Do men have issues “down there” too? We often hear of pelvic floor (PF) problems in women, but men too can have issues and complications in this area, we just don’t hear about it as much. Men are less likely to seek medical help or to access available services and less likely to have a strong social support system. Therefore, they often have feelings of shame, embarrassment and even failure. Let’s explore male pelvic health.

What Is The Pelvic Floor?

pelvic floorThe Pelvic Floor is comprised of layers of muscles and tissues located from your tailbone to your pubic bone and between your sit bones. Functions include support for your organs, sexual functions (including erection, orgasm, ejaculation), continence control – ability to urinate and defecate, and stability as the PF works intricately with your abdominal and back muscles and diaphragm to provide proper core activation.

What Are Some Typical Conditions Seen In Men?

  • Pelvic pain: including pain between your sit bones, penile or testicular pain, tailbone pain, pain post bowel movement
  • Sexual dysfunction: pain with ejaculation, painful intercourse, erectile dysfunction, premature ejaculation
  • Continence issues: urinary urgency and frequency, constipation
  • Post prostate surgery: pain, urinary and erectile issues
  • Hard Flaccid Syndrome: newly recognized condition of younger men with penile microtrauma from excessive sexual activity including masturbation and jelqing
  • Athletic pelvic pain: from aggressive exercise; can include hip, groin, pubic, abdominal issues along with pelvic or genital pain, urinary frequency and mild erectile dysfunction

Just Do “Kegels” Right? 

Wrong! Kegels are an exercise that contracts the pelvic floor muscles. While kegels are beneficial in some conditions, they may be the complete opposite of what is needed to help heal and relax the pelvic floor. Many pelvic conditions stem from overactive pelvic floor muscles that require techniques to relax the area. Men generally have poor awareness of their pelvic floor and do not have a good understanding of what “normal” is. It is important to seek help from a physical therapist in order to best treat your condition.

UNDER versus OVER activity needs to be assessed along with other contributing factors from the hip and back, stress levels, habits, nutrition, and medications.

What To Expect With Physical Therapy?

  • Detailed history intake with review/discussion
  • Spinal assessment
  • Hip/pelvic assessment
  • Palpation
  • External pelvic floor assessment (sometimes with ultrasound imagery to assess function)
  • Internal pelvic floor assessment
  • Exercise prescription
  • Pain management
  • Stress management and breathing assessment
  • Education

The medical field is steadily making progress regarding these male pelvic health issues. It has been said that the knowledge, awareness and treatment are a decade behind what is known and done for female pelvic issues.

In Summary

McNaughton et al (2012) noted the impact on quality of life is similar to those suffering from cardiac complications, angina or Crohn’s disease. This can result in disturbed sleep, fatigue, withdrawal, social isolation, shame, anger and depression, and, in some cases, suicidal feelings. So, it is vital that if you are struggling with male pelvic health issues, to consult your doctor and physical therapist. At One on One Physical Therapy, we offer help in a safe and private environment. We are here for you. To book an appointment, contact us at 770-500-3848.

About The Author

Savas Koutsantonis PT, DPT, CMTPTSavas Koutsantonis, PT, DPT, CMTPT is a male physical therapist with over 35 years of clinical experience specializing in chronic pain conditions, male pelvic health, headache and jaw issues.