Reviewed by Jill Johnson, FNP
Written by Our Editorial Team
We’re all familiar with the biceps, pectorals and other major muscle groups that make up our bodies. But behind the scenes, numerous other unseen groups of muscles play vital roles in helping us complete a diverse range of bodily functions.
One such group of muscles can be found on your pelvic floor. The pelvic floor muscles play a key role in regulating your ability to control urination and bowel movements, meaning they’re less visible than your superficial muscles, but arguably much more important.
When your pelvic muscles can’t properly relax or coordinate, it’s generally referred to as male pelvic floor dysfunction.
Male pelvic floor dysfunction is a serious issue that can have a real impact on your wellbeing and quality of life. Luckily, it’s usually treatable with a combination of physical therapy, simple changes to your habits, biofeedback and medication.
Below, we’ve explained what male pelvic floor dysfunction is, as well as the specific symptoms you may experience if you’re affected.
We’ve also discussed the potential causes of this type of pelvic floor dysfunction and covered the most effective treatments for strengthening your pelvic floor, restoring optimal function and improving your quality of life.
Pelvic floor dysfunction is a term that refers to a range of disorders that can affect the muscles in your pelvic area. These disorders generally occur when the muscles or connective tissue in your pelvis is injured or gradually weakens over time.
To understand what pelvic floor dysfunction is and how it can affect you, it’s important to quickly go over the basics of your pelvic floor anatomy and its function.
The term “pelvic floor” refers to the muscles that span across the floor of your pelvis in a shape similar to a hammock. These muscles hold and provide support to your pelvic organs, such as your intestines, rectum, bladder and urethra.
In women, the pelvic floor also contains the organs that support and sustain fetal growth, such as the uterus and vagina.
Many of the pelvic floor muscles are involved in controlling your ability to urinate and defecate (essentially, to go to the bathroom) on demand. They also play a key role in holding the pelvic organs firmly and securely inside your body.
When your pelvic floor muscles weaken, this may affect your ability to control your bladder and bowel movements. In women, it may also cause pelvic organ prolapse — an issue in which one of the pelvic organs loses support and descends from its normal position.
Male pelvic floor dysfunction can cause a range of symptoms related to your ability to urinate and defecate. In some cases, changes to your pelvic floor musculature can even affect your sexual health and function.
For lots of men, the most obvious pelvic floor dysfunction symptoms are related to control over urination. If you have a pelvic floor disorder, you may:Notice that it takes a long time to start urinating
Find it difficult to urinate, even when “pushing” with your muscles
Experience urinary incontinence (involuntary urinary leakage)
These symptoms can vary in severity. For example, you may notice that you leak a tiny amount of urine when you do something that puts pressure on your muscles, such as laughing strongly, coughing or exercising.
Pelvic floor dysfunction can also cause issues related to defecation, or bowel movements. If you have a pelvic floor issue, you may:
Feel bloated and uncomfortable
Experience constipation (finding it difficult to pass stool)
Have fecal incontinence (inability to control your bowel movements)
Pelvic floor muscle dysfunction can also cause other issues unrelated to your urinary continence or bowel movements. For example, you may develop pelvic pain, muscle spasms or bulging that occurs in the perineal muscles between your penis and buttocks.
Although scientific research on the link between pelvic floor muscle function and sexual health is limited, some evidence also suggests that pelvic floor dysfunction may play a role in some forms of sexual dysfunction.
In fact, one study published in the journal Scientific Reports in 2021 found that men with erectile dysfunction were more likely than their peers to display signs of low levels of pelvic floor muscle strength.
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Experts aren’t aware of precisely what causes pelvic floor dysfunction to develop, but they have identified certain risk factors and events that may cause the pelvic muscles to lose some of their function.
These include obesity, certain types of surgery, abnormalities in connective tissue proteins such as collagen, smoking and injuries that affect the pelvic area. In women, pregnancy and childbirth can also play a role in pelvic floor dysfunction.
Although male pelvic floor dysfunction isn’t uncommon, pelvic floor issues are more common in women than in men. In fact, research suggests that up to 50 percent of childbearing women will experience pelvic floor dysfunction at some point in life.
Pelvic floor dysfunction can be extremely frustrating to deal with, as even fairly mild pelvic floor symptoms can have a serious negative impact on your self-confidence and quality of life.
The good news is that pelvic floor dysfunction is treatable, usually with a combination of healthy habits, biofeedback, medications, relaxation techniques and targeted pelvic floor exercises that can enhance your muscle function.
If you think you might have pelvic floor dysfunction, your first step should be talking to a licensed healthcare provider. You can do this by either talking to your primary care provider or scheduling an appointment with a urologist (a specialist in the urinary tract and male reproductive system).
Your healthcare provider may ask you about your symptoms and medical history. You may need to tell them about any infections you’ve had in your urinary tract, injuries to your pelvic region or lower body, or other issues that could play a role in pelvic floor pain and dysfunction.
They may also carry out a physical exam to check your pelvic muscle function. In some cases, your healthcare provider may need to give you a digital rectal exam to check the function of your sphincter and pelvic muscles. This type of exam is usually quick and painless.
To determine the cause of your pelvic floor dysfunction and select the most appropriate form of treatment, your healthcare provider may perform one or several additional tests.
Common tests for pelvic floor dysfunction include:
Electromyography (EMG). This type of test uses external electrode pads to check your pelvic muscle function. Your healthcare provider might use this type of test if you prefer not to have an internal examination of your pelvic floor structures.
Anorectal manometry. This measures pressure within your anal canal and the function of your anal sphincter muscles. Your healthcare provider might perform this type of test if you have issues related to anal pain or anal incontinence.
Defecography. This test involves imaging tools to measure anal continence and detect issues related to defecation. It can help to identify issues with your pelvic muscles that may affect you from going to the toilet comfortably.
Urodynamics (uroflow test). This test measures the function of your urethral sphincter (the muscle structure that controls the flow of urine). It can help to detect problems that may stop you from urinating, storing urine or controlling urination.
Make sure to closely follow your healthcare provider’s instructions and tell them if you have any questions about the tests used to diagnose pelvic floor dysfunction.
Based on the type and severity of your pelvic floor dysfunction, your healthcare provider might suggest treatment options such as biofeedback and at-home pelvic floor exercises, changes to your lifestyle or taking medication to control your symptoms.
Pelvic floor muscle exercises, or kegel exercises, are simple but effective exercises that develop your pelvic muscle strength and improve your level of control of your bladder and bowels. Your healthcare provider may recommend these exercises in addition to other lifestyle changes.
Before you can do pelvic floor exercises, you’ll need to be able to identify the correct muscles to train. One common method for identifying these muscles is to stand in front of the toilet and start urinating, then tighten your pelvic floor muscles to stop the flow of urine.
When you do this, you should feel your bladder and external sphincter muscle tighten, stopping the flow of urine. Do not repeat this, as this is simply an exercise to identify the correct muscles, not to train them.
Another option for identifying and monitoring pelvic muscle activity is biofeedback. This type of training is performed in a healthcare provider’s office and involves the use of electrodes placed on your skin or inside your anus to measure the effects of pelvic floor muscle exercises.
Your healthcare provider may recommend a combination of in-office biofeedback treatment and at-home pelvic floor muscle exercises.
To train your pelvic floor muscles at home, start by emptying your bladder. In a seated position or lying down, tighten your pelvic floor muscles and hold them in a tight, firm position while you count to ten. Then, relax the muscles and count to 10 again.
You can repeat this process for 10 repetitions three times per day to gradually strengthen your anus and bladder muscle fibers over time. Many people notice improvements in their ability to hold in urine or control bowel movements after four to 12 weeks.
Avoid performing these exercises more than the recommended amount, as this may contribute to muscle fatigue and worsen your symptoms in the short term.
If you experience any pain or discomfort while performing pelvic floor exercises, it’s important to inform your healthcare provider.
Our detailed guide to pelvic floor training for men provides more information about the potential health and sexual function benefits of pelvic floor exercises.
Some habits and changes to your lifestyle may help to reduce the severity of urinary and fecal incontinence, as well as other symptoms of pelvic floor muscle dysfunction.
Try the following habits for better pelvic floor muscle function and quality of life:
Limit your intake of alcohol. It’s best to either limit your alcohol intake or try to avoid alcohol if you have noticeable symptoms of pelvic floor dysfunction. If you must drink, do so responsibly by limiting your consumption to as little as possible.
Avoid caffeinated beverages. Coffee, tea, soda, energy drinks and other beverages that contain caffeine could aggravate some colorectal symptoms of pelvic floor issues by increasing your need to use the bathroom.
Other beverages that could stimulate your bladder include citrus fruit drinks and drinks that contain artificial sweeteners. Try replacing these with good old-fashioned water.
If you’re overweight, try to lose weight. Even a small reduction in your weight — for example, three to five percent — may reduce the severity of urinary incontinence by as much as 50 percent.
Try increasing your fiber intake. If you have constipation as a result of a pelvic floor muscle issue, try increasing your fiber intake. A diet that’s rich in fiber helps your body with digestion, which can make passing bowel movements easier.
Good dietary sources of fiber include whole grains, vegetables, fresh fruits, beans and lentils.
Stay physically active and focus on core exercises. Exercises that strengthen your abdominal muscles, such as crunches, planks and supine toe taps, may also improve your pelvic floor muscle function.
Although there’s no medication that can strengthen your pelvic floor muscles, several common medications can provide relief from the symptoms of pelvic floor dysfunction.
If you have an overactive bladder that’s causing discomfort or affecting your quality of life, your healthcare provider may prescribe an anticholinergic medication or beta-3 agonist to limit your need to urinate. You may also be prescribed medication to control your bowel movements.
For short-term relief of accidental bowel leakage or constipation, over-the-counter drugs are a convenient and often effective option. These include:
Loperamide (Imodium®) for treating diarrhea and improving bowel control
Bulk-forming fiber laxatives such as Benefiber® and Metamucil® for softening stool
Make sure to talk to your healthcare provider before using any medications to treat pelvic floor dysfunction symptoms.
If you have pelvic floor dysfunction and erectile dysfunction, your healthcare provider may also prescribe ED medication such as sildenafil (the active ingredient in Viagra®), tadalafil (Cialis®) or avanafil (Stendra®) to improve your erections and sexual function.
Pelvic floor dysfunction can take a serious toll on your wellbeing, self-confidence and quality of life. Research suggests that it may also contribute to sexual health and performance problems, including erectile dysfunction.
If you’re experiencing common symptoms of pelvic floor dysfunction, it’s best to meet with your primary care provider.
If you have erectile dysfunction and think weak pelvic floor muscles could be involved, you can get help online with our range of erectile dysfunction treatments.
Finally, if you’re looking for ways to improve your sexual health and wellbeing, you can access simple but effective tips in our guide to habits for boosting your sexual performance.