Men’s Pelvic Health Matters: What Every Man Should Know About His Pelvic Floor
November is Men's Health Month, a time to encourage men to prioritize their physical and mental health, schedule preventive care, and pay attention to symptoms they might otherwise ignore.
At Empowered Pelvic Health, we want to add another important topic to that conversation: pelvic health.
Yes, men have pelvic floors too.
And your pelvic floor plays an important role in bladder and bowel control, sexual function, core support, and overall pelvic health. When these muscles are too tight, too weak, or not coordinating properly, they can contribute to symptoms that affect everyday life.
From pelvic pain and urinary changes to prostate health and recovery after prostate surgery, men's pelvic health deserves more attention.
What Does the Male Pelvic Floor Do?
The pelvic floor is a group of muscles, connective tissues, and other structures at the base of the pelvis.
These muscles help:
Control urination and bowel movements
Support the bladder, bowel, and pelvic organs
Contribute to sexual function
Assist with erections and ejaculation
Work with the deep abdominal and back muscles to support the core
Stabilize the pelvis during movement
Like any other muscle group, the pelvic floor needs to be able to contract, relax, and coordinate appropriately.
That last part is important.
Pelvic floor problems aren't always caused by weakness. Sometimes the muscles are too tight or overactive. Sometimes they are weak. And sometimes the issue is that the muscles have difficulty coordinating when you need them to.
What Are Signs Your Pelvic Floor May Need Attention?
Men's pelvic health symptoms can look different from person to person. Some are obvious, while others may be easy to dismiss or attribute to getting older.
Possible signs of pelvic floor dysfunction include:
Pain or discomfort with prolonged sitting
Difficulty starting or stopping your urine stream
Feeling like you haven't completely emptied your bladder
Urinary leakage
Constipation or straining with bowel movements
Pain with urination
Pain with ejaculation
Erectile or sexual difficulties
A feeling of pressure, tightness, or discomfort in the pelvis
Persistent pelvic pain, urinary symptoms, and sexual symptoms can sometimes be associated with pelvic floor muscle dysfunction, including an overactive or tight pelvic floor. These symptoms can also have other causes, which is why appropriate medical evaluation is important.
You don't have to simply live with these symptoms.
Your Prostate and Your Pelvic Floor Are Connected
As men age, prostate health becomes an increasingly important part of the conversation.
The prostate sits just below the bladder and surrounds part of the urethra. Changes involving the prostate can affect urination and sexual function.
Conditions such as benign prostatic hyperplasia (BPH), prostatitis, and prostate cancer can all have implications for pelvic health. Symptoms may include changes in urinary flow, increased frequency or urgency, difficulty emptying the bladder, or discomfort with urination or ejaculation.
This is one reason regular medical care and appropriate prostate screening are so important.
But the conversation shouldn't stop with the prostate itself.
The muscles surrounding and supporting the pelvic region are part of the picture, too.
What If You Need a Prostatectomy?
For men undergoing prostate surgery, pelvic health becomes especially important.
A prostatectomy can result in changes to urinary control and sexual function, and some men also experience pelvic discomfort, muscle tension, or changes in mobility during recovery.
This is where pelvic floor physical therapy can become an important part of the rehabilitation process.
Before Surgery
When possible, beginning pelvic floor physical therapy before surgery can help you understand where your pelvic floor muscles are, how to properly contract and relax them, and how they coordinate with your breathing and core.
When possible, pelvic floor physical therapy before surgery can help men learn how to identify and properly coordinate their pelvic floor muscles before entering the recovery period. Current AUA guidance states that pelvic floor muscle exercises or training may be offered before radical prostatectomy, although research on whether preoperative training consistently improves continence recovery is mixed.
After Surgery
After prostatectomy, pelvic floor PT can help you progressively restore muscle strength, coordination, and control.
Treatment may address:
Urinary leakage: Learning how to properly activate and coordinate the pelvic floor can help support urinary control as you recover.
Pelvic and abdominal discomfort: Manual therapy, mobility work, and treatment of muscle tension or scar-related restrictions may help improve comfort.
Core and pelvic stability: Your pelvic floor works as part of a larger system. Rehabilitation can help reconnect the pelvic floor with the deep abdominal and other supporting muscles.
Return to activity: As your body heals, your therapist can help you safely progress back toward exercise, work, hobbies, and everyday activities.
Sexual health: Sexual function can be affected following prostate surgery. Pelvic floor rehabilitation can be one component of a broader medical plan addressing sexual function and recovery.
Pelvic floor muscle training is specifically recommended as part of post-prostatectomy continence rehabilitation, and guided training may help men achieve continence sooner during the recovery process.
Pelvic Floor PT Isn't Just Kegels
One of the biggest misconceptions about pelvic floor physical therapy is that treatment simply means doing Kegels.
It doesn't.
For some men, strengthening is appropriate. For others, the pelvic floor is already too tight and needs to learn how to relax.
A pelvic floor physical therapist may use:
Manual therapy
Myofascial techniques
Breathing and relaxation strategies
Mobility and stretching
Neuromuscular re-education
Biofeedback
Pelvic floor strengthening when appropriate
Core and movement retraining
Functional exercises
An individualized home program
A comprehensive evaluation helps determine what your pelvic floor needs—not what someone else’s needs.
When Should You See a Pelvic Floor Physical Therapist?
You don't have to wait until your symptoms become severe.
Consider talking with a pelvic floor physical therapist if you're experiencing persistent:
Pain with sitting
Urinary leakage, urgency, or frequency
Difficulty emptying your bladder
Constipation or straining
Pain with urination or ejaculation
Sexual or erectile concerns
Symptoms following prostate surgery
Difficulty returning to normal activities after pelvic or abdominal surgery
If you have new or unexplained symptoms, it's important to speak with your physician or other appropriate medical provider as well. Pelvic floor physical therapy can work alongside your medical care rather than replacing it.
Men's Health Is More Than a Mustache
Movember may have started a conversation around men's health, but taking care of yourself shouldn't stop when the mustache comes off.
Men's health includes preventive care, prostate health, physical activity, mental health, sexual health, and pelvic health.
If something has changed—you're leaking urine, waking up constantly to use the bathroom, experiencing pelvic pain, dealing with constipation, having pain with ejaculation, or recovering from prostate surgery—don't assume it's something you simply have to live with.
Your pelvic health is part of your overall health.
At Empowered Pelvic Health, our pelvic floor physical therapists provide individualized, confidential care for men experiencing pelvic pain, urinary and bowel symptoms, sexual health concerns, and post-prostatectomy recovery.
If something doesn't feel right, let's talk about it.
References:
American Urological Association (AUA), GURS & SUFU. Incontinence After Prostate Treatment: AUA/GURS/SUFU Guideline (2019; Amended 2024). This is the strongest reference for the prostatectomy section. It supports pelvic floor muscle exercises/training after radical prostatectomy and states that patients may be offered pelvic floor muscle training before surgery. It also notes that evidence for preoperative training is not completely consistent. AUA/GURS/SUFU Guideline
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Prostate Problems. Useful for the general prostate-health section, including urinary frequency, urgency, leakage, weak stream, difficulty emptying the bladder, pelvic pain, and pain with ejaculation. NIDDK – Prostate Problems
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Enlarged Prostate (Benign Prostatic Hyperplasia). Supports the information about BPH and symptoms such as difficulty starting urination, weak/interrupted stream, urgency, frequency, nocturia, and incomplete bladder emptying. NIDDK – Enlarged Prostate (BPH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Prostatitis: Inflammation of the Prostate. Particularly useful for the male pelvic pain portion. It discusses chronic prostatitis/chronic pelvic pain syndrome and symptoms including pelvic/perineal pain, penile or scrotal pain, urinary symptoms, and pain during or after ejaculation. NIDDK – Prostatitis
American Cancer Society. Surgery for Prostate Cancer (Prostatectomy). Supports the discussion of radical prostatectomy and potential postoperative urinary incontinence and erectile dysfunction. It also explains that urinary control can improve gradually over weeks or months following surgery. American Cancer Society – Surgery for Prostate Cancer
Empowered Pelvic Health. Male Pelvic Pain Explained. Your existing EPH article can serve as an internal reference for the male pelvic pain/pelvic floor section. Male Pelvic Pain Explained
Empowered Pelvic Health. The Crucial Role of Physical Therapy in Post-Prostatectomy Recovery. This can be linked as a related resource for readers who want more detail about pre- and post-prostatectomy rehabilitation. The Crucial Role of Physical Therapy in Post-Prostatectomy Recovery
Comments