Activity-related incontinence is a problem for women, many with limited access to specialty clinics and practitioners. Incontinence inhibits participation in health-promoting levels of physical activity. Vaginal weights are a treatment option available without a prescription for home use that may help some of these women. This multiple baseline across-participant case study investigated the use of weights in a 'hands-off' pelvic floor exercise program for pre-menopausal women. Three of four participants improved, but did not cure, their incontinence with use of the weights. A fourth participant was unable to successfully use the weights. Referral to a women's health physical therapist was suggested for her. Poor adherence was noted at follow-up in two of three participants, with the one who maintained practice demonstrating continued improvement and increased physical activity. Weights provide a low-cost exercise adjunct to women interested in a flexible and independent incontinence management program. For continued improvement, behavioral factors promoting adherence should also be addressed. Weights are one of the options for women wanting a low-cost solution for activity-related urinary leakage. Problems using the weights or failure to benefit from their use may be indicators of a need for more advanced evaluation by women's health specialists.