Pelvic Floor Health For Men: Myths, Taboos And You

An area that remains a challenge is men’s health related to… you know, down there. Many men are slow to seek medical attention for health issues, especially those relating to our penis, perineum, anus and the internal area of our pelvis – your pelvic floor. Many men are unaware that they even have one, what it is, what it does, how to care for yours and, importantly, what to do if you have issues.

Here at King Edward VII’s Hospital, we want to help men of all ages understand their pelvic floor better: signs of pelvic floor issues, conditions, what can be done about issues and how to maintain a healthy pelvic floor. To do this, we spoke to pelvic floor expert Karin Goldschmidt.

Don’t forget that KEVII offers a comprehensive pelvic floor clinic for men and women. Find out more about our Pelvic Floor Clinic here.

What is the pelvic floor and what does it do?

The pelvic floor is a hammock-like group of muscles that attach to the pubic bone at the front, the coccyx (tailbone) at the back, and the hips at the sides. This structure plays a vital role in supporting the internal organs located in the pelvic region, such as the bladder, intestines and for women, the uterus.

The pelvic floor plays many roles, for example, is integral to maintaining continence, as it controls the sphincters that manage the release of urine and faeces. Additionally, the pelvic floor muscles are important for sexual function, as they contribute to sexual sensation and arousal.

I didn’t know I had a pelvic floor!

This is the issue. Many men don’t realise that they have a pelvic floor, let alone what it is and what it does.

Many men are too embarrassed and shy to reach out. Many men think they can – or should – just put up with it, or that it’ll just get better. But the best thing to do is seek medical attention because not only might we be able to relieve pain but symptoms may be a sign of cancer – which of course you want to act on quickly.

So what conditions relate to the pelvic floor?

It’s important to note that the pelvic floor is an area of your body that contains bones, muscles, nerves and organs. As such, there are a number of conditions related to the area, for example:

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)

A common condition involving pain and inflammation in the prostate and pelvic region, often associated with pelvic floor muscle tension or dysfunction. This affects many active men – for example, athletes. It’s caused by a tight pelvic floor where the muscles are too tight to relax. It can also be associated with anxiety and stress, physical and emotional trauma and can occur post-surgery.

Find out more about Pelvic Floor Dysfunction

Other chronic pain conditions

Chronic pelvic pain can also relate to a number of conditions, including pudendal neuralgia, levator ani syndrome and pelvic floor myalgia.

Post-Prostatectomy Incontinence

Incontinence following prostate surgery is often linked to damage or weakness in the pelvic floor muscles and sphincter mechanism.

Erectile Dysfunction (ED)

While multifactorial, ED can be associated with pelvic floor muscle dysfunction, particularly in cases where there is a lack of coordinated muscular activity. The condition is far more widespread than believed because it is so rarely talked about, with more than 50% of men over 40 suffering from ED.

Urinary and faecal Incontinence

This includes stress, urge, and mixed incontinence, often related to pelvic floor muscle weakness, overactivity, or coordination issues. Can be associated with weakened pelvic floor muscles or damage to the anal sphincter, often post-surgery or trauma.

Other conditions include:

• Benign Prostatic Hyperplasia (BPH)
• Pelvic Floor Dyssynergia
• Coccydynia
• Pelvic Organ Prolapse (POP)
• Dyspareunia
• Anismus
• Hernia
• Haemorrhoids

And of course, it is possible to have multiple conditions.

So what symptoms am I looking out for?

When considering potential issues with the pelvic floor, there are several key symptoms to be aware of. These include:

• Urinary incontinence, which can manifest as a loss of bladder control or an urgent need to urinate.
• You might also experience faecal incontinence or difficulty controlling bowel movements.
• It’s also important to be aware of any difficulties with urination or bowel movements, such as straining, pain, or incomplete emptying.
• Chronic pain in the pelvic region, including the lower back and genital area, is another significant indicator.
• For men, symptoms can extend to erectile dysfunction or pain during sexual activity.
• You may notice a feeling of heaviness or bulging in the pelvic area, which could indicate a pelvic organ prolapse.

If you experience any of these symptoms, consult a healthcare professional or come to our Pelvic Floor Clinic for a thorough evaluation and appropriate management.

Am I at risk from a pelvic floor condition?

Here’s the best way to answer this.

• Men over 60 are more at risk from prostate cancer – the most common cancer in men
• 2 in 10 men will have chronic prostatitis or pelvic pain
• 16% will have overactive bladder
• 70% of men suffer from urinary incontinence following prostate surgery

READ: Pelvic Floor in Your Forties and Beyond

As for lifestyle factors, men who suffer from stress and anxiety are more at risk from pelvic floor issues. Athletes and people who are very active are at risk – general strains. Also, all the usual other lifestyle factors can raise the risk for individuals: smoking and being overweight – people who are unhealthy.

Why pelvic floor exercises can help men as well as women

Pelvic floor exercises are often associated with women post-childbirth or during menopause but they are just as beneficial for men.

In men, pelvic floor exercises enhance bladder and bowel control, which can be particularly beneficial for those experiencing post-prostatectomy incontinence or other forms of urinary dysfunction.

For both men and women, a strong pelvic floor is crucial for sexual function as it contributes to erectile function and ejaculation control in men, and vaginal muscle tone and sensation in women.

When the pelvic floor is weak, targeted exercises can fortify these muscles, restoring their function and resilience. Conversely, if the pelvic floor is tight or tense, a different set of exercises can be employed to alleviate this tension, promoting relaxation and balance within the muscle group.

What might those exercises be?

When it comes to specific exercises we recommend trying the following simple exercises:

Pelvic floor stretch

• Gently stretch and relax the pelvic floor muscles. This is particularly beneficial for those experiencing tightness or tension in this area.
• Squeeze and lift from the back passage
• This exercise targets the muscles around the back passage (anus). It involves squeezing and lifting these muscles, akin to trying to stop a bowel movement. This movement is good for strengthening the muscles responsible for continence.
• Drawing the penis inward towards the body to engage and strengthen the muscles at the base of the penile area. This exercise not only helps muscle toning but also plays a role in sexual health and urinary control.

What does a pelvic floor clinic for men and women involve?

When you come in for an assessment, whether you’ve been referred by a doctor or you’re seeking help on your own, we conduct a comprehensive evaluation.

This practical assessment includes examining your strength, movement, and posture, both standing and sitting, as well as assessing your lifestyle. We’ll also review your family history for any instances of cancer, as this can be an important factor in your overall health assessment.

Based on our findings, we may prescribe a tailored combination of treatments. This could include a range of exercises aimed at building strength, manual therapies such as massage, passive and active stretches, and aided stretches, alongside relaxation and breathing exercises.

We also incorporate educational elements so you understand your condition better.

If you’re suffering from any pelvic floor symptoms or want more information, why not come to a Pelvic Floor Clinic at K.

• If you’re worried about your symptoms, speak to your GP about possible treatments. (Don’t have a GP?)
• If you’re suffering from any pelvic floor symptoms or want more information, why not come to a Pelvic Floor Clinic at King Edward VII’s Hospital