Do men have pelvic floors?

While men may not have as many organs to hold up, they certainly have a pelvic floor. In men, the pelvic floor muscles and ligaments are responsible for keeping the bladder, bowel, and prostate in place. While pelvic organ prolapse is not so common in men, up to 16% of men may suffer from pelvic floor dysfunction. Luckily, pelvic floor physical therapy and other treatments can help.

"Up to 16% of men may suffer from pelvic floor dysfunction"

What is pelvic floor dysfunction?

Pelvic floor dysfunction is an all-encompassing term for issues associated with abnormal function of the pelvic floor muscles and ligaments. It occurs when pelvic floor muscles are contracted and can't properly relax or coordinate movements responsible for urinating and bowel movements. This may coexist with other conditions, including urinary dysfunction, erectile dysfunction, and prostatitis.

Some causes of pelvic floor dysfunction may be prolonged sitting, a traumatic injury, such as a bicycle or car accident, over-straining the muscles by pushing too hard when using the bathroom, pelvic surgery, being overweight, or advanced age. In response to these stressors or injuries, the pelvic floor muscles tighten. This hypertonic state then causes pain and other uncomfortable symptoms. Some of these symptoms may be:

Difficulty starting a urine stream or the feeling of incomplete emptying
Urinary frequency/nocturia (frequently getting up at night to urinate)
Low or weak urine flow
Pain while sitting, or the feeling of “sitting on a golf ball or rock”
Pain in the scrotum, perineum, testicles, and/or groin
Rectal pain or pain that wakes you up at night (Prostatic Fugax)
Pain during or after a bowel movement or urination
Difficulty keeping an erection
Constipation

For treatment, a pelvic floor physical therapist will focus on releasing the tension in these muscles. The best access to the pelvic floor muscles is intrarectally, or through the anus. Other options are bowel and bladder retraining or muscle relaxants. Additionally, some good ol’ self-care can help! Try yoga, stretching, and taking a warm bath to relax those tightened muscles. And remember to avoid straining when using the bathroom. If you or someone you know is experiencing these symptoms, get them checked out! There's no need to live with discomfort or pain.

What about Kegel exercises?

Firstly, Kegel exercises aren't recommended as a treatment of pelvic floor dysfunction. But, that doesn't render them useless for men. Kegel exercises can help improve bladder control and possibly improve sexual performance. Kegel exercises may be an important tool in preventing or treating urinary and fecal incontinence. So, if you're experiencing dribbling after you've left the bathroom, then Kegel exercises may be the way to go. They can also be vital in strengthening the pelvic floor after surgical removal of the prostate gland.

"Kegel exercises can help improve bladder control and possibly improve sexual performance."

How to do Kegel Exercises

To find the right muscles, try stopping urination midstream or try to tighten the muscles that hold in gas. These are your pelvic floor muscles. You can practice strengthening them anytime by contracting for three seconds, then relaxing for three seconds. Don't tighten your thighs or buttocks. The goal is to isolate the pelvic floor muscles. Repetition is key, as it takes between a couple of weeks to months to see results. Try aiming for three sets of ten repetitions per day. If you're having trouble with dribbling after you've left the bathroom, try doing a set after you urinate to get those last drops out.

"If you're having trouble with dribbling after you've left the bathroom, try doing a set after you urinate to get those last drops out."

It might be easier to start in a lying-down position, but as you get better at it you can do it while sitting, standing, or walking. Start slow, and increase repetitions over time. Try incorporating Kegel exercises into everyday activities and remember to breathe!

If you're having trouble, or you want to make sure that you're doing it correctly, ask for help. Your doctor or physical therapist can provide you with feedback to be certain that you're training the right muscles. Biofeedback training is another option, where a probe is inserted to monitor your muscle contractions. This is especially useful for people with fecal incontinence.

In conclusion, yes, men do have pelvic floors. Though prolapse is possible (and preventable with Kegel exercises!), pelvic floor dysfunction is a more common issue for men. So, while Kegel exercises are an important tool for strengthening, remember to properly relax those muscles as well.

Article written by

Dama Awadallah, Medical Doctor

Research assistant for the Mary S. Easton Center for Disease Research

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