Leaking in Menopause? Here’s How to Strength Train Without Fear
If you have ever leaked (sneezing, coughing, jumping or even laughing) you know the moment. The sudden panic. The mental math of, “Can anyone tell?” The urge to discreetly excuse yourself.
First, you are not alone. Leaking in menopause and perimenopause is common, and it is your body’s way of saying something’s up. FYI, it does not mean you have to avoid strength training. In fact, the right kind of strength training can be one of the most supportive things you do for your body in midlife.
Let’s talk about why it happens, what to change, and how to move with more confidence.
Why leaking can show up in menopause (even if it never happened before)
Hormonal shifts in perimenopause and menopause can affect pelvic and urethral tissues. Many women notice changes in dryness, irritation, urgency, or leaking. Add in stress, poor sleep, constipation, and a busy life, and your body may feel less resilient in your daily activities.
Here’s the reframe that matters most.
Leaking is often a pressure management problem, not simply a “weak pelvic floor” problem.
When you cough, sneeze, laugh, lift, jump, or brace, pressure increases inside your abdomen. If your pelvic floor and core system cannot manage that pressure well in the moment, you might leak. That can happen because the pelvic floor is underactive, overactive, tired, not timing properly, or because the breathing strategy is working against you.
Is strength training safe if you have incontinence?
In most cases, yes.
Strength training is not the enemy. The approach matters. We want to reduce unnecessary downward pressure, build coordination, and gradually increase capacity. When a symptom like incontinence appears, my first recommendation is to see a pelvic physiotherapist for an assessment and make a plan from there.
The most common reasons you leak during exercise
Here are patterns I see all the time:
You are holding your breath.
Breath holding is common when things feel heavy or challenging. It can spike pressure and increase leaking, especially early on.
You are bracing too hard, too soon.
Many women try to “tighten everything” to feel safe. That can backfire if the pelvic floor is already tense.
Too much impact too early.
Jumping, running intervals, and high-impact activities is a recipe for disaster if the foundation isn’t ready.
Fatigue workouts push form to the side.
When the goal is maxing out, your body compensates. Pressure management usually gets worse when you push yourself to your limit. (Reduce your reps or load!)
You have been told to “just do more Kegels.”
Kegels are not bad, but they are not a universal fix. If your pelvic floor is “too tight,” more tightening can worsen symptoms like leaking, urgency, pelvic pain, or discomfort with intimacy.
A better approach: Strength training that supports your pelvic floor
Step 1: Learn pressure management with breathing
The simplest cue that helps many women quickly is this:
Exhale on exertion.
If you are standing up from a squat, exhale as you stand. If you are lifting a laundry basket, exhale as you press. You are training your system to manage pressure instead of trapping it.
A helpful image is “blow before you go.” Start your exhale just before the hardest part of the rep.
Step 2: Train the whole support system
Your pelvic floor does not work alone. Your glutes, hips, deep core, posture, and breath are all part of the team.
A strong, well-coordinated body often reduces leaking more effectively than obsessing over one tiny muscle.
Step 3: Start with stable positions that build confidence
If you leak with loaded squats, we do not need to quit forever. We need a better starting point.
Stable options first. Supported variations first. Then we progress.
Step 4: Progress slowly and on purpose
A lot of “menopause leaking exercise” advice is either overly cautious or overly intense. You need something practical.
We build your foundation with control, then we layer load, range, and impact gradually.
Exercises to modify first if you are leaking
This is not a forever list. It is a “not first” list.
Jumping jacks, skipping, burpees, jump squats
Running intervals or high-impact classes
Instead, choose low impact options
Heavy lifting when you are breath holding
Reduce your load while you correct the dysfunction
Long planks if you feel pressure, bulging, or leaking
Regress the movement both in time and position and gradually build back up
High-rep squat and lunge burnouts that turn into bracing and rushing
This one can be hard if you like to “feel the burn” and sweat a lot. I know slow can be boring, but it’s necessary to heal your pelvic floor imbalances.
Some of these can be a huge mindset shift if you have been a fitness enthusiast for a long time and thrive on intensity. Please know, you are not failing if you modify. You are training intelligently.
Quick tips that often reduce leaking fast
Exhale on exertion during your reps
Slow down your tempo and add control
Reduce range of motion temporarily and rebuild it gradually
Rest longer between sets so you are not rushing and gripping
Do not dehydrate to avoid leaking. Hydration matters
Watch constipation. Straining increases pelvic pressure
Stop “just in case” peeing all the time. This contributes to urgency incontinence.
Final thoughts
Leaking in menopause can feel isolating, but it is incredibly common. You deserve to feel safe in your body and welcome in the weight room. Strength training can be part of your solution when it is built on breathing, pressure management, and smart progressions.
If you want help tailoring this to your body and your symptoms, I offer a variety of programs that include a full-body review of strength, mobility, and pelvic-core strategies so you know exactly what to do next. Ready to connect? Book a free consult here
