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I Thought Only Females Had Pelvic Floor Muscles

Hi friends! Often in pelvic health we spend much of our time talking about the pelvic floor in individuals assigned female at birth, but did you know that those assigned male at birth have pelvic floor muscles, too? June is Men’s Health Month, so to celebrate we’re going to talk all about the male pelvic floor.


There is often an assumption that only females have pelvic floor muscles because females are more likely to have dysfunction and symptoms. While it happens less frequently than women, men often suffer from many of the same issues like urinary incontinence, constipation, pain, and sexual dysfunction.


Let’s take a brief look at male anatomy. The male pelvic floor muscles still sit at the base of the pelvis and span from the pubic bone in the front and the tailbone in the back. Males do not have a vaginal canal, but they have a prostate (a large gland that makes secretions for sperm) that sits underneath the bladder.

Both males and females have a urethral canal (where pee leaves the bladder to exit the body) but the male urethra is much longer in length.


The male pelvic floor muscles help to achieve and maintain an erection during intercourse and help to promote ejaculation.


Even though there are differences, males still have a pelvic floor (made of up many of the same muscles and ligaments as women) that support their pelvic organs and controls peeing, pooping, and sexual function.


When the pelvic floor muscles aren’t working properly, we can start to see the same issues many women experience. The pelvic floor muscles might be weak, tight, or have trouble doing the right thing at the right time.


Pelvic Pain

Just like women, men can suffer from chronic pelvic pain, sometimes called “chronic prostatitis.” (Davia, 2014) These can lead to urination problems, sexual dysfunction, and depression(Davia, 2014).


It is important to see a healthcare provider if you are having pelvic pain because it can be a symptom of an underlying medical condition, like an infection.


Pelvic pain can be caused by, you guessed it: your pelvic floor muscles! Muscles in and around the pelvic floor can become tight and painful just like any other muscle in your body—the only difference is, we can’t see these muscles. But the good news is, these muscles can be treated and strengthened like the rest of our muscles.


Urinary Retention

Slow urine stream with weak flow? Need to strain to pee? These can all be signs of a condition called urinary retention. Urinary retention in males is can be caused by an enlarged prostate and/or pelvic floor muscles that have difficulty relaxing (Tanguay, 2009). Both of these can make it difficult for urine to pass from the bladder into and out of the urethra.


Incontinence After A Prostatectomy

1 in 7 men is diagnosed with prostate cancer making it the second most common type of cancer in males. (Stallings Roscow, 2016). A radical prostatectomy is a common procedure that is used to treat prostate cancer. This surgery involves removal of the prostate and its cancerous tissue. While this surgery often has great outcomes for removing cancer, it often causes stress in incontinence (leaking with activities like sneezing, coughing, bending, lifting, position changes, and exercise) after surgery. Stress incontinence is the most common side effect after radical prostatectomy with up to 90% of patients experiencing it (Rahnama, 2021; Milios, 2019). Pelvic floor muscle training is the first treatment choice of incontinence (Rahnama, 2021).


Sexual Dysfunction

The pelvic floor muscles help with arousal, pleasure, and orgasm during sex. If they aren’t working properly, this can lead this can lead to erectile dysfunction, leaking urine with orgasm, premature ejaculation, and anorgasmia (lack of orgasm).

Pelvic floor muscle training can help with these problems. Studies have actually shown that having more orgasms may help you to live longer (Davey,1997; Friedman, 2011), so don’t wait to address these problems!


The good news for many of these conditions is that a pelvic floor therapist can often help! A pelvic floor therapist should do a comprehensive examination and give you a treatment plan that individualized to you.


As always, we are pelvic physical therapists, but we are not YOUR therapists. The information in this blog post is not meant to be used as medical advice and should be used for educational purposes only. Talk with your provider about any concerns you may have. Ask for a referral to a pelvic floor therapist near you, or find one at www.mypfm.com/find-a-pt.


To learn more about your pelvic floor muscles, check out these great resources:


For providers, join our Ambassador Program and most of our courses are included with your membership!

  • Does the Inabiltiy to relax pelvic floor muscles cause pelvic pain? with Dr. Susie Gronski, DPT, PRPC, WCS

  • Treating Chronic Prostatitis for Health Professionals with Dr. Susie Gronski, DPT, PRPC, WCS

  • Testicular Pain and Evaluation with Sarah Prestegard, PT, DPT

  • Treating Erectile Dysfunction: Guidance for Health Professionals with Dr. Susie Gronski, DPT, PRPC, WCS

  • Treating Premature Ejaculation: Guidance for Health Professionals with Dr. Susie Gronski, DPT, PRPC, WCS


Written by Emily Reul, PT, DPT


References

  1. Davey Smith G, Frankel S, Yarnell J. Sex and death: are they related? Findings from the Caerphilly Cohort Study. BMJ. 1997 Dec 20-27;315(7123):1641-4. doi:10.1136/bmj.315.7123.1641

  2. Davia J, Welty A. Manual therapy and education for physical therapy management of male chronic pelvic pain syndrome. J Womens Health Phys Therap. 2014;38(1)3-10. DOI: 10.1097/JWH.0000000000000007

  3. Friedman HS. The Longevity Project: Surprising Discoveries for Health and Long Life from the Landmark Eight-Decade Study. Hudson Press; 2011.

  4. Milios JE, Ackland TR, Green DJ. Pelvic floor muscle training in radical prostatectomy: a randomized controlled trial of the impacts on pelvic floor muscle function and urinary incontinence. BMC Urology. 2019;19:116.

  5. Rahnama MS, Marcelissen T, Geavlete B, Tutolo M, Husch Tanja. Current management of post-radical prostatectomy urinary incontinence. Frontiers in Surgery. 2021;8:1-10. doi: 10.3389/fsurg.2021.647656

  6. Stallings Roscow A, Borello-France D. Treatment of male urinary incontinence post-radical psotatectomy using physical thearpy interventions. J Womens Health Phys Therap. 2016; 40(3)129-138. DOI: 10.1097/JWH.0000000000000064

  7. Tanguay S, Awde M, Brock G, Casey R, Kozak J, Lee J, Nickel JC, Saad F. Diagnosis and management of benign prostatic hyperplasia in primary care. Can Urol Assoc J. 2009; 3(3 Suppl 2): S92-‐‐S100.

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