Women’s health often garners significant attention, but when it comes to pelvic health, men are increasingly finding themselves in the spotlight. While women’s pelvic health has been extensively researched and discussed, men’s pelvic health is only now beginning to receive the attention it deserves. According to Dr. Shan Morrison, a specialist pelvic health physiotherapist, the understanding of men’s pelvic health has been limited for years. “For a long time, we just applied what we knew about women to men, and that did not work. There are similarities but there are differences,” she explains.
The pelvic floor, a group of muscles lining the base of the pelvis, plays a crucial role in men’s bowel, bladder, and sexual function. Despite its importance, the topic remains somewhat taboo. “It’s not dinner table conversation to talk about a bladder problem or pain in your penis,” Morrison notes. This cultural reticence has led many men to suffer in silence, often delaying seeking medical support.
The Importance of Pelvic Health for Men
Research into men’s pelvic health has gained momentum over the past 15 years. Dr. David Cowley, a men’s health clinical stream leader at Active Rehabilitation Physiotherapy, highlights that prostate cancer, which accounts for about 28% of cancers diagnosed in males, is a significant risk factor for pelvic health issues. “Pelvic floor health is also important for general wellbeing, which can be maintained with simple exercises,” Cowley advises.
Pelvic floor muscle training can improve erectile function and prevent urinary issues. Cowley adds, “If their bowel movements aren’t as good as they could be or they’re prone to things like hemorrhoids, then looking after pelvic health care can prevent those conditions from progressing into anything more serious.”
Recognizing the Signs of Pelvic Floor Dysfunction
Pelvic floor dysfunction affects about one in eight men, with common symptoms including urinary or fecal incontinence and erectile dysfunction. Dr. Morrison and Cowley identify chronic pelvic pain syndrome (CPPS) and post-prostatectomy incontinence as the most frequent conditions treated in their clinics.
CPPS affects approximately 7.8% of Australian men and is often referred to as the “black hole of men’s health” due to the lack of scientific research and understanding.
Prostate cancer treatments, such as prostatectomy, often lead to incontinence, a side effect many men are unprepared for. “Men aren’t used to wearing pads, and often there’s not a place to dispose of them in toilets,” Morrison explains. However, emerging research indicates that preoperative muscle training can significantly reduce post-operative symptoms and enhance rehabilitation.
Understanding the Causes and Seeking Treatment
Stress is a leading cause of pelvic floor issues, as it can activate the fight or flight response, causing muscle tension. “The pelvic floor muscles, interestingly, are one of the first ones that get tension in them,” Morrison notes. In the United States, there has been an increase in referrals for pelvic floor issues from men in high-stress jobs, such as those on Wall Street.
Morrison emphasizes the importance of considering both psychosocial and physical factors when assessing pelvic health issues. “We will look at the whole person, and see if their nervous system’s contributing, their thoughts and feelings, and what’s happening in the world around them,” she says. Overtraining with weights may also contribute to problems, though data on this is limited.
The key message for men experiencing pelvic health issues is to seek help. “These problems don’t normally get better by themselves,” Morrison advises. Fortunately, many issues can be resolved with non-invasive treatments. Cowley recommends exercises that involve visualization and muscle engagement, such as imagining drawing the penis in or stopping and starting the flow of urine without actually urinating.
As awareness and research into men’s pelvic health continue to grow, the hope is that more men will feel empowered to address these issues, leading to improved health outcomes and quality of life.
