Yes, Men Have a Pelvic Floor Too
When we hear of pelvic floor issues we often associate this with female anatomy.
However, men have a pelvic floor too!
When a man’s pelvic floor isn’t working properly it can also leads to bladder and bowel issues, erectile dysfunction or pelvic pain which can be felt into the groin, hips, pelvis and genitals. Many of these problems can be resolved by seeing a pelvic health physiotherapist that specialises in men.
What are these muscles and how to they work?
There are three main parts to the male pelvic floor:
puborectalis- is the main muscle group which we all think about when we think about the pelvic floor. It starts at the front part of the pelvis, wraps around the back passage and attaches onto the other side)
ischiocavernosis/bulbospongiosis- They are the muscles for helping to maintain erection but also class the last bit of urine after going for a wee
urethral sphincter complex- this is responsible for helping to stop and start the flow of urine
You can see they each have distinctive roles in a male’s pelvic function and they can each be targeted for rehab depending on symptoms.
What Problems Can Occur When The Pelvic Floor Muscles Aren’t Working Properly?
When your pelvic floor muscles aren’t working properly, the following problems can occur:
Bladder: leaking of urine and needing to rush to the bathroom, increase in urinating frequency during the day and overnight, stop/start flow or difficulty fully emptying and painful emptying or painful bladder filling.
Bowel: accidents with stool or holding onto wind, needing to rush to empty bowels, constipation and painful bowel emptying.
Pelvic & Sexual Pain: pain can refer anywhere from the belly button down around the pelvis. Pain can be felt into the testes, hips, groin, anus, coccyx. Pain can also be felt with erections or orgasm.
Erectile Dysfunction: if you have had prostate surgery and you can gain and erection but have difficulty holding, this may be due to pelvic floor muscles. Pelvic floor dysfunction may also play a role in premature ejaculation.
How can the muscle cause issues?
From a muscle perspective it can either be one of two things. They can be weak and not able to strongly contract and fatigue quickly. Or they can be too tense and what we refer to as overactive.
The pelvic floor is just like any other skeletal muscle. We need to use these muscles to keep them strong. So we tend to see the weaker muscles occur with inactivity and as we age. Sometimes after surgery such as prostate removal, we may have pain at the site which makes it harder to switch on and contract these muscles.
A tense or overactive pelvic floor is something that we also commonly see. An overactive pelvic floor can be from chronic constipation, poor abdominal pressure management (breath holding/constantly tensing abdomen), prolonged sitting or bike riding or following infection or surgery to the pelvis.
How can physiotherapy be helpful:
During a consult we would take a full history of your symptoms as well as discussing any bladder, bowel or sexual function issues you may be experiencing. We would also ask about your general health, exercise levels previous surgeries and injuries to see if they may be contributing to the issue.
We would then offer a physical assessment. This may be external or internal to help determine the underlying cause.
You will given education about why you are experiencing the symptoms that you are. As well as a tailored home program to complete. Over time we will progress your exercises and program to get you back to your goals.
So what should I do if I’m having these issues?
If they have come on suddenly, it is always best to check in with your GP to clear any sign of infection or pathology which may be causing your symptoms. If that is all clear, book in with your pelvic floor physiotherapist to help address your issues. You don’t have to go through this alone.
