Hey Ladies, How’s Your Man’s Pelvic Health?

Men’s health month is in June, buttttttt I’m writing from the middle of October. It’s so October, in fact, that my husband helped me brainstorm all the talking points for this blog post (thanks, babe!) on the way to a fall festival where we indulged in apple cider donuts, went down slides on burlap sacks, and tromped through fields of mud to pick the perfect pumpkins for our front porch.

So why the sudden post about men’s pelvic health when the 100+ other blogs I’ve written so far are specifically for women? Well, first of all…I’ve had a few requests to cover this topic from readers like you. Second, I’ve encountered more “wait…guys can have pelvic floor problems too?!” kinda questions in the clinic and I love having a quick resource to send people to.

Enterrrrrrr my first ever (but maybe not last…you’ll have to tell me what you think!) post about men’s pelvic health. As a pelvic rehab therapist for the military population, half of my patients are males. And if I’m being totally honest, I actually think men are easier to treat because there aren’t hormone imbalances, menstrual cycles, or childbirth events complicating things in the background.

What make guys harder to treat are the stigma, shame, and lack of education and conversation around the whole pelvic health situation, but that’s what brings me here today. The more men know about their anatomy, what’s abnormal, and where to go for answers, the more confident they’ll be admitting there’s a problem and asking for help.

First, a little anatomy lesson

The pelvic floor is a sling in the bottom of the pelvis that runs from pubic bone to tailbone (front to back) and between the sit bones (side to side). It’s made up of three layers of muscles whose jobs include sphincter control of the bowel and bladder, sexual function, and stabilizing the spine, hips, pelvis, and pelvic organs.

Both men and women have a pelvic floor, and when you see them side by side (like in this picture) you’ll notice they actually looks quite similar. The primary differences between the two is that 1) the female pelvic floor has three holes that pass through it whereas the male’s only has two, and 2) the female pelvis (and therefore pelvic floor) is generally wider than a male’s.

A message for my fellow ladies

Ok ladies, the rest of this post is going to be geared towards the guys, but if you want to keep reading and learning…more power to ya! The fact that you’re still here probably means you’ve got a man (or two) comin’ to mind, and both he and I thank you in advance for prioritizing his pelvic health.

If you’re looking for a few ways to help, may I first recommend forwarding this along to any and every guy with a pelvic floor (PS – that’s all of them ;)). I’m guessing pelvic floor dysfunction is more prevalent than men make it out to be, and you never know who’s silently suffering behind the scenes. Next you might consider grabbing him a book from the recommendations below, or if you’re feeling especially generous, treat him to a virtual consult with yours truly. From there, your steady support means the world to him…I’m sure of it.

Aaaaaaand now one for the guys

Guys, let’s cut to the chase, eh? You’re either here because the Google and algorithm gods did you a solid or a lady in your life sent you the link. Either way, I’m so happy to have ya in my little corner of the world wide web. I’m a certified pelvic rehab therapist, and while I treat both the male and female population in the clinic, just one peek at the rest of my posts and you’ll see that women are my primary audience [here]. The good news is that many of the same principles for healing your pelvic floor apply, so feel free to browse the “related posts” I’ve linked throughout!

If this is your first exposure to any and all things pelvic health, then settle on in because it’s the perfect place to start. I’ve got a lot of information to share, but am always applying my “less is more” approach on the subject to keep things realistic and relatable with real results on the other side. Sound good? Let’s get to it!

Signs & symptoms of male pelvic floor dysfunction

Once you know where the pelvic floor is (check!) and what it’s responsible for (check!), it’s easier to determine if the issues you’re experiencing are caused by pelvic floor dysfunction. In order for this to all make sense, let me remind you that this is a complex area with multiple layers, systems, and responsibilities. So if there is, in fact, pelvic floor dysfunction, it’s going to cause issues both locally and in other areas of the body.

By now you’re likely wondering…is this me?…do I have pelvic floor problems? And since I can’t physically examine you, I’ve found sharing the typical signs of pelvic floor dysfunction is the next best way to answer this question. Some of these may surprise you, so read all the way through to learn the most common symptoms.

BLADDER SYMPTOMS

About 10% of middle-aged men experience bladder issues, and that prevalence only increases with age. But remember…”common” and “normal” are two very different things, and I don’t care how old you are or how long these concerns have been going on, there’s likely something you can do about it.

Leakage – urine leaving the urethra any time you don’t want or expect it to…even if it’s “just a little bit”
Urgency – a strong and sudden “gotta go” feeling that can feel uncontrollable, uncomfortable, and sometimes result in urine leakage
Frequency – urinating more than 6-8 times per day, or more than once every 2-3 hours
Nocturia – the need to wake up and urinate at night (unless you’re over the age of 60, then you get a pass for one trip to the restroom per night)
Hesitancy – difficulty urinating with a slow (longer than 30 seconds from start to finish) or inconsistent urine stream
Dysuria – pain with urination that can occur in the penis, testicles, lower abdomen, low back, or pelvic floor

If you don’t know where you land when it comes to some of these bladder benchmarks, specifically urinary urgency, frequency, and time, tracking it for a few days is the best way to find out. The Bladderly app is the easiest and most convenient place to record bladder habits and patterns and see improvement over time as you address your pelvic health.

BOWEL SYMPTOMS

If you just indulged in a Taco Bell chalupa supreme, then we can’t blame your bowels for going bazerk. But if those toilet troubles are becoming more consistent or are combined with other signs of pelvic floor dysfunction, that’s when the pelvic floor may be at play.

Constipation – less than three bowel movements per week and having to strain or aggressively push to pass stool
Incomplete emptying – the feeling of stool still being present in the rectum after having a bowel movement or sensation of blockage or obstruction in the rectum or anus
Leakage – stool leaving the anus any time you don’t want or expect it to…even if it’s “just a little bit”
Urgency – a strong and sudden “gotta go” feeling that can feel uncontrollable, uncomfortable, and sometimes result in bowel leakage
Hemorrhoids – swollen veins in the anus or rectum that can cause pain, itching, or bleeding, often associated with constipation
Anal fissures – a tear in the lining of the anus that can result in pain and bleeding during bowel movements, often associated with constipation

SEXUAL SYMPTOMS

“I’ve got a few personal questions…”, is how I start [this] conversation with every guy that comes in my clinic. And rather than resist, many of them sigh in relief because help really does exist for so many of the sexual symptoms men experience. Difficulty getting or maintaining an erection, pain with erection or ejaculation, premature ejaculation, and testicular or pelvic pain (associated with sexual activity or not) are all often caused by the pelvic floor, or it’s at least a contributing factor.

MUSCULOSKELETAL SYMPTOMS

Because of where the pelvic floor attaches, it can create pain in the low back, hips, and groin. Pelvic floor muscle weakness can cause instability in the spine and joints whereas pelvic floor tightness can encourage secondary tension in these other structures. If you’ve tried “regular” physical therapy, massage, acupuncture, or chiropractor, and especially if you experience any of the above bladder, bowel, or sexual symptoms as well, it’s possible your pelvic floor is the culprit.

Causes of male pelvic floor dysfunction

We’ve already covered that the pelvic floor is muscle. And like every other muscle in the body, there are two main reasons they start to rebel – weakness and tightness. What I’ve found in my clinic (and what you’ll see here) is that a majority of male pelvic floor issues stem from pelvic floor tension.

I liken it to a fist…your hand should be able to make a fist, but it shouldn’t be stuck in a fist. A hand constantly clenched in a fist is painful, weak, and dysfunctional, and a tight pelvic floor is no different. So pelvic pain, back & hip pain, bladder, bowel, and sexual issues can all be caused by pelvic floor muscle tension, and getting to the bottom of how and why you have that tension to begin with is the best first step to seeing improvement in symptoms.

So let’s get to it, shall we? The following list is meant to be an eye-opening guide to help you not only continue to determine if you have pelvic floor dysfunction, but also where you can begin focusing your efforts to improve it. Do not, I repeat…DO NOT let this become a source of overwhelm. If two or more points resonate with you, you’re not alone. Set yourself up for success and pick the one that’s easiest or most convenient to address first (a path of least resistance kinda thing), then go from there.

Taking it one step further, at the end I’m sharing a few of my favorite resources for addressing allllllllll of this (*waves hands wildly*). No posting and ghosting here, my friend…I’ve got you! There’s hope and healing on the other side of this one, and I’m just as ready as you are.

STRESS & ANXIETY

Yeah…we’re divin’ right in, because over 60% of the adult population considers themselves stressed or anxious, and with those feelings often comes muscle tension. While most would vouch for an aching jaw or tight shoulders, the pelvic floor has the same response, it’s just not always as obvious as our awareness of “down there” is limited. I ~always~ ask my patients if their pelvic floor issues started around a time of stress, worry, or fear, and more often than not, there’s an *ahem* not-so-coincidental correlation.

POOR POSTURE

Every time I talk about posture I remember my mom encouraging me to stand up straight and pull my shoulders back. Buttttttt…she was right (surprise, surprise), and now I know posture effects so much more than how I look. Posture – specifically pelvic posture – plays a HUGE role in pelvic floor tightness. A posterior pelvic tilt (glutes and abs clenched and tail tucked) promotes muscle tension by creating a “shorter” pelvic floor. This posturing is common when sitting in cars, desk chairs, and on the couch to name a few, and while standing at the urinal. Mindfulness and a bit of body awareness are all you need to correct this, making it one of my favorite places to start.

PROLONGED SITTING

Between binge-worthy Netflix series, a growing number of desk jobs, and an increased frequency of travel, people nowadays spend more time sitting than ever before. Sitting for extended periods causes hip and back tightness and poor blood flow to the pelvis. Add in the whole poor posture “thing” from above and you’ve created the perfect storm for a tight pelvic floor. While sitting is inevitable, taking stretch or stand breaks at least every thirty minutes (and being mindful of your posture in between) can significantly decrease the affects of prolonged sitting on the pelvic floor muscles.

BACK, HIP, & GROIN PAIN & TIGHTNESS

This is one of those “chicken and the egg” situations, because chronic back and hip pain can cause pelvic floor muscle tension, but a tight pelvic floor can also create back and hip pain. At the end of the day, it really doesn’t matter who’s at fault, but rather that all issues are resolved, am I right!? A symptom timeline can help determine the difference, with the guilty culprit often being the issue that started first. Core and glute strengthening combined with deep hip stretching can be helpful when trying to decrease back and hip pain, and everything else you need for the pelvic floor is below.

SURGERY

Back, abdominal, and pelvic surgeries (the most common I see in men being appendectomy, vasectomy, and hernia repair) create adhesion at and around the area of surgery and can cause pulling, tension, and tightness in the surrounding muscles, fascia, and nerves. Some of these surgeries also involve mesh, which just adds to the mess. If you realize your pelvic floor symptoms started within a year of surgery, the secondary effects of that procedure may be to blame. The good news is that there’s something that can be done about it.

OCCUPATIONAL “HAZARDS”

Jobs that require carrying or wearing heavy gear or equipment, especially on the back or around the belt, can result in pressure and tension on the pelvic floor. These also tend to be high-stress jobs (see above), contribute to poor posture (see above for that one too), and add to back and hip pain also (yep…you guessed it…we already covered that one as well). While you can’t necessarily say “no thanks” to said gear, you can do you best to make sure it fits you appropriately and the load is properly distributed. Keeping your core and hips strong with resistance training will also make it easier for your body to support the load.

CHRONIC PAIN

Pain that’s been present for a significant amount of time is bound to affect other areas of the body. And because muscles respond to pain by tensing up, surprise, surprise!!!…the pelvic floor typically follows suit. A tight pelvic floor often tags along or results from pain caused by fibromyalgia, diabetes, cancer, and arthritis, and the vicious pain-tension cycle can ensue. Getting these chronic diseases and their symptoms under control as best as possible is key as you work simultaneously to decrease pelvic floor muscle tension.

A HISTORY OF ABUSE

Trauma or abuse in any form and at any age can lead to pelvic floor muscle tightness. Humans carry many of their emotions in the pelvis, and if you’ve experienced physical, mental, or emotional abuse, the pelvic floor will “close off” as a defense mechanism. Treating pelvic floor dysfunction in conjunction with talking to a mental health specialist is a helpful route to take in these situations.

THE BIG, BAD, & UGLY

Ok…so I want to finish by being clear that there are other things that can cause the bowel, bladder, sexual, and musculoskeletal symptoms we’ve discussed. Cancer, prostate issues, urinary tract infections (UTIs), and sexually transmitted infections (STI’s) can all create them too. But once your doctor (or urologist, oncologist, or GI specialist) has ruled out the big, bad, and ugly, you can pursue pelvic floor physical therapy with confidence, excitement, and peace of mind.

Why [this] is worth addressing

I hope by now I don’t have to convince you that ^^this^^ is worth addressing, but if you’re still not sold or those excuses are already starting to creep up, permit me to put you on pause while I plead my case. I’m passionate about addressing male pelvic floor dysfunction because I know how easy it can be to fix with the right education and guidance. I also appreciate the hesitation and even humiliation are real, but they’re worth getting over for the reasons here.

IT WILL ONLY GET WORSE

Not to be a negative Nellie, but these kinds of things don’t just disappear. In fact, I find (and maybe you have too) that they only get more frequent, severe, irritable, and complex over time. The faster you catch pelvic floor dysfunction, the easier it is to treat, so sitting there, crossing your fingers, and hoping it gets better is kinda silly (no offense).

IMPROVED QUALITY OF LIFE

Do me a favor and scroll back up to all the signs and symptoms of pelvic floor dysfunction…now imagine that every box you checked is no longer an issue. Less pain, better sex, no more worry, stress, or embarrassment mean a better quality of life for you all around. Why merely manage or power through when you could be vibrant, thriving, and healthy!?

INCREASED GYM PERFORMANCE

I had to experience this one for myself, but its true! I can’t tell you how many men I’ve treated for testicular pain, bladder leakage, erectile dysfunction, etc., and in the end they come back reporting they can move faster, lift heavier, and last longer in their workouts. Healing the pelvic floor improves muscle function, strength, and length, breath control, and body awareness, all of which naturally seem to carry over to gains in the gym.

Where to start

Not to toot my own horn, but toot freakin’ toot…a pelvic rehab therapist really is the best person to treat everything I’ve mentioned here. While the profession is growing, it can still be difficult to find a specialist in your area, and even harder to find one that treats men. But remember…healing and relief is possible, so I’ve rounded up a few accessible and actionable (like right now!) places for you to start.

MY FAVORITE BOOKS

I will forever preach that books are the cheapest and most convenient form of education. And if you’re a reader and/or DIY’er like me, then this would be the best place to start with the lowest barrier to entry. Now where are there bananas and eggplants on the front of all these books? Good question. I promise the information inside makes up for the cringy cover choices…girl scout’s honor.

“The Penis Book” by Aaron, Spitz, MD – Dr. Spitz covers it all – erections, masturbation, piercings, and kegels – in an educational yet engaging way most men appreciate. He even makes a few shout-outs to pelvic rehab therapists! I tell most of my male patients to buy this book and they come back so thankful for the recommendation.

“Pelvic Pain The Ultimate Cock Block” by Susie Gronski, DPT – Fellow pelvic rehab therapist, Dr. Gronski, shares the latest research on male pelvic pain then follows it up with real life-approved advice that I’ve personally seen produce results. She utilizes a full-body approach (my favorite) that I also think you’re gonna love.

“Penis Exercises” by Richard Howard, PH – This book’s subtitle is “a healthy book for enlargement, enhancement, hardness, and health”…need I say more? I wouldn’t start with this one if you have pelvic pain, bowel or bladder issues, but if your concerns have more to do with erections and ejaculation, read away, my friend.

AN ONLINE CONSULT

All this information can be a bit overwhelming, and while that’s not my intent, sometimes good ol’ analysis paralysis sneaks in and stops the best of us dead in our tracks, even if the motivation’s there #guilty. Working one-on-one with a pelvic rehab therapist is thee best way to nix confusion and get results quickly when it comes to treating pelvic floor dysfunction and all the symptoms that come along with it. Schedule an appointment (and start seeing positive change in your pelvic health) today! I’ve helped hundreds and hundreds of men do the same, and there’s no reason you can’t too.

A PELVIC FLOOR PT NEAR YOU

If you prefer to work with a pelvic rehab therapist in person, click here to find the closest one to you. I then recommend you call to see if they treat the male population and if you’re feeling brave, specify what you’re experiencing to be sure you’re a good fit.

What are you waiting for?

They say there’s a first for everything, and it was my absolute pleasure to create this resource for men’s pelvic health on a women’s wellness blog. There’s so much more I could say, especially when it comes to *how* to treat male pelvic floor dysfunction, but my hope is that a seed has been planted so you can start taking action. So what are you waiting for, friend? You now know what’s wrong & why & what to do…get to it!

– Amanda

Disclaimer: The content provided here does not constitute medical advice, nor is it a substitute for personalized healthcare. I’m a doctor, but I’m not your doctor. If you have concerns about a medical condition, diagnosis, or treatment, you should consult with a licensed healthcare professional.

Disclosure: Some of the links above are affiliate links, meaning, at no additional cost to you, I will earn a commission if you click through and make a purchase. No pressure, but I have a feeling you’re gonna like what I’ve taken the time to put my recommendation behind.