by Ashley Newton, PT, DPT
Immediate disclaimer: when I am referring to “male pelvic health”, I am specifically referring to the health of those folks who have a penis and biologically male anatomy. Folks that do not identify as male can and do have male anatomy and need this info too!
So, the male anatomy has a pelvic floor?
Yes! If you have a pelvis, you have a pelvic floor which means that there is opportunity for that pelvic floor to be dysfunctional. The male pelvic floor has two fewer muscles than the female pelvic floor and the prostate. But otherwise, the muscular anatomy is largely the same. Believe it or not, male and female anatomy has the same amount of erectile tissue!
So, why don’t we as a culture talk about it?
Honestly, this is multi-factorial, but put simply I don’t think our culture focuses on male pelvic health in a way that is holistic and informed. Make pelvic health is often only focused on through the lens of sexual functioning and the treatment that is most widely known is medical. It is rare, in my experience, that males have knowledge of the sexual health cycle and the intersection of pelvic floor and the central nervous system in sexual functioning. This is not to mention that the other functions of the male pelvic floor are largely ignored or misunderstood.
What do people with male anatomy need to know about the pelvic floor?
First and foremost they need to know that they have one and where it is! Next, folks need to be able to identify when their pelvic floor may have an issue. Common diagnoses associated with male anatomy that can indicate pelvic floor dysfunction include, but are not limited to, the following:
- Erectile dysfunction
- Spraying with urination
- Dribbling ejaculate
- Abdominal separation/diastasis recti
- Tailbone pain
- Rectal pain/burning
- Pain with orgasm/difficulty achieving orgasm
- Groin pain
- Testicular pain
- Penile pain
How can people with male anatomy help their pelvic floor?
- Stop holding your breath when you lift! True, when the breath is held and Valsava maneuver performed, this does generate more pressure in the abdomen and allows one to generate more force to lift, but it is so unsafe for the heart and pelvic floor! Holding the breath puts excess pressure down onto the pelvic floor and pressure on the heart and abdomen. Over time, this could predispose someone to abdominal separation, hernia, and other pelvic problems. So always, always, always EXHALE if you are going to lift something heavy.
- Stop straining to poop! This puts one at risk of hemorrhoids and anal fissures which can be very painful! Instead, exhale and make the belly big and hard to push out the stubborn poop! This allows you to use the lengthening of the abdominals and pelvic floor to safely propel the stool. Also, use that Squatty Potty as long as you don’t have orthopedic precautions that prevent you from having your hips at 110 degrees!
- Don’t believe everything you read! If you are having problems with sexual functioning, you are not alone and it is not normal. It is not a normal consequence of aging and it is not something you need to “just deal with”. Sexual functioning is multifaceted and requires the health of the nervous, cardiovascular, and musculoskeletal systems especially. Your health is in your hands and if you have any of the problems listed above, the pelvic floor could be partially to blame!
- Make sure you are breathing into your rib cage. Breathing with the shoulders can create abnormal tension in the front of the body and pelvic floor. Poor rib movement means the thoracic diaphragm and pelvic floor aren’t moving well together. Thusly, they will not function as well. The pelvic floor is responsible for sexual functioning, stability, support of abdominal contents, pumping of blood and lymph fluid, and sphincteric function at the level of the rectum and urethra. Poor breathing mechanics translates directly to poor core health and the potential for pelvic floor dysfunction.
- Make sure your hip strength is balanced. On leg day, do you just work the hip flexor? Do you even have a leg day? Make sure that you are incorporating stabilization exercises in all hip planes – adduction, abduction, internal rotation, external rotation, extension, and flexion. A well-balanced hip means good mobility and good load transference of the leg to the pelvis. This prevents tightness and overloading of tissues and healthy core functioning.
If you suspect you may have pelvic floor dysfunction, pelvic floor physical therapists are here to help! And if you are in the Princeton area, come visit me at Activcore Pelvic Health Center!