I get this question frequently. Men can absolutely benefit from pelvic floor physical therapy for many of the same reasons women seek care. While their anatomy shares many of the same muscles, there are differences in structure and function. Men have a prostate, a longer urethra, and do not have a vaginal opening.
Reasons men may need pelvic floor PT include:
Urinary dysfunction such as incontinence, frequency, urgency, or difficulty emptying the bladder
Bowel issues such as constipation or fecal incontinence
Pelvic pain, including perineal pain or testicular pain
Sexual dysfunction such as erectile dysfunction or pain with erection and/or ejaculation
Post-surgical rehabilitation (for example, after a prostatectomy)
Coccydynia (tailbone pain)
Chronic hip or back pain
However, men are often less likely to reach out for help and may experience delays in treatment. There are a variety of reasons for this, including lack of awareness, the tendency for men to underutilize primary care compared to women (Tudiver & Talbot, 1999), feelings of embarrassment or vulnerability, and limited access to providers who feel comfortable treating male pelvic floor conditions.
In my experience, many men have been referred to pelvic PT multiple times by a medical provider before finally scheduling an appointment. Others seek treatment because a partner has attended pelvic PT and experienced positive results.
Men are often unsure or nervous about what pelvic PT looks like for them and what to expect at the first appointment.
A physical therapy evaluation for someone with male anatomy may include:
A thorough subjective interview and medical history review
Assessment of lifestyle factors and behaviors
A musculoskeletal screening of posture, movement patterns, breathing mechanics, spine mobility, hip mobility, and strength
An external and/or internal pelvic floor examination if the patient is comfortable and provides consent
From there, the PT and patient work together to establish goals, and the therapist develops an individualized treatment plan to help achieve them—whether that’s returning to a sport, reducing symptoms, or being able to play with their kids more comfortably.
While treatment is nuanced and there is no one-size-fits-all approach, some common areas men often need to address include thoracic mobility, abdominal tension, core strength, hip mobility and strength, and learning how to connect with and coordinate their pelvic floor muscles. Depending on the individual, this may mean learning how to relax the pelvic floor, strengthen it, or improve overall coordination.
It’s not always about kegels. Pelvic floor muscles are part of a larger system and don’t function in isolation. Men can also have overly tight pelvic floor muscles that contribute to their symptoms. Difficulty emptying the bladder, a stop-and-go or slow urine stream, constipation, and pelvic pain may all indicate that the pelvic floor muscles are having trouble relaxing. Sometimes conditions like errectile dysfunction can be either due to tight or weak pelvic floor muscles, thus evaluation by a professional trained in treating males is important.
The bottom line: pelvic floor issues are not just a women’s health concern. Men experience pelvic floor dysfunction too, and they deserve access to treatment and support. If you’re dealing with bladder, bowel, sexual, or pelvic pain symptoms, know that these concerns are common, treatable, and worth discussing with a healthcare provider. You don’t have to just live with the symptoms—and pelvic floor physical therapy may be an important part of the solution.
At Archer Physical Therapy we have therapists that are excited to help and ready to provide comfortable environment whenever you are ready to walk through that door. If you are female and have male partner that is experiencing any of these symptoms, let them know that pelvic PT may be an option.