Men, You Have Pelvic Floors Too and Should Exercise Them Regularly
Kegel and pelvic floor exercises are commonly associated with “women’s affairs” – think pregnancy, childbirth and menopause. But men also have pelvic floor.
Just like women, at various times in their lives, men can benefit from training their pelvic floor to address various health issues. About 30% of men who visit the doctor suffer from urinary incontinence or urine leakage, but a large majority do not talk about it. About 15% of men also suffer from faecal incontinence or leaky bowels and take longer to seek help than women.
The pelvic floor muscles are also involved in sexual function. Erectile dysfunction affects around 10% of healthy men and up to almost 40% of men with chronic conditions and can be associated with pelvic floor problems.
People sometimes assume that these problems are just a normal part of aging. but common does not mean inevitable. There is often a lot of improvement to be made with a few simple strategies, including pelvic floor retraining.
Pelvic floor dysfunction in men is very common
Although pelvic floor problems are more common in women, one in eight men have pelvic floor, bladder or bowel problems.
The pelvic floor is a group of muscles lining the base of the pelvis. For men, this supports the bladder, prostate, and bowels. It is essential for maintaining core stability, bladder and bowel control, as well as erectile function and sexual satisfaction.
Most men have little reason to think about their pelvic floor for most of their lives until something goes wrong medically (compared to women, who tend to be introduced to pelvic floor exercises much younger, often in the context of pregnancy and childbirth) .
Why does it happen
Risk factors for incontinence and pelvic floor problems in men include aging, prostate problems, pelvic surgery, bowel problems including constipation, chronic cough, frequent heavy lifting and 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 biggest source of referral to pelvic floor physiotherapy for men tends to be in the context of prostate surgery. This is because surgery on the prostate (which sits very near the base of the bladder) causes trauma to nearby structures and nerves that maintain bladder control and erectile function.
However, we know that training the pelvic floor early (starting before surgery) means that post-surgery side effects like incontinence go away faster.
How can men exercise their pelvic floor?
To engage the pelvic floor, sensation should be felt as pressure, lifting, and relaxation of the muscles between the pubic bone, tailbone, and seat bones. Some popular clues include visualization:
- stopping mid-flow urine (but not actually doing it)
- wind resistance
- to retract the penis/the testicles
- pulling the perineum (skin between the genitals and the back passage) away from your underwear.
It is important to ensure that the abdominal, gluteal (buttocks) and thigh muscles remain relaxed, with sustained breathing throughout.
The exercises can be done in any position, and if done well, they should be able to be done discreetly (even if there are other people around!). But it is quite common to find the exercises difficult to do without guidance.
Working with a medical professional like a pelvic floor physiotherapist can be beneficial. Physiotherapists trained in men’s health and pelvic floor conditions will teach clients how to perform the exercises correctly. Often they do this with biofeedback devices such as real-time ultrasound imaging that can help identify the correct muscles to use and refine technique.
Not all pelvic floor problems require more strengthening. Optimal muscle function requires good strength, but also good 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 an overactive bladder, and bowel problems.
Your specific concerns will inform how your physio might prescribe exercises for you, but good goals to aim for are being able to:
- activate and deactivate the pelvic floor 10 times in 10 seconds
- hold firmly 10 seconds, repeat 10 times
- maintain an easy grip for 1 minute.
If I don’t have pelvic floor problems, should I do exercises?
Just as a good gym routine keeps you in peak physical health and helps avoid injury, it stands to reason that a regular pelvic floor training routine could serve to combat the risk 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 can even have happy side effects, like a reduction in nighttime wakings with the need to urinate, a reduction in dripping after urination, better bowel emptying. , and improved sexual satisfaction.
If you’re unsure if pelvic floor exercises are right for you or if you’re doing them correctly, consult a trusted healthcare professional.
Mischa Bongers, Lecturer, CQUniversity Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.