Pelvic floor dysfunction in men is no different than in women and the old stereotype has to find its way out! From my experience, I see younger aged patients, gender neutral, with pelvic floor dysfunction and find our lifestyle and habits playing a huge role in the formation of pelvic instability, leading to pelvic floor dysfunction. At this juncture in my professional life and having been in practice for over 25 years I can comfortably say that blaming age for so many of our issues is simply a cop-out!! In this blog, we will look at the factors that are generally missed in the treatment of pelvic floor dysfunction.

While pregnancy is the number one blaming factor for pelvic floor dysfunction, then what happens to the cases involving men, women who have never been pregnant, young individuals, and women who have been pregnant but don’t have pelvic floor dysfunction? Clearly, We are mistaken and need to continue chasing the why behind the issue. 

To understand what pelvic floor dysfunction is we need to understand some basic information about the pelvis, pelvic floor, and the influencers of pelvic stability.

What Is The Pelvic Floor? 

If you think of your pelvis as a bowl with 2 holes (and their associated sphincters) to the outside (penis and anus), some muscles that line the inside of the bowl which are the pelvic floor muscles. I will spare you the names but let’s say that there are more than one or two and they are all involved when walking and any movement that involves the pelvis.

pelvic floor

men pelvic floor dysfunction

What Influences The Pelvic Floor In Men?

The pelvic floor is not suspended in the air and is influenced by all body parts that are connected to the pelvis itself.

  • Pelvis Influencers

Your hips, the joints of the pelvis called SI joint or sacroiliac joints and pubic symphysis, the lower back, the lower portion of the mid-back, as well as the connective tissues connecting the joints and to the pelvis all impact the integrity of the pelvic floor.

male pelvic floor dysfunction

  • Internal Organs

The pelvic floor is also influenced by the internal organs that are held in the “bowl”; which are the bladder, prostate, lower intestines, and bulbourethral glands, bearing in mind that their size and shape matter. For instance, an enlarged prostate can add more weight than the floor can handle. Over the course of time when coupled with a pelvic tilt (due to poor posture) and gravity, the enlarged prostate may lead to symptoms such as pain with urination, and incontinence from pressing on the other ‘residents’ within the pelvic girdle. The tilting of the pelvis stresses the surrounding soft tissue, causing lower back pain and SI joint pain.

  • Lifestyle And Habit

Our lifestyle is another huge influencer of the pelvic floor and contributes to pelvic floor dysfunction. Our sedentary lifestyle dictates forward flexion which compromises our posture, leads to our lack of walking, compresses our internal organs which leads to their enlargement due to inflammation, and then there is gravity that certainly becomes a disadvantage. I have explored and dissected the concept of lifestyle and its influence on the brain and how that influences our movement in detail here.

Bad workouts are a huge contributor to most male individuals I see in my practice with pelvic floor dysfunction. Using the wrong muscles to perform an exercise is the culprit. If we commit to the form vs the number of reps and sets, many of these problems will never develop.

I find over-masturbation to be a big factor in pelvic floor dysfunction because the body is taken out of the natural position that is involved with intercourse. This factor is shocking to most people while when looking at the biomechanics of the area and the activity, the conflict is pronounced.

  • Breathing

Our breathing apparatus is another influencer of the pelvic floor and its dysfunction. When the pelvis, lower back, and hips don’t move as they are designed to (due to injuries, habits, and lifestyle for instance), then our posture is compromised and the basic requirement of effective breathing which we are born with is no longer in place. Here is a video of what I am talking about:

When breathing in correctly, we relax the muscles inside the pelvis, and with breathing out, we contract the same muscles. Kegel exercises that IMO we do incorrectly are a sad attempt to duplicate this very natural process that happens with breathing!

  • Nerves

Another influencer of the pelvic floor is the nerves exiting the lower back spine and going to not only the internal organs but the muscles of the area including the ones in charge of the sphincters. Anything that compromises those muscles may lead to pelvic floor dysfunction. The most commonly talked about nerve is the Pudendal nerve, and when it is involved, the issue becomes much more complex and more difficult to treat. I have done a series of blogs on Pudendal nerve that are worth exploring.

How To Treat Pelvic Floor Dysfunction In Men?

Chances are high that by the time you are reading this blog, you have already seen a urogynecologist, have tried different medications, and perhaps even used an external device with an attached catheter that you manually insert through your penis to ‘work’ some of the muscles involved in pelvic floor dysfunction. You may have resorted to wearing adult diapers, pads, or leak-proof underwear. You may be thinking your age is catching up, but what if you are not that old? What is old btw?

When it comes to lower back disc issues impacting the nerves in the region, treatment of the area and promoting functional movement is the key. Physical Rehab. therefore is very important and I happen to disagree with the types of rehab. that are generic and do not address the whole body movement. Remember, you are your whole body and the dysfunction in one area does not remain in that area so the whole body movement and coordination of movement is the key. I use Developmental Kinesiology exercises called DNS or Dynamic Neuromuscular Stabilization to ensure functionality in movement.

Once some stability is restored on the outside, and you can breathe biologically, we need to address the muscles inside the pelvis so they coordinate their relaxation and contraction with the outside. This is when I use the Emsella Chair and my own protocol to address this very important and almost always missed factor in the comprehensive treatment of pelvic floor dysfunction in both men and women.

In my practice, I treat pelvic floor dysfunction; that means not just incontinence (in fact, I don’t treat incontinence per se but our treatment seems to help many with that issue) but all associated subtle and not-so-subtle issues that get missed. Remember, if you catch a problem at the beginning, it is much easier to fix and prevent further damage. Pelvic floor dysfunction does not need to be a life sentence and with the right approach and right presentation, it will be easily fixed.

If you have pelvic floor dysfunction or are receiving treatment and are not happy, contact us. For those in other states and countries, we provide telehealth coaching.

Dr. Shakib

Recommended Reading:

Constipation And Pelvic Floor Dysfunction

How Is the Treatment for Pelvic Floor Dysfunction?