Your pelvic floor is kinda like plumbing: you never really think about it unless there’s something wrong. Although we don’t pay much attention to our pelvic floor muscles, they make everyday bodily functions possible.
Much like the pipes that run through your home, your pelvic floor muscles can’t be seen on the surface, but they’re incredibly important. They support your pelvic organs — think your intestines, reproductive organs and bladder — and ensure that those organs function properly.
Because of this, pelvic floor dysfunction in men could cause erectile dysfunction, incontinence, pelvic pain and more.
So while these muscles aren’t exactly ones you’ll be flexing in front of the mirror in the weight room, your pelvic health certainly shouldn’t be ignored. Let’s discuss your pelvic floor muscles, the symptoms of pelvic floor dysfunction and some ways to keep these muscles as healthy as possible.
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First, if you’re not sure what your pelvic floor is or does, here’s a quick biology refresher. Your pelvic floor muscles provide support to the organs in your pelvis, including your intestines, bladder and urethra. These muscles span across the floor of your pelvis in a hammock-like shape.
You know the muscles you’d clench if you were trying to stop yourself from urinating mid-stream? Those are your pelvic floor muscles. (You’re squeezing them now, aren’t you?)
You use this group of muscles throughout the day, mostly without even realizing it. Whenever you go to the bathroom, your pelvic floor muscles help you control the flow of urine, as well as your bowel movements.
Pelvic floor dysfunction — or PFD — is a term for a variety of disorders that affect the muscles in your pelvic floor. If the connective tissue or muscles in your pelvis weaken over time or get injured, it can lead to pelvic floor problems like incontinence.
The male pelvic floor also plays a role in penile health, so pelvic floor dysfunction may lead to sexual health issues like erectile dysfunction and ejaculatory disorders.
So basically, pelvic floor health is a really important part of men’s health — which is why it’s important to keep an eye out for the signs of pelvic floor dysfunction, and to seek medical advice if you think you’re experiencing any of these issues.
Pelvic floor dysfunction can affect one or more of your pelvic organs.
Common symptoms of pelvic floor dysfunction in men include:
Difficulty urinating, even when trying to “push” with your muscles
Urinary incontinence (involuntary urinary leakage), especially when coughing, sneezing or exercising
Fecal incontinence (inability to control your bowel movements)
Difficulty controlling gas
Chronic pelvic pain
Bulging in the perineum (between the scrotum and buttocks)
Although it’s rare, you may experience pelvic organ prolapse, which is when a pelvic organ moves out of place. Pelvic organ prolapse in men usually affects the rectum, causing it to protrude out of the anus.
You might also experience sexual issues, including erectile dysfunction or different types of ejaculatory dysfunction like:
Retrograde ejaculation, which is where semen flows into your bladder instead of through your urethra
Not every man with pelvic floor dysfunction will experience all of the above symptoms. For some men, the condition may mostly affect their ability to urinate, while others might primarily experience difficulty with bowel movements.
But as you can imagine, pelvic floor issues of all types can affect your quality of life. That’s why it’s a good idea to speak with a healthcare professional if you notice any signs of pelvic floor dysfunction.
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The causes of pelvic floor dysfunction aren’t well understood.
Experts know that weakened muscles and connective tissue in the pelvis can contribute to it, as can injuries to the pelvis.
There are also other risk factors for pelvic floor dysfunction, including:
Having had certain types of surgery
Regular or extreme heavy lifting
Women are more likely to develop pelvic health issues than men, since pregnancy and childbirth can be risk factors for pelvic floor disorders. In fact, women who give birth at least once have about a 50 percent chance of developing pelvic floor dysfunction.
So, how is pelvic floor dysfunction diagnosed?
Generally, you can make an appointment with a healthcare professional, like your regular primary care provider.
They’ll first start by asking you about your symptoms and medical history. Then, they may use a number of different tests to examine whether your pelvic floor is functioning correctly.
They might use:
A physical evaluation to check for muscle spasms, bulging muscles or weakness
A visual inspection of the bladder and urethra, known as a cystoscopy
Urodynamic testing to measure your ability to store and release urine
Anorectal manometry, a noninvasive procedure that which measures the strength of the anus and rectum
Electromyography (EMG), which is where electrodes are used to measure muscle response to stimulation
Your doctor might perform additional tests to confirm your diagnosis or look for other causes of your symptoms. These could include:
An endoscopy, where a tube with a small camera is put into your body. This could be a colonoscopy, sigmoidoscopy or anoscopy, all of which look at different parts of your digestive tract
MRI or CT scan of the abdomen and pelvic region
If necessary, you might be referred to another healthcare professional. For example, you may need physiotherapy or physical therapy to improve your muscle tone.
Pelvic floor dysfunction can have a big impact on your quality of life — but fortunately, there are a few different treatments available.
Contrary to popular belief, pelvic floor exercises aren’t just for women. Many men can also benefit from physical therapy for their pelvic muscles.
Also called pelvic floor muscle training, these exercises might help:
Improve urinary incontinence
Reduce erectile dysfunction
Provide relief from pelvic pain
Increase time to ejaculation in people with lifelong premature ejaculation
The good news is that even a few minutes per day of pelvic floor exercises can make a difference.
Kegel exercises are a popular type of pelvic floor exercise. This is how you do them:
Empty your bladder, and then locate your pelvic floor muscles — they’re the same muscles you’d use if you’re trying to stop urinating. When you squeeze those muscles, you’re activating your pelvic floor muscles.
Clench your pelvic floor muscles and hold them for five seconds.
Relax those muscles fully.
Repeat steps two and three 10 to 20 times, three to four times a day.
You can do a similar exercise using the muscles in your anus.
Pelvic floor muscle exercises are often done with biofeedback. Biofeedback uses special sensors to monitor how you relax and contract your muscles. This allows a healthcare professional to observe your muscles and instruct you on how to improve your coordination. Research shows that biofeedback is effective at helping with pelvic floor issues.
A pelvic floor physical therapist or physiotherapist can also advise you on how to continue your pelvic floor dysfunction treatment at home, whether it’s through Kegel exercises, lifestyle changes or other techniques.
A number of lifestyle changes can prevent and treat pelvic floor dysfunction. If you have difficulties with your pelvic floor, certain healthy habits can reduce the severity of your symptoms.
Try the following:
Stop or limit your intake of alcohol. Alcohol may increase bowel movements and urination, which can aggravate some symptoms of pelvic floor dysfunction.
Reduce caffeine. Like alcohol, caffeinated drinks can increase your need to use the bathroom.
If you’re overweight, try to lose weight. Research shows that obesity is a risk factor for pelvic floor issues, and that weight loss may improve your symptoms. A healthcare professional can advise you on safe ways to lose weight.
Increase your fiber intake. This can improve digestion and make your bowel movements easier. Fiber-rich foods include whole grains, vegetables, fruits, beans and lentils.
Keep exercising. Exercise has benefits for many aspects of your health, including your pelvic floor function. Physical training that targets your abs, core and lower back may improve your pelvic floor muscles.
Stay hydrated. In addition to benefiting pretty much all your bodily functions and organs, getting enough water will keep your bowel movements regular and make it easier to pass stools.
While these lifestyle changes can benefit your pelvic floor muscles, it may take a while before you notice an improvement. For best results, you might have to practice these healthy habits alongside regular pelvic floor exercises — and if necessary, medication.
We’d love to tell you that there’s a medication that strengthens your pelvic floor muscles, but sadly, that’s not the case.
With that said, there are some common medications that can improve the symptoms of pelvic floor dysfunction. Depending on your symptoms, you may have a few different treatment options.
For urinary incontinence, a healthcare provider may prescribe:
Anticholinergic medications, which target the neurotransmitters that control urination
Beta-3 agonists, which relax the smooth muscle in your bladder and reduce the urge to urinate
TofranilⓇ (imipramine), a tricyclic antidepressant, which may also relax your bladder
BotoxⓇ injections, to keep your bladder muscles from spasming
For issues with bowel movements (fecal incontinence), you may be prescribed:
Imodium® (loperamide) for treating diarrhea and improving bowel control
Medications containing diphenoxylate and atropine, like LomotilⓇ
Fiber laxatives to reduce constipation, such as Benefiber® and Metamucil®
If you’re experiencing erectile dysfunction, your healthcare provider may prescribe ED medication like:
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Lastly, if you’re experiencing premature ejaculation — which is the most common sexual dysfunction, by the way! — you can look into premature ejaculation treatments like sertraline or paroxetine. If neither of those medications are an option, our Delay Spray for Men and Clockstopper Climax Delay Wipes may help.
Although your pelvic floor muscles may not always be on the forefront of your mind, they play an important role in your overall well-being.
Your pelvic floor muscles are important. Pelvic floor dysfunction can affect your bowel movements, urinary continence and sexual function. In fact, pelvic floor dysfunction is associated with erectile dysfunction and ejaculatory conditions.
But pelvic floor dysfunction is treatable. To keep those muscles healthy, you can practice pelvic floor exercises. Lifestyle changes can also help with the symptoms of pelvic floor dysfunction — think exercising, staying hydrated and avoiding beverages that irritate your bowels.
There is no medication that strengthens the pelvic floor. But certain medications can help with the symptoms of pelvic floor dysfunction. For example, a healthcare practitioner might prescribe medications for bladder incontinence or erectile dysfunction medications if necessary.
Relief from pelvic floor dysfunction often starts with reaching out to a healthcare professional. When you’re ready to take that step, we can help connect you with a licensed practitioner.
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Dr. Martin Miner is the founder and former co-director of the Men’s Health Center at the Miriam Hospital in Providence, Rhode Island. He served as Chief of Family and Community Medicine for the Miriam Hospital, a teaching hospital of the Warren Alpert Medical School, from 2008 to 2018. The Men’s Health Center, under his leadership, was the first such center to open in the US. He is a clinical professor of family medicine and urology at the Warren Alpert Medical School of Brown University in Providence and has been charged with the development of a multidisciplinary Men’s Health Center within the Lifespan/Brown University system since 2008.
Dr. Miner graduated Phi Beta Kappa from Oberlin College with his AB in biology, and he received his MD from the University of Cincinnati College of Medicine. Upon receiving his MD, he completed his residency at Brown University. He practiced family medicine for 23 years, both at Harvard Pilgrim Health Care and in private practice.
Dr. Miner presently holds memberships in the American Academy of Family Physicians, the Rhode Island and Massachusetts Academy of Family Physicians, and the American Urological Association, and he is a fellow of the Sexual Medicine Society of North America. He is the former president of the American Society for Men’s Health and the current historian. He is the vice president of the Androgen Society, developed for the education of providers on the truths of testosterone therapy. Dr. Miner has served on the AUA Guideline Committees for erectile dysfunction, Peyronie’s disease, testosterone deficiency, and early screening for prostate cancer. He has served on the testosterone committees of the International Consultation on Sexual Medicine. He has presented both at the NIH and the White House on men’s health initiatives and has authored over 150 peer-reviewed publications and spoken nationally and internationally in multiple venues. He has co-chaired the Princeton III and is a steering committee member and one of the lead authors of Princeton IV, constructing guidelines for the evaluation of erectile dysfunction, the use of PDE5 inhibitors, and cardiac health and prevention.
Dr. Miner was chosen as the Brown Teacher of the Year in 2003 and 2007 and was recognized by the Massachusetts Medical Society’s Award as achieving the most significant contribution to Men’s Health: 2012.
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