Did you know pelvic floor physiotherapy can also help males (designated at birth)?

Although still perceived as a taboo, pelvic floor problems in women are getting to be more known and more widely discussed in our society. Particularly during and after pregnancy, it is common to hear women talking about the importance of checking and taking care of their pelvic floor health. However, for many men the mere notion of having a pelvic floor is often unheard of.

Everyone with a pelvic floor, regardless of the biological anatomy, gender and sexual orientation, or identity, should be aware that pelvic conditions exist and can often be treated.

Male designed pelvic floor anatomy: where and how?

The male designed pelvic floor is located at the bottom of the pelvis and has three main functions:

1.     Sexual function – it promotes and maintains erection and helps with orgasm

2.     Continence – it helps to prevent leaking of urine and stools. Additionally, the pelvic floor has to be able to voluntary relax so the bladder can empty and the urethra can relax.

3.     Support – the pelvic floor supports the pelvic organs (bladder, prostate and rectum) in the pelvic cavity  

Pelvic floor physiotherapy can help if there are any issues with these functions.

Sexual function problems

An erection is complex phenomenon that results from the coordination of several body systems such as the neural, endocrine, psychological, neurovascular, immune and muscular systems.

A healthy pelvic floor is designed to help the blood flow into the penis and, once this pressure increases to a level when the firmness of the tissues is sufficient, a muscle known as the bulbospongiosus is designed to contract. This phenomenon assures the maintenance of an erection. Moreover, the pelvic floor has a crucial role during ejaculation and orgasm via producing rhythmic contractions and relaxations.

If the harmonious system that assures a healthy sexual function gets impacted in any way (such as in the present of a hypertonic pelvic floor), the sensitivity of the tissues, as well as the quality of the erection and orgasm, can be impacted. Common complaints are flaccid erections, early ejaculation and pain during erection and ejaculation or orgasm.

Bowel and anal pain

Although it isn’t widely spoken of, male designed bodies can also have pain in the pelvic area. The pelvic floor has links to the abdomen, the lower back, the pelvic bones and the hips. It works like a bowl for the organs above it and, due to its location, if for any reason it develops a poor coordination it can also impact your bowel function.

The pelvic floor is originally designed to relax during defecation. The posture we adopt as well as the way we help the stools to move through the rectum during defecation are crucial for a healthy bowel function. Pelvic floor physiotherapists can greatly help improving the defecation dynamics.  

Common complaints from patients with poor pelvic floor coordination are pain before, during and after defecation and a history of repeated hemorroids and anal fissures. Moreover, pain in the base of the penis or anus while sitting is also a common complaint.

*Note: a change in the curvature of the penis (such as what occurs in Peyronie’s disease) can also be a source of penile pain. Pelvic floor physiotherapy has been shown to have a role in helping to decrease the pain levels and decrease penile curvature.

Continence

Perhaps the most known function of the pelvic floor muscles is its role in continence. A healthy pelvic floor muscle when it voluntary relaxes, allows for complete emptying of the bladder, urethra and bowel / rectum. On the other hand, when the pelvic floor muscles voluntary contract, they prevent leaking of urine and stools. The pelvic floor can be impacted by many conditions and even ageing. A pelvic floor that is “tighter” can be linked with conditions such as overactive bladder and increased urinary urgency (this is a feeling you may get when you suddenly have to go to the toilet and you aren’t able to defer this feeling).

Problems with leaking can also be a result of other pelvic conditions such as constipation. This is the reason why during the initial appointment with a pelvic physiotherapist patients are asked many questions regarding their bowel, bladder and sexual function. Moreover, it is crucial to understand the past and current history since they can have an impact on the outcomes and therapy choice.

Common complaints from patients with pelvic floor problems that impact continence are leaking after emptying the bladder or during activities, constant or sudden feeling of wanting to empty the bladder, difficulties in starting to void / relax the urethra, leaking stools, smearing the underwear, among others.

A note about pelvic floor physiotherapy for during and after prostate / urologic cancer treatment

Prostate and bladder cancer treatment can have a great impact on pelvic health. Pelvic floor physiotherapy can help prepare for surgery as well as help with the side effects after surgery and during and after adjutant therapy such as radiation therapy, chemotherapy and hormone therapy.

These treatments often can have a great impact in the continence mechanisms and sexual function. Pelvic floor physiotherapy can help male designed bodies to improve continence and sexual function via pelvic floor strengthening / coordination as well as helping with gadgets and tools and finding new ways to promote erection and sexual function along with your health professional team.

Know that despite having had treatment for cancer, the pelvic floor and the urethra can compensate up to some degree in the pressure mechanisms that assure your continence and sexual function. Research has shown that pelvic physiotherapy can be highly beneficial for those during and after prostate cancer treatment.

Pelvic floor physiotherapy is designed to help everyone who has a pelvic floor regardless of gender, age, sexual orientation and sexual identity. A healthy pelvic floor is designed to work at ease, without the need of much brain activity. If you find yourself straining for emptying the bladder or bowel, have difficulties with creating or maintaining an erection or if you feel pain during sex or emptying the bladder or bowel, there is chance that your pelvic floor may be having an impact in your problem.

If you have any concerns about your pelvic floor, reach out to aline@thepelvictuner.com or book your appointment in Lawson Physiotherapy and Pilates or Blackheath Physiotherapy and Pilates.

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