Let's talk about men's pelvic health

Yes, it is true, men can suffer from pelvic floor dysfunction too.  Many of the symptoms of pelvic floor dysfunction below are common among men:

• Pain in the groin, abdomen, low back, tailbone, penis, or testicles
   
• Urinary/bowel incontinence when you cough, stand, lift, or exercise
   
• Pre-mature ejaculation or pain with ejaculation
   
• Difficulty with erection
   
• Pain during or after a bowel movement
   
• Frequent urination at night

These symptoms can severely affect an individual’s quality of life and men often feel isolated and alone due to their pelvic health concerns. It’s important to know that you do not have to suffer through these symptoms! You are not alone, so let’s confront this taboo topic and talk about male concerns below the belt.

The role of the pelvic floor

First, you may be asking what exactly is your pelvic floor and what role does it play in your everyday life? The pelvic floor is a group of muscles that stretch from the pubic bone in the front to the tailbone in the back. These muscles play a key role in the maintenance of sexual function and pelvic organ support, acting as a hammock to hold the prostate, bladder, and bowel.

The pelvic floor muscles contract to prevent your bladder and bowel from releasing, then relax when you are ready to release. If these muscles are tight or weak, they are unable to contract and relax effectively - which results in pelvic dysfunction.

Therefore, just like any other muscle in the body, it is important for these muscles to maintain a proper balance between strength and their ability to become overactive which can result in tightness.

How can physiotherapy help?

There is an abundance of scientific evidence supporting the role of physiotherapy treatment for male pelvic health issues. As discussed above, the pelvic floor muscles are often weak and/or tight, leading to dysfunction.

Similar to other muscles, the muscles that are part of the pelvic floor can be strengthened through muscle training.

You may be thinking, “well I do my kegels, so I am already strengthening my pelvic floor muscles.” However, it is essential to understand that most people cannot properly activate these internal pelvic floor muscles on their own without at least one consultation with a physiotherapist. Research has shown that strengthening your pelvic floor with the guidance of a physiotherapist can lead to incontinence being decreased by as much as 80%.

Additionally, pelvic floor muscles can also become tight in the same way other muscles in your body do. Pelvic floor physiotherapists often assess pelvic floors that are overactive or tight, meaning they need help with the relaxation aspect of the muscle’s role.

When these muscles have too much tension, they will often cause pelvic pain or urgency and increase frequency of the bladder and bowels. Pelvic physiotherapy uses a variety of techniques to assist with both the strengthening and tension release of pelvic floor muscles.

Sexual dysfunction is highly prevalent in men, affecting 40% of males by the age of 40. Furthermore, men regard sexual function as a vital part of health and well-being. Men that are dealing with sexual dysfunction finds that it negatively affects their overall quality of life and relationships.

Male pelvic floor dysfunction has been associated with erectile dysfunction as well as dysfunction of ejaculation and orgasm. The pelvic floor muscles play an important role in erection, ejaculation, and orgasm for males. Specifically, voluntary pelvic floor muscle activation has been shown to be more efficient in men who have full erectile function than in those with erectile dysfunction. With this, it is crucial to be able to voluntarily control the activation and relaxation of the pelvic floor muscles.

A significant component of pain and dysfunction is related to tight pelvic floor muscles. Research has found that the implementation of male pelvic floor treatment plans leads to improvements in both ejaculation/orgasm and erectile function.

Pelvic floor treatment often includes neuromuscular re-education which is a guided retraining of your pelvic floor muscles. This helps to coordinate contraction and relaxation, ensuring the pelvic floor muscles are activating and relaxing properly to prevent tightness and weakness.

What should your next steps be?

There are multiple exercises available that can help address pelvic floor dysfunction. However, it is important to have an assessment done by a pelvic floor physiotherapist.

By doing this, the physiotherapist will be able to give you an individualized program to assist with your specific concerns. Find a pelvic physiotherapist near you or book an appointment online if you’re experiencing symptoms and want to seek treatment.

This blog was written by Kayla Teeter, a Physiotherapy student at The University of Toronto