“Kegels” and pelvic floor exercises are usually associated with “women’s stuff” — think pregnancy, childbirth, and menopause. But men also have pelvic floor.
Just like women, at various times in their lives, men can benefit from pelvic floor training to address a variety of health concerns. About 30% of men who visit the doctor have urinary incontinence, or loss of urine, but the vast majority do not mention it. About 15% of men also experience fecal incontinence or bowel leakage, and take longer to seek help therefore compared to women.
The pelvic floor muscles are also involved in sexual function. Erectile dysfunction It affects around 10% of healthy men and up to almost 40% of men with chronic health problems, and can be associated with pelvic floor problems.
People sometimes assume these problems are just a normal part of aging; but common does not mean inevitable. Much can often be improved with a few simple strategies, including pelvic floor rehabilitation.
Pelvic floor dysfunction in men is very common
Although pelvic floor problems are more common in womenone in eight men have problems with your pelvic floor, bladder, or bowel.
The pelvic floor is a group of muscles that cover the base of the pelvis. For men, this supports the bladder, the prostate and the intestine. It is essential for maintaining core stability, bladder and bowel control, and for erectile function and sexual satisfaction.
Most men have little reason to think about their pelvic floor for most of their lives, until something medically goes wrong (compared to women, who tend to start with pelvic floor exercises much younger, often in the context of pregnancy and childbirth). .
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why it happens
Risk factor’s for incontinence and pelvic floor problems in men include aging, prostate problems, pelvic surgery, intestinal problems including constipation, chronic cough, frequent heavy lifting, and being overweight.
Prostate cancer affects up to 15% of men and is the second most common cancer in men (and the fourth most common cancer overall).
The largest source of pelvic floor physical therapy referrals for men tends to be in the context of prostate surgery. This is because surgery on the prostate gland (which is very close to the base of the bladder) causes trauma to nearby structures and nerves that maintain bladder control and erectile function.
However, we know that early pelvic floor training (starting pre-op) means post-op side effects like incontinence. resolve more quickly.
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How can men exercise their pelvic floor?
To engage the pelvic floor, the sensation should be like a squeeze, lift, and release of the muscles between the pubic bone, tailbone, and sit bones. Some popular signs include visualizing:
- stop the midstream of urine (but i’m not actually doing this)
- holding in the wind
- retraction of the penis/testicles
- pulling the perineum (the skin between the genitals and the anus) away from the underwear.
It is important to ensure that the abdominal, gluteal (buttocks) and thigh muscles remain relaxed, holding your breath at all times.
The exercises can be performed in any position and, if done correctly, should be able to be performed discreetly (even when other people are around!). But it is quite common to find the exercises difficult to do without some training.
Work with a health professional such as a pelvic floor physical therapist may be beneficial Physical therapists trained in men’s health and pelvic floor conditions will teach clients how to perform the exercises correctly. They often do this with biofeedback devices, such as real-time ultrasound images, which can help identify the correct muscles to use and refine technique.
Not all pelvic floor problems require further strengthening. Optimal muscle function requires good strength, but also correct timing, coordination, and relaxation.
An overly tight pelvic floor can be problematic for both men and women and can contribute to symptoms of pelvic or genital pain, sexual dysfunction, urinary problems including overactive bladder, and bowel problems.
Your specific concerns will inform how your physical therapist may prescribe exercises, but good goals to aim for are to be able to:
- turn pelvic floor on and off 10 times in 10 seconds
- hold hard 10 seconds, repeated 10 times
- hold an easy hold for 1 minute.
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If I don’t have pelvic floor problems, do I need to exercise?
Just as a good fitness program keeps you in optimal physical health and helps prevent injury, it stands to reason that a regular pelvic floor training routine will help combat the likelihood of bladder, bowel, and erectile dysfunction. However, the literature is sparse for preventive use in asymptomatic men.
Knowing where your pelvic floor is and how to exercise it correctly can never be a bad thing, and training might even have some happy side effects, like reduced waking at night with the need to urinate, reduced postvoid dribbling, better bowel emptying, and improved sexual satisfaction.
If you are not sure if pelvic floor exercises are right for you or if you are doing them correctly, consult a trusted health professional.
