to normal function. Treatment may include: Education for both parents and children about how the bowel works and why soiling happens Helping children develop regular toilet routines, especially after meals when the bowel is naturally more active Improving toilet posture, including correct foot support and positioning, to make bowel motions easier to pass Teaching breathing and relaxation strategies to reduce straining, fear, or withholding behaviours Supporting children to better recognise body signals and respond to the urge to open their bowels Addressing pelvic floor muscle tension or coordination difficulties that may affect bowel emptying Working through sensory challenges, toileting anxiety, or distractions that may contribute to accidents Pelvic health physiotherapy is gentle, supportive, and child-focused. Appointments are designed to help children feel safe and comfortable while also giving parents practical strategies to use at home. The goal is to reduce accidents, improve bowel emptying, and make toileting a less stressful experience for the whole family. With patience and the right support, children can regain confidence and work toward long-term healthy bowel habits.