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Men Have Pelvic Floors, Too

Over the past month, I’ve had two young men, both in their early twenties, walk into my clinic with ongoing pelvic floor issues. Their stories were strikingly similar—both had been bouncing from one specialist to another, trying to figure out why they were experiencing discomfort and dysfunction in such an intimate area of their bodies. It was clear they felt frustrated and a bit lost, not knowing that a pelvic floor therapist could be the solution they were looking for. Their difficulty in finding the right resources prompted me to write this article.

So, men, listen up; if you’re feeling uneasy or even a little afraid of trying something new for a problem that feels so private, you’re not alone. But I’m here to tell you that understanding and caring for your pelvic floor can make a world of difference, saving you time, pain, and money in the long run.

What Exactly Is the Pelvic Floor?

Before we dive into the specific functions and potential issues, let’s start with a basic understanding of what the pelvic floor is. Picture a hammock made of muscles, stretching from your tailbone to your pubic bone. This muscular structure is your pelvic floor, and it plays a crucial role in supporting your pelvic organs, including the bladder, bowels, and in men, the prostate.

But the pelvic floor is more than just a support system—it also plays a role in sexual function, continence (the ability to control your bladder and bowels), and overall core stability. When the pelvic floor is functioning well, you probably don’t even notice it. But when things go wrong, the symptoms can range from uncomfortable to downright painful, impacting your quality of life in ways you might not have imagined.

Sexual Function: More Than Just Performance

One of the primary functions of the pelvic floor is to contribute to sexual health. These muscles are involved in achieving and maintaining an erection, as well as ejaculation. When your pelvic floor muscles are strong and functioning properly, everything tends to work as it should. But if these muscles are tight, weak, or uncoordinated, you might start noticing issues such as:

  • Erectile Dysfunction (ED): Difficulty in achieving or maintaining an erection can be a sign of pelvic floor dysfunction. The pelvic floor muscles help control blood flow to the penis during arousal, and if these muscles are not functioning properly, it can result in ED.
  • Premature Ejaculation: Tightness or weakness in the pelvic floor muscles can affect the timing of ejaculation, leading to premature ejaculation.
  • Pain During or After Intercourse: Men with pelvic floor dysfunction may experience discomfort or pain during or after sexual activity, which can stem from muscle tension or inflammation in the pelvic region.

It’s important to note that if you’re experiencing sexual dysfunction, the first step should be to rule out other causes, such as a sexually transmitted infection (STI). Bloodwork and a visit to your primary care physician can help identify or rule out these issues. But if everything checks out and you’re still having trouble, your pelvic floor could be the culprit.

In some cases, conditions like epididymitis (inflammation of the epididymis) or prostatitis (inflammation of the prostate) can cause pelvic pain and dysfunction. These conditions are often linked to an overactive or tight pelvic floor, which can be addressed through pelvic floor therapy.

Sphincteric Function: Keeping Continence

Another key role of the pelvic floor is sphincteric function, which involves the muscles that control your ability to hold in urine and feces. When these muscles are working well, they provide the necessary closure to keep things in until you’re ready to go. But when they’re not functioning properly, you might experience incontinence—either urinary or fecal—constipation, or difficulty fully emptying your bladder or bowels.

  • Urinary Incontinence: Leaking urine when you sneeze, cough, laugh, or during physical activity can indicate weakened pelvic floor muscles. This condition, known as stress urinary incontinence, can be particularly frustrating and embarrassing.
  • Urge Incontinence: A sudden, intense urge to urinate, followed by an involuntary loss of urine, is another symptom of pelvic floor dysfunction. This condition, known as urge incontinence, occurs when the bladder muscles contract too often, leading to frequent trips to the bathroom.
  • Bowel Incontinence: Difficulty controlling bowel movements, leading to accidental leakage, can also be a sign of a compromised pelvic floor.

For men, symptoms of dysfunction can also include swelling in the scrotum, pain, hemorrhoids, or fissures. These issues can be embarrassing and deeply uncomfortable, but they’re also treatable. And it’s worth mentioning that a tight pelvic floor can contribute to a swollen prostate, which, if left unchecked, can progress into more serious conditions.

Muscle Support: Strength and Stability

Your pelvic floor muscles do more than just help with sexual function and sphincter control—they also play a key role in supporting your internal organs and stabilizing your core. When these muscles are weak or imbalanced, it can lead to a host of problems:

  • Lower Back Pain: When pelvic muscles are weak or dysfunctional, they can’t properly support the spine, leading to lower back pain. This pain might be persistent or flare up during activities like lifting, bending, or prolonged sitting.
  • Pelvic Pain or Pressure: When the pelvic floor muscles aren’t functioning optimally, the lack of support can cause a sensation of heaviness, pressure, or aching in the pelvic region, often worsening throughout the day.
  • Hip Pain: Dysfunction in pelvic muscles attached to the hip can lead to compensatory patterns in the hip muscles, resulting in hip pain. This pain may be sharp or dull and can affect one or both hips.
  • Weak Core Stability: If the pelvic floor is weak, it can compromise overall core stability, making it difficult to perform activities that require balance and strength, such as exercising, lifting, or even maintaining good posture.

In men, pelvic floor dysfunction can also contribute to chronic pelvic pain, a condition that’s often misdiagnosed or overlooked. This pain can be persistent and debilitating, affecting your quality of life and making it hard to engage in everyday activities. If you’ve been experiencing unexplained pain in your lower abdomen, groin, or perineum, it might be time to consider whether your pelvic floor is to blame.

Your Next Step Toward Wellness

If you suspect that your pelvic floor might be the source of your discomfort, pelvic floor therapy could be the solution you’ve been searching for. Our team of therapists is trained to assess and treat the muscles and tissues in this area, both externally and internally. I understand that the idea of pelvic floor therapy might feel intimidating, especially when it involves such a private part of your body. But let me reassure you—the process is gentle, respectful, and entirely focused on helping you feel better.

Moment of Truth Physical Therapy offers a “Discovery Session”, where you can expect a comprehensive explanation of your anatomy and how it relates to the symptoms you’re experiencing. This session is designed to give you the space to share your history, voice your concerns, and help us pinpoint the underlying issues. We’ll perform both external and internal exams to accurately identify what’s going on. One of the key goals of therapy is to remove restrictions in the pelvic floor—such as those that might be causing a swollen prostate or other forms of discomfort—which can prevent the progression of symptoms into more serious conditions. Together, we will create a treatment plan that is personalized to you and reduces any inflammation (and pain!).

Book your discovery session today, and let’s start your journey toward better pelvic health together. I look forward to working with you!

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