2 hours ago
1
Women’s health lags men’s in many ways, but there is one area where the scales are tipped the other way: pelvic health.
“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,” says specialist pelvic health physiotherapist Dr Shan Morrison.
Women’s pelvic floors receive a lot of care and attention, particularly after childbirth, and rightfully so.
But it’s just as important that men pay attention to their pelvic health.
Credit: Aresna Villanueva
Why is pelvic health important for men?
The pelvic floor is a group of muscles that line the base of the pelvis, and for men, play an important role in bowel, bladder and sexual function.
Loading
Morrison says research into the pelvic floor for people with penises has only started to pick up in the past 15 years.
“It’s a bit taboo. It’s not dinner table conversation to talk about a bladder problem or pain in your penis … and people still don’t talk about sexual issues much,” she says. “Men are not quite as good [as women] at seeking medical support … so they tend to just suffer in silence.”
Dr David Cowley, men’s health clinical stream leader at Active Rehabilitation Physiotherapy, says prostate cancer – accounting for about 28 per cent of cancers diagnosed in males – and its associated surgery is a risk factor for men developing pelvis-related problems. But pelvic floor health is also important for general wellbeing – which can be maintained with simple exercises.
“If men want to improve their erectile function or stop that little dribble at the end of urination, pelvic floor muscle training can help with that,” he says.
“If their bowel movements aren’t as good they could be or they’re prone to things like haemorrhoids or fissures, then looking after pelvic health care can prevent those conditions from progressing into anything more serious.”
What are the signs?
Pelvic floor dysfunction affects about one in eight men. Some of the most common signs are urinary or faecal incontinence and erectile dysfunction.
The two most common pelvic health conditions men present with at their clinics, according to Cowley and Morrison, are chronic pelvic pain syndrome (CPPS) and post-prostatectomy incontinence.
Loading
CPPS – experienced by about 7.8 per cent of Australian men – is often referred to as the “black hole of men’s health” due to a lack of scientific research and understanding among health professionals and the fact it can’t be seen, says Morrison. Symptoms include pain while sitting and pain anywhere from the belly button to the perineum and buttocks.
Prostate cancer is one of the most common forms of cancer for men, and one of its main treatments – a prostatectomy – often leads to incontinence. But post-surgery side effects are something men are often not prepared for, says Morrison.
“Men aren’t used to wearing pads, and often there’s not a place to dispose of them in toilets. And they’ve gone from being completely dry their whole life to then being quite wet,” she says.
Thankfully, emerging research shows that preoperative muscle training can significantly reduce post-operative symptoms like incontinence and erectile dysfunction, as well as improve rehabilitation.
What causes pelvic floor dysfunction?
According to Morrison, one of the leading causes of pelvic floor issues in her clinic is stress, which can trigger our fight or flight mechanism that “switches on” our muscles.
“And the pelvic floor muscles, interestingly, are one of the first ones that get tension in them,” she says.
Tensing these muscles for extended periods of time can lead to pain. In the United States, clinicians have reported seeing an uptick in referrals for pelvic floor issues from men working on Wall Street, thought to be associated with the stress of the industry and prolonged periods of sitting. As a physio, Morrison says she always looks at psychosocial causes, as well as physical ones, when assessing pelvis-related 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.”
Morrison says overtraining with weights might also lead to issues, but there is limited data on this.
How can you treat pelvic floor dysfunction?
Morrison’s main message if you’re experiencing issues is to not be afraid to seek help.
“These problems don’t normally get better by themselves.”
And often, the solution is simple.
Loading
“A lot of men are a bit scared they might need surgery, but the vast majority of the time, we can help just by improving pelvic-floor muscle function,” she says.
Cowley recommends exercises involving visualisation and muscle engagement.
“Imagine drawing your penis in or stopping and starting a flow of urine [without actually urinating].”
But to ensure you are performing exercises properly, it’s a good idea to see a pelvic floor specialist, he says.
Make the most of your health, relationships, fitness and nutrition with our Live Well newsletter. Get it in your inbox every Monday.
Most Viewed in Lifestyle
Loading
