Health Conditions / Sexual and Reproductive Health / Vaginal Health

Urinary incontinence tends to strike when you least expect it. Whether you accidentally leak when you let out a laugh or feel a sudden urge to go at the worst moment, the anxiety of not knowing when your next accident may happen can, understandably, take a major toll on how you feel in your body, both physically and mentally.If you’ve been dealing with this issue, rest assured that it’s very treatable, as long as you check in with a doctor as early as you can. Once you have an open conversation about your symptoms, it’s likely that you’ll discuss an area of the body called the pelvic floor—and how its proper functioning is essential for keeping your urinary muscles, including those in your bladder, in tip-top shape.How does the pelvic floor influence urinary incontinence?First, a little 101: The pelvic floor is a group of hammock-like muscles that stretch across the bottom of the pelvis. With the help of surrounding tissues, the pelvic floor keeps the bladder, urethra, intestines, rectum, and reproductive organs like the uterus and vagina where they need to be, according to the National Institutes of Health (NIH). That’s why the strength of your pelvic floor is so crucial, Rachel Benjamin, DPT, a licensed physical therapist at Spaulding Rehabilitation Hospital in Boston, tells SELF. “Your pelvic floor is constantly changing throughout your life,” she says, so being aware of its role in stabilizing different parts of your body is so important. When the pelvic floor muscles are doing their thing, you can hold in urine when you need to and go to the bathroom when you’re ready. If these muscles become compromised in some way—say, they become too tight, too weak, or stretched out—that’s when urinary incontinence can develop, Farzeen Firoozi, MD, the director of female pelvic medicine and reconstructive surgery at Lenox Hill Hospital in New York City, tells SELF.The two most common types of urinary incontinence include stress urinary incontinence (SUI) and urge incontinence (overactive bladder). SUI occurs when some kind of force—a laugh, cough, sneeze, or challenging deadlift, for example—puts too much pressure on the bladder or abdomen. In turn, the sphincter muscles in the urethra, which help control the flow of urine, release and open a bit, causing you to leak.Urge incontinence, on the other hand, is characterized by a strong, sudden urge to pee, regardless of how much urine you’re holding in, per the US National Library of Medicine. “The bladder almost develops a brain of its own, and it signals itself to contract,” Dr. Firoozi says. Many things can cause an overactive bladder, including certain infections, bladder stones, neurological problems, and nerve damage; in many cases, it’s hard to identify a specific cause.Beyond pee leakage, other signs of pelvic floor dysfunction can include frequently needing to use the bathroom, constipation, painful urination, painful sex, lower back pain, or a sensation of heaviness in any part of your pelvic area.What causes pelvic floor dysfunction?Lots of things can affect the health of your pelvic floor muscles, but here are the biggies to be aware of, per the NIH:

You’ve certainly heard this advice before: Always pee before you leave home. These seemingly wise words, often drilled into us as children, are meant to help us avoid smelly rest stops and that awkward moment when you rush into a store to ask if they have a bathroom, only to be turned away.But even if you followed this recommendation consistently, you may experience a frustrating phenomenon: You still need to pee while you’re out and about. You might even have to pee more than once or have trouble holding it in. So what gives? Here’s the gist: By forcing yourself to pee before you head to your next destination, you’re probably achieving the exact opposite of what you’d hoped for. What happens when you habitually pee without the urge?First, some anatomy 101: The bladder is a very flexible organ, like a balloon. It has really stretchy muscle fibers. This means you shouldn’t hold in your pee for too long, because your bladder may start to stretch out and have trouble bouncing back, like a big floppy balloon. On the flip side, one of the reasons you shouldn’t pee when you don’t need to is that you can build up muscle in the organ, which stiffens the bladder wall. Both of these habits can lead to issues emptying your bladder down the road.However, the brain controls every bodily process, including urination, according to Victoria Handa, MD, MHS, the director of the department of gynecology and obstetrics at Johns Hopkins Bayview Medical Center in Baltimore. “There’s absolutely a mental component to needing to pee,” Dr. Handa tells SELF. (If you’ve ever been hit by a bout of nerves and felt a subsequent urge to use the bathroom, you know what we’re talking about.) Thanks to this mental association, peeing if you don’t have the urge may actually prime (and train) your brain and bladder to go more frequently.“The connection between the brain and the bladder—how and when and why the bladder sends its ‘I’m full’ signal to the brain—is complicated, but in short, the bladder is a very trainable organ,” Lauren E. Stewart, MD, an ob-gyn who specializes in female pelvic medicine and reconstructive surgery and an assistant professor at NYU Grossman School of Medicine, tells SELF. Over time, Dr. Stewart explains, if you continue to pee before your bladder is actually full, it may learn that it should empty itself when there’s less inside. “This means that you’ll be urinating more frequently since your bladder thinks it cannot hold as much,” she says. Also, know that the bladder can hold quite a bit of urine: Research1 suggests people with vaginas can store up to 500 milliliters of urine—or about two cups—in their bladders; if you fall into this camp, you’ll probably feel the urge to pee when the bladder has between 200 and 350 milliliters of pee in it.So before you head to the bathroom, you might want to make sure that you actually need to pee so you’re not sending your bladder mixed messages. Of course, there’s no need to stress over this too much either; you won’t instantly train your bladder to go all the time by partaking in a precautionary pee every so often. “Generally speaking, the bladder takes time to learn (and unlearn) these behaviors,” Dr. Stewart says. How can you tell if you’re peeing too often?There’s the “just in case” pee before you leave the house, and then there’s peeing too much in general. Because peeing is so psychological—in other words, you can talk yourself into needing to go—it can be hard to tell when it’s necessary to see a doctor about urinary frequency (needing to pee often), overactive bladder (the urge to pee suddenly), or even stress incontinence (when some form of pressure causes urine leakage, rushing you to the bathroom).

Hailey Bieber shared a photo of herself on her Instagram story Monday, drawing attention to what she says is an apple-sized ovarian cyst. “I don’t have endometriosis or PCOS but I have gotten an ovarian cyst a few times and it’s never fun,” she wrote, joking that the cyst is “not a baby.”Bieber explained that the cyst is causing all sorts of uncomfortable symptoms. “It’s painful and achey and makes me feel nauseous and bloated and crampy and emotional,” she wrote.An ovarian cyst is exactly what it sounds like: a fluid-filled sac in or on an ovary. Most people with ovaries will develop an ovarian cyst during their lives, per the US National Library of Medicine (NLM). These cysts usually form during ovulation (when the ovary releases an egg), and most of the time they’re small and generally harmless. Though most ovarian cysts don’t cause major issues, some can cause immense pressure, bloating, swelling, and pain if they get big enough, per the NLM. Usually, ovarian cysts simply go away on their own, but in some cases, surgery might be needed to treat it—say, if the ovarian cyst ruptures, as SELF previously reported. “We often see someone come to the ER at night with terrible pain that came on all of a sudden during intercourse from a ruptured ovarian cyst,” Alyssa Dweck, MD, FACOG, a New York-based gynecologist, previously told SELF. Symptoms of a ruptured ovarian cyst run the gamut but can include dull or sharp pain; a heavy feeling in the abdomen; fever; vomiting; pain during or after sex; weakness; referred shoulder pain; quick breathing; chilly, clammy skin; and abnormal vaginal bleeding.Again, ovarian cysts can happen to anyone with ovaries and are pretty common, but certain health conditions may cause them to develop more frequently in some people, per the US Office on Women’s Health (OASH). These include pregnancy, PCOS, and endometriosis—all of which Bieber ruled out in her Instagram story—as well as severe pelvic infections.This isn’t the first time Bieber talked openly about her health this year: In March, she was hospitalized with stroke-like symptoms, as SELF previously reported. At the time, she said on her Instagram story: “They found I had suffered a very small blood clot to my brain, which caused a small lack of oxygen, but my body had passed it on its own and I recovered completely within a few hours.” The reason for the blood clot was originally unknown, but Bieber eventually shared it was caused by something called patent foramen ovale (PFO), for which she underwent surgery. In late April she shared that she was recovering from the procedure “really well, really fast.” In her recent post about her cyst, Bieber offered a word of encouragement to her Instagram followers. “I’m sure a lot of you can overly relate and understand,” she wrote. “We got this.”Related:

Heavy lifting and high-impact movements, like running and jumping, also put pressure on your bladder and the surrounding muscles.1 If you notice that you pee a little, say, during intense workouts or even when you’re rushing out the door to get to the office quickly, that’s a good indication you may be experiencing stress incontinence.2. You constantly wake up at night to go to the bathroom.An overactive bladder causes frequent urination and makes you feel a strong urge to pee, sometimes when you don’t actually need to go. That might wake you up during the night, Dr. Sutherland says. It might also mean you need to take several bathroom breaks during work meetings or constantly have to pause Netflix to go pee (even if you’re not drinking a ton of fluids).3. You feel like you need to pee, but can’t go once you try.Maybe this scenario sounds familiar: You feel such a strong urge to pee that you can’t ignore it and rush to the bathroom. But, once you get there, just a little dribble comes out. This urge, even when your bladder isn’t actually full, is a symptom of an overactive bladder. “Basically, someone is going all the time, and every time they go, there’s just not that much in there,” Dr. Sutherland says.4. You just can’t get to the restroom quickly enough.“Sometimes, you feel like you have to go to the bathroom, and you can’t get there in time,” Dr. Sutherland says. This is a symptom of an overactive bladder. Things that may affect your mobility, especially as you get older, like an injury, disability, or arthritis, might also make it tough to reach the bathroom or unbutton your pants quickly enough, potentially leading to an accident.25. You carry around extra underwear, just in case.How much do you worry about leaking? If you carry extra underwear, pads, or panty liners with you at all times “just in case,” that means urinary incontinence is making a big enough impact in your day to be top of mind. If it’s come to this, Dr. Sutherland suggests talking to your doctor.6. You notice blood in your urine.If you suspect you have any type of urinary incontinence and also spot blood in your urine, talk to your doctor immediately, Dr. McAchran urges. Blood in your urine, known as hematuria, might make your pee look pink, red, or brown. This can be one telling symptom of a urinary tract infection (UTI) or kidney stones. Luckily, if one of these things is causing your incontinence, getting the right treatment will resolve your bladder control issues. In rare cases, hematuria can be a rare sign of cancer in the urinary tract, so it’s important to make your doctor aware so they can rule it out if needed, according to the National Institute of Diabetes and Digestive and Kidney Diseases.7. You feel pain when you go to the bathroom.If it’s ever painful to pee, Dr. McAchran urges talking to your doctor as soon as possible. Dysuria, or pain or burning discomfort when you urinate, could be a sign of a UTI, bladder infection, or inflammation of your bladder or urethra, all of which can trigger or exacerbate incontinence. It’s important to get a proper diagnosis and treatment so that any underlying infection causing the pain doesn’t move deeper into your body and become even more serious.8. Your worry is starting to take over your life.Worrying about leaking or always making sure that you’re close to a bathroom weighs on you. If it’s stopping you from going to the gym, jumping on the trampoline with your kids, or dissuading you from going out in public, call your doctor, Dr. McAchran says. “If the incontinence is keeping you from doing things that you want to do, that’s absolutely a reason to get help.”How is urinary incontinence treated?Dr. McAchran suggests starting with your primary care physician, who can refer you to a urologist or urogynecologist. When you meet with a specialist, they’ll ask you lots of questions, such as when your symptoms started, how often you’re leaking, what seems to cause the leaks, whether you feel a strong urge to go to the bathroom and how often, and how all of this is affecting your day-to-day life, Dr. McAchran says.

As a result, Dr. Sutherland says she sometimes tells patients with bladder control issues to drink more. “It sounds counterproductive, but when you drink enough, your urine isn’t as concentrated,” she stresses.3. …but do recognize when you’re drinking enough.While you should drink plenty of fluids to stay hydrated, drinking to excess can certainly affect your bladder control. How do you walk that fine line?“I tell my patients to look at their pee color. If it’s light yellow or clear, they don’t need to drink more,” W. Stuart Reynolds, MD, MPH, associate professor in the department of urology at Vanderbilt University Medical Center, tells SELF. “If their urine is dark yellow or orange, they need to drink more.”Remember, hydration doesn’t just come from your water bottle. Soups, juices, and even certain foods (like some water-rich fruits and veggies) contribute to your daily fluid intake as well, which can help your goals feel more realistic.4. Space out your beverages.“There’s no point in guzzling,” Dr. Sutherland says. Spreading out your drinks throughout the day is the best way to stay hydrated and be kind to your bladder. She recommends having a full glass of water or another beverage with each meal, and then sipping the rest of your fluids throughout the day.This can help you avoid getting into a cycle of “catching up” all at once because you’ve been busy or generally avoiding fluids, which Dr. Sutherland says is common. Glugging a ton of water at once will only make your bladder fill up more quickly. The result? You’ll probably end up making multiple trips to the bathroom, usually right around when (or after) you’ve gone to sleep.If you do wake up a million times a night to pee, Dr. Sutherland suggests scaling back on when you take your last sips in the evenings. You may have to experiment to figure out the best timing, but the Cleveland Clinic says pausing all drinks at least two hours before bed is a good rule of thumb to start with.5. Be honest about your coffee habit.Caffeine is a mild diuretic, meaning it prompts the kidneys to make urine faster, Dr. Sutherland explains. “The bladder is then the holding tank, and when the bladder gets full faster, it’s going to tell you to go to the bathroom more,” she adds. Even caffeine-free versions of your favorite energizing beverages, like coffee, tea, and certain fizzy drinks, can act as a bladder irritant for some people, per the Mayo Clinic, so that’s worth noting as well.To that point: Remember that coffee isn’t the only caffeinated drink out there. Many teas and packaged drinks can also be full of the stuff, and therefore affect your bladder. Dr. Sutherland stresses enjoying these in moderation for those whose bladders seem to be especially sensitive. The only way to know if that’s you is to experiment a bit. Pay attention to how you feel after drinking caffeine, and then try to scale back from there as needed.

Are you noticing that a little bit of pee leaks out when you get the giggles? What about during your morning jog? Do you have to get up to use the bathroom several times throughout the night? If this sounds familiar, you should be aware of urinary incontinence or loss of bladder control. You might think it’s an issue you couldn’t possibly deal with until you’re older, but the truth is that anyone of any age can experience urinary incontinence.According to the Urology Care Foundation, anywhere from 25 to 33% of American adults have some form of urinary incontinence, and it affects twice as many people with vaginas as it does people with penises. Though your urinary incontinence risk does generally increase as you get older, you can experience it as early as your 20s—but a lot of young people assume they’re alone in their experience.Sarah McAchran, MD, urogynecologist and associate professor of urology at the University of Wisconsin School of Medicine and Public Health, tells SELF that there’s a misconception that incontinence is an “old lady disease.” This spikes the effects of the stigma that younger people with the condition sometimes feel. “I think it’s difficult for people to talk about because there’s a lot of shame associated with it,” Dr. McAchran says. “If someone is in their 30s, they may think they’re the only person who has it.”First, a little urinary incontinence 101.Let’s back up a bit: Urinary incontinence refers to any leaking of urine that you can’t control, according to the Urology Care Foundation. It’s a physical problem, yes, but it can also affect a person’s emotional well-being. After all, it can interfere with your daily life and cause you to avoid activities you enjoy because you may worry about leaking in public or needing to be close to a bathroom, which can set off a ton of stress.That’s because incontinence is often caused by pelvic floor trauma from all types of causes, including childbirth, menopause, hysterectomy, chronic coughing, constipation, and the list goes on, according to experts at Yale Medicine. Basically, anything that puts extra strain on or causes dysfunction of the pelvic floor muscles—the group of muscles that support the bladder, urethra, uterus, and bowels—can lead to urinary incontinence. Plus the bladder and nearby muscles tend to just naturally weaken with age, per the US National Library of Medicine.There are two main types of urinary incontinence: stress incontinence and urge incontinence, Suzette Sutherland, MD, director of female urology and associate professor at the University of Washington School of Medicine, tells SELF.Stress urinary incontinence (SUI) means the pelvic muscles let urine leak out uncontrollably, usually due to some kind of pressure—like when you cough, sneeze, or jump. “You’re not strong enough down below for whatever reason and a little bit of urine comes out,” Dr. Sutherland explains.Urge incontinence, also called overactive bladder, is when you feel the urge to urinate frequently. Some people may experience a combination of SUI and overactive bladder (known as mixed incontinence). Overflow incontinence, when your bladder doesn’t fully empty, and functional incontinence, when a physical or mental impairment makes it hard to get to the bathroom, are other less common types.Urinary incontinence in your 20sWelcome to adulting! SUI and overactive bladder can occur at any age, even in your 20s. Incontinence can be set off by certain lifestyle habits, like drinking too much caffeine or alcohol, and health issues, like urinary tract infections, hormonal changes, or having to take certain medications, according to the Mayo Clinic.

If avoiding infection is your goal, wearing full-butt undies (bikinis, briefs, hipsters) with a breathable cotton crotch is best, Dr. Yamaguchi says. Or opt for seamless full styles, which tend to be made of synthetic fabric but are still better than a thong in this case because they’re not, well, shoved up your crotch. Whatever you wear, make sure your pair fits well and is not overly tight, Dr. Yamaguchi advises—again, to avoid chafing and spreading potentially harmful bacteria.But if you don’t want to deal with undie lines or you’re just not a full-bottom person, then going commando is a healthier habit to ward off infection. Yes, a tight pair of yoga pants could also trap sweat, but they’re also not rubbing against your anus and then vagina as you move, Dr. Yamaguchi says. Ideally, the crotch of the pants will be made of moisture-wicking fabric, adds Dr. Dweck, since, again, bacteria thrive in a moist environment.The vulva-friendly way to wear yoga pantsOf course, there are a lot of factors that could potentially lead to a vaginal infection or irritation, but making health-conscious underwear choices is an easy way to decrease your risk of both, Dr. Dweck says. Here are a few more gyno-approved tips to keep in mind:Swap undies. If you’re going from work to the gym, are currently wearing a thong, and want to continue wearing a thong, change into a new one, advises Dr. Yamaguchi. A clean pair ensures that the back strip of fabric is free from bacteria from your rectum prior to working out.Change ASAP. Regardless of what underwear you wore (or didn’t wear!) to exercise, “get out of your wet workout garments as soon as you’re able to” in order to help avoid irritation or a possible infection, Dr. Dweck says. And if you’re showering after your workout, be sure to towel yourself off well for the same reasons.Clean up with mild soap. Speaking of showering, washing the sweat and bacteria away from your vulva after a workout can also keep it happy, but if yours is on the sensitive side (i.e., you regularly experience irritation or infection), Dr. Dweck recommends sticking with mild soap and water. Check the label and look for words like “mild,” “gentle,” or “sensitive”—and avoid fragrance if you can, since added scents can be irritating, she says. (Also worth noting: Soap should only be used around your vulva—it should never go inside your vagina. That usually doesn’t end well!)Let your vulva breathe. After your shower, change into underwear (thong or otherwise) that has a cotton or moisture-wicking crotch. It’s also ideal to wear clothes that are on the looser side to let the area breathe, Dr. Dweck says—this helps keep moisture away from your vulva. What you want to avoid is showering and then putting your sweaty yoga pants back on, she adds.Don’t worry if you forget. If you’re about to work out or halfway through your routine and realize you’re wearing a thong under your yoga pants, it’s okay. Just try to remember next time—and don’t sweat it. (Har, har.) “You are not going to permanently ruin your vagina by wearing a thong to a hot yoga class,” Dr. Yamaguchi says.Related:

Peeing yourself at inopportune times (or really any time) can, understandably, be upsetting and anxiety-inducing. If you have stress urinary incontinence (SUI), seemingly harmless activities—like laughing during dinner with friends, having sex, or sneaking in a quick workout—can be potential triggers for a dreaded dribble (or gush) of urine. In these moments, weakened or damaged urinary muscles put excess pressure on the abdomen and bladder, which causes the sphincter muscles—circular muscles in the urethra that control the passage of urine—to open briefly, allowing a bit of pee to trickle out. With SUI, pressure is caused by “forceful” activities like sneezing, coughing, laughing, or exercising. Unfortunately, you can’t exactly predict when a case of the giggles or climbing a few stairs may trigger leakage—and that can impact how you live your life or even start to make you feel anxious about when your next “accident” will strike.That said, SUI isn’t something you just have to live with—and you deserve to feel at ease in your own body. Here’s what you should know if you’re dealing with this, and what you can do take back control of your life (and your bladder). 1. More people experience SUI than you might think.About one in three people with vaginas experience SUI at some point in their lives, according to the Urology Care Foundation, and it can happen at any age. SUI occurs when the pelvic floor muscles—a hammock-like group of muscles that support the bladder, rectum, and uterus—become stretched, damaged, or weakened, or when your urethra—the tube that transports urine from the bladder out of the body—can’t fully close, or both.One reason people with vaginas are more likely to have this issue is that their urethras are much shorter compared to people with penises. (People with penises can still experience SUI, but it’s much less common.) Having a shorter urethra generally translates to having less muscle power, which means any damage or weakness in the area can make it more difficult to control your urine flow, according to the Office of Research on Women’s Health (ORWH). Another big reason people with vaginas are more susceptible to SUI: pregnancy and childbirth. Having a baby can weaken the pelvic floor muscles responsible for holding organs in place, like the bladder, and can press on or injure the nerves that signal the activity to release urine.2 For older people, menopause may also be a culprit, as hormonal changes are thought to affect the pelvic muscles, which can lead to incontinence, per ORWH. In any case, “incontinence is not ‘normal,’ or ‘just a part of aging,’ or a ‘par for the course if you have babies,’” Dr. Reynolds stresses. “It’s very common—probably more common than most people think—but too many people suffer in silence about it.”2. SUI doesn’t just affect people who’ve given birth, though.“Childbirth is simply one contributor or risk factor,” Miranda Harvey, DPT, OCS, director of education at The Academy of Pelvic Health Physical Therapy, tells SELF. Less obvious risk factors include chronic obstructive pulmonary disease (COPD), allergies, and constipation, which can all cause repeated and forceful coughing or straining that can weaken those pelvic muscles over time, she says.

Regardless of whether you get care through your college, a local Planned Parenthood clinic, or another provider who isn’t associated with your campus, you’ll also probably want to know how your provider handles information you might like kept confidential, like prescriptions for birth control, says Dr. Lincoln. For example, even though you have a legal right to medical privacy, your parents might get statements that show you visited an ob-gyn if you go through their insurance for the visit. Dr. Lincoln says you can ask your provider what types of information the insured party might get in the mail and notes that a Planned Parenthood or campus-based clinic is more likely to be discreet.If you live in a dorm, your resident assistant may also have some answers to your questions about your school’s sexual-health services, including those that are specific to the LGBTQ+ community. For example, at least 149 colleges and universities offer insurance plans that cover hormones and gender-affirming surgeries for transitioning students, according to data collected by the non-profit Campus Pride.And even if you aren’t sexually active at the moment, it’s a good idea to get familiar with the health care services you have available so that you feel comfortable using them if and when you need them. If you have a vagina, it’s particularly important to have a provider to speak to when you suspect that you have an infection, such as bacterial vaginosis, a yeast infection, or a UTI, because you’ll want to get speedy treatment.3. If you want to avoid pregnancy, decide on a contraception plan.Using a condom during sex can significantly reduce your odds of getting an STI or becoming pregnant—with perfect use, they’re effective at pregnancy prevention 98% of the time. But user error is common: In a 2017 analysis of contraceptive failure published in Perspectives on Sexual and Reproductive Health, condoms had, on average, a 13% failure rate over the span of one year. In other words, if you’re having the kind of sex that can lead to pregnancy, ideally, you’ll have a backup method of birth control.Choosing a birth control method can be daunting, though, since there are so many options available, says Dr. Lincoln. Your best bet is to do a little research beforehand so that you have an idea of what method would work best for you. “It’s important to go to legitimate sources, and not TikTok, which can scare you off just about every birth control option,” Dr. Lincoln says. She points out that experiences with birth control that you might see on social media are pretty much like online business reviews, where people only share “if it’s really awesome or really horrible.”Dr. Lincoln recommends FindMyMethod and Bedsider.org as sites to consult as you start your research. Once you’ve compiled a list of pros, cons, and potential side effects for a few birth control options, you’ll be more empowered for a conversation with your provider.4. Understand when to get tested for STIs.STIs can be an unfortunate part of being sexually active. That’s true even if you aren’t engaging in penetrative sex of any kind. If body fluids like saliva, semen, or vaginal secretions are getting swapped, your risk of infection will never be zero, Kristen Mark, PhD, a professor of family medicine and community health at the University of Minnesota Medical School’s Institute for Sexual and Gender Health, tells SELF.

Kelly Ripa has always been pretty frank, especially when it comes to sharing the scoop about her relationship with her husband, Mark Consuelos. And based on a recent story the 51-year-old talk show host revealed, which is in her forthcoming memoir, Live Wire, her honesty isn’t going to let up anytime soon. Excerpted in Haute Living, Ripa writes about a time she passed out while having sex with Consuelos—and she didn’t even realize it until she woke up in the emergency room. That’s how she found out she had ovarian cysts.An ovarian cyst is a sac filled with fluid that can form on or inside the ovaries. They’re pretty common, and about 8% of people who haven’t hit menopause will develop a cyst large enough that needs treatment, according to the Office on Women’s Health. When an ovarian cyst ruptures, you may not feel anything at all—most tend to be small, so they don’t always cause noticeable symptoms. It’s not totally clear what, exactly, made Ripa pass out, nor if or how her cyst burst. However, the bigger a cyst grows, the bigger your risk of feeling some pretty serious—and maybe very sudden—pain. You may also experience an intense feeling of pressure, major swelling or bloating, and nausea or vomiting, among other unpleasant symptoms. Not all ovarian cysts need treatment, but some may need to be surgically removed. “My eyes shift between the fuzzy images on the screen, the remnants of my ovarian tormentor, and Mark happily snacking away,” Ripa writes, per the excerpt. “Sex can be traumatic I think, and yet one of us is completely undaunted. There he is, happily munching on the saltines now and ordering a second apple juice. Mark could be at a movie, or a spa. Instead, I’m flat on my back wondering when the other two cysts will burst.”The ordeal occurred shortly after the birth of the couple’s first son in 1997, and Ripa joked about the outfit Consuelos dressed her in to take her to the hospital. When she came to, she was wearing a leotard, red Manolo Blahniks, and her husband’s sweatpants. Luckily, it seems like Ripa recovered and now laughs about it; although she thinks the entire situation, particularly her “costume,” as she called it, is “still baffling.”Ripa also dished some details about working with Regis Philbin, her thoughts on aging, and her relationship with her three children in Live Wire, which is out September 27. In an Instagram post from April, she stressed that she put a lot of herself into this book. “My husband said writing a book is like giving birth,” Ripa wrote in the caption. “He’s never done either. Although it would be like giving birth, if giving birth lasted 18 months. A labor of love nonetheless.”Related: