So, ladies, you might relate.

You feel a sneeze coming on in a public place, or a cough, even a hearty laugh. You tense up and hope for the best. Or, you’re at the gym and your 20-something male trainer wants you to jump rope or do extra sit-ups. Rather than prepare for the sweat, you prepare for the worst kind of wetness. And pray it doesn’t show on your workout clothes or the gym equipment.

Stress incontinence it’s called clinically.

You just call it an embarrassing mess.

If leaking pee is a quality of life issue for you, you aren’t alone. One in three women over the age of 15 suffer from this pelvic floor issue. And you may not know there are options that can help, beyond just wearing pads, resorting to surgery or refusing to leave the house.

First, educate yourself about your anatomy. There are a variety of muscles that support the floor of the pelvis, more that you are probably aware of until you see a diagram or model. As is the case with so much of our female anatomy, time, gravity, childbirth and so on can take its toll. But just as physical therapy can strengthen other muscle groups of the body, turns out it can strengthen the pelvic floor as well.

Physical therapists specifically trained in women’s pelvic floor issues can provide helpful tips and information and teach you exercises to strengthen your pelvic floor, core and all the various muscles that support urination. (Let’s just say it’s Kegels on steroids, and in a variety of versions.) The PT also can assess your need for a support device called a vaginal pessary (somewhat like a diaphragm) that you can wear as often or as little as you need it (which is fitted and monitored by your GYN). If you don’t have a major prolapse, new tampon-like products now on the market may provide the support you need.

Yes, the physical therapy can feel a bit odd or invasive, but you’ll get over it the minute you remember you might not have to change your underwear multiple times a day. Progress can be made fairly quickly if you stick to your homework. The PT is a professional who likely has trained in this specialty specifically to make a big difference in and improve women’s quality of life. These PTs have seen and heard it all about your kind of problem, so don’t be shy.

Talk to your primary care provider or OB-GYN to get a referral to a PT in your area. They are fairly rare, and I’m aware of only three in the Dallas-Fort Worth Metroplex. Not all insurance covers PT, so check your plan, especially if it is through the Affordable Care Act insurance marketplace.

And if your insurance doesn’t cover PT, technology can come to your rescue. From England comes the Elvie (, a device accompanied by a mobile app that guides you through a Kegel program in the privacy of your own home. It allows you to actually view the progress of your muscle strength. (And just between us girls, it might just help your sex life, too.) Not cheap at $199, but compare it to a six-week program of PT with an insurance copay of $25 or so a pop. Just sayin’.

So, you don’t have to struggle in embarrassed silence. You have options! Stress incontinence is definitely worth researching, consulting with your doctor about what’s best for you, and then spreading the good word about what you learn. Might be just what a family member or a friend needs.