Ah, the question we get asked every single week: Do men have a pelvic floor?

Typically this is coming from a new patient who is asking for their partner, a curiosity after learning about all that the pelvic floor does for individuals with a vagina, or because they see the penis pelvic model in the clinic and decide to ask.

Regardless of why they are asking, the answer is: YES, men (or those born with a penis) do have a pelvic floor!

If you think about the five functions of the pelvic floor it makes sense! The pelvic floor is key for:

So as long as men (or any person AMAB) are doing these activities, their pelvic floor will be important!

Shortly after that question, we get asked: What do you see guys for?

Honestly, the answer is pretty similar to the things we see women for - urinary or bowel issues including leakage, frequency/urgency, difficulty going (including constipation), pelvic pain, and issues navigating intimacy. Let’s dig deeper.

Urinary & Bowel Issues

Any person with a pelvic floor (aka everyone!) can have issues with muscle tightness, weakness, or discoordination. As a result, they may experience issues holding things in (leakage), letting things out (retention), or lacking the right communication between the bladder and brain which can lead to voiding frequency or strong urges due to the feeling of never fully emptying. 

Recently we worked with a patient who reported going 40 times per day due to the feeling of needing to go as well as not fully emptying each time he is in the bathroom. That urge continued to build without relief which results in this patient feeling uncomfortable, landing him back in the bathroom every 20 minutes or so trying to get relief.

This same urgency, frequency, and leakage can be true for the bowels; however another common bowel symptom we treat is constipation. While constipation may have a multitude of factors, in pelvic floor therapy we focus on dietary fiber (how much soluble and insoluble fiber are they consuming daily/weekly), muscle tightness and/or coordination for getting stool out. 

Pelvic Pain

Pelvic pain is oftentimes the catalyst that will bring men in for treatment. Well that and issues around intimacy, but more on that later. 

Men commonly experience pain in their pelvic floors in a few locations:

• The groin line
• The perineal body
• The testicles
• The penis (more in the tip than the shaft, but both occur!)
• The anus/rectum

This can occur for many reasons, but the most prevalent are muscle tension due to holding stress in our pelvic floor muscles or compression to the pelvic floor muscles and nerves during seated activities like riding a bike. With nerve compression, patients will likely describe burning, numbness, tingling, and/or shooting pain. The pain could be local to one spot or may refer to other areas of the body. We see this frequently with pudendal nerve involvement which sends pain into the penis, perineal body, or anus.

During our evaluation we will get to the bottom of these symptoms as we pinpoint where the pelvic pain is coming from. This will help guide our treatment to ensure you experience relief of your pelvic pain

Intimacy

Issues related to intimacy is another common catalyst to get patients in the door. Whether the issues are related to premature ejaculation, pain with erections/ejaculation, or difficulty with erections/ejaculation, male patients are looking for answers ASAP!

While we approach pain with erections and ejaculation much like the rest of our exploration into what is causing other pelvic pain, when it comes to premature ejaculation, difficulty achieving or maintaining erection, and arriving at orgasm/ejaculation we are looking more into muscle coordination, pelvic floor communication with the brain, and any other sinister pathology that could be occurring.

In this instance, we are going to work closely with your medical team to rule out bigger issues such as cardiovascular issues, hormone imbalances, and pelvic cancers. Once those are cleared and/or treated, we will place our focus on addressing any pelvic floor tension, educating on anatomy and function as it relates to the pelvic floor muscles and vascular systems, and providing you with techniques to employ at home to help support our work in the clinic. 

Prostate Issues

Another area we work with male patients in pelvic floor therapy is before and after prostate surgery. It has been reported that individuals may experience urinary leakage, erectile dysfunction, and Irritable Bowel Syndrome after undergoing a prostatectomy. 

In a prehab setting we will work to ensure the pelvic floor muscles are engaging appropriately to minimize or prevent urinary leakage and bowel leakage related to IBS symptoms and address any underlying pelvic floor tension ahead of surgery. After surgery we will turn our focus to pelvic floor strengthening for continued support of the bladder and bowels, discuss new methods for voiding, as needed, and monitor for healing, swelling, and pelvic floor muscle guarding as a result of pain.

Pelvic Floor Treatment for Men

In pelvic floor therapy we will assess for weakness, tightness, and coordination as well as review proper bowel and bladder habits to ensure all systems are working as they should. We will incorporate manual therapy techniques as needed to help with tight pelvic floor muscles and instruct patients in a home exercise program to help support the work we do in the clinic.

But is it awkward?!



We hope not! 

But we understand that walking into a new space to sit down and discuss very personal issues can be tough. We work hard to make Pelvic Pride as welcoming and safe as possible for all patients. We recognize that this question may be coming from past experiences of going to PT for an injury, working out in a gym full of people, and talking very loudly and openly about your symptoms.

Pelvic floor therapy is different! You will work one-on-one with your pelvic floor therapist in the comfort of our private treatment rooms. All manual therapy, patient education, and exercises will be performed in that room so you don’t feel exposed out in a gym surrounded by people. 

So what are you waiting for? If you are experiencing any of the issues we discussed above or have some other pain or problem that you don’t feel like you are getting great answers for, give us a call!