By Melinda Fontaine, DPT, PHRC Walnut Creek
Did You Know….
- Pelvic floor exercises are equally effective as sildenafil (Viagra) in treating erectile dysfunction.
- Pelvic floor physical therapy can help incontinence, erectile dysfunction, post void dribbling, overactive bladder, premature ejaculation, and pelvic floor tension myalgia.
- Erectile dysfunction is associated with twice as much absenteeism, decreases in work productivity, and decreases in health related quality of life compared to people without erectile dysfunction.
- Young men visit their general practitioner (GP) less frequently than young women and tend to utilize primary healthcare services reluctantly.
- The prevalence of urinary incontinence after radical prostatectomy is widely reported, ranging from 2% to 60%.
Pelvic Floor Dysfunction and Men’s Health
- Symptoms patient experience:
- Erectile dysfunction, premature ejaculation, hard flaccid syndrome, painful erection or ejaculation, post-surgical problems, post-prostatectomy incontinence, urinary urgency, frequency of urination, incontinence of urine/feces/gas, constipation, penile or scrotal pain.
- Associated diagnoses:
- Interstitial Cystitis/Painful Bladder Syndrome, enlarged prostate, prostate cancer, overactive bladder, Irritable bowel syndrome, diabetes, cardiovascular disease, Peyronie’s disease, prostatitis, urinary tract infections.
- Examples of mechanisms for symptoms development, evidence-based if possible and scenarios:
- ED is an independent risk factor for cardiovascular disease (CVD).3
- Diabetes can lead to erectile dysfunction or urinary urgency and frequency.
- If your workouts overuse certain muscles and cause trigger points or knots to form in the muscle, that can refer pain to the genital area. See Robert’s case in the blog post: Scrotal Recall: A Case of Male Pelvic Pain. The same referred pain can occur if you develop trigger points for other reasons, say if a chronic cough makes your abdominal muscles work harder.
- Prostatectomy is a surgical treatment for prostate cancer, and recovery from the procedure may include treating urinary incontinence and erectile dysfunction, such as Ted in The Case of Post-prostatectomy Urinary Incontinence.
- Pelvic floor muscle weakness or tightness can affect the quality of an erection and the comfort level during sexual activity.
- Diagnostic Challenges
- People do not always know that it’s ok to bring up sexual health issues, what is within the range of normal regarding sexual function, or who to talk to about it. Once issues are identified, pelvic floor physical therapists can help create a treatment plan for many sexual complaints. It may surprise you to find out that pelvic floor dysfunction can create the variety of symptoms listed above. Pelvic floor disorders may exactly mimic medical conditions, such as urinary tract infections or prostate hypertrophy. If you have ruled out or already been treated for an infection or prostate dysfunction and still have symptoms, you should have a pelvic floor evaluation.
What is PFPT for Men’s Health and how can it help Pelvic Floor Dysfunction
Pelvic floor physical therapists are in a unique position to be able to discuss sexual concerns and bowel and bladder issues in detail. I can spend the majority of my day talking honestly about urination, bowel movements, and sex in order to make a difference in men’s symptoms. I can identify what contributes to your symptoms and create an individualized treatment plan to return you to normal function. For example, if you have pelvic pain and frequent urination, you may need a combination of manual therapy and home exercises to reduce stress and tension on the pelvic floor muscles and surrounding structures. You may also need a referral to a urologist to rule out or treat certain diagnoses. If you are facing erectile dysfunction or are leaking urine, feces, or gas, you may need to retrain your pelvic floor muscles to help you control your bladder and bowels until you reach a bathroom. If you struggle with constipation, you may need to retrain your pelvic floor muscles while making sustainable lifestyle modifications. Each person that has each session of pelvic floor physical therapy will likely include some reevaluation of your symptoms and your physical state, manual treatment, education on what to do at home, and recommendations on what other treatments may be complimentary.
- PHRC YouTube Videos
- PHRC Blogs
- Dorey G, Speakman MJ, et al. Pelvic floor exercises for erectile dysfunction. BJU International. 2005; 96: 595-597. doi:10.1111/j.1464-410X.2005.05690.x
- Pelvic Floor Muscle Training in Males: Practical Applications. Siegel AL. Urology 84: 1e7, 2014.
- The association of erectile dysfunction with productivity and absenteeism in eight countries globally. Goldstein I, Goren A, et al. Int J Clin Pract. 2019;00:e13384
- Jeffries M, Grogan S. ‘Oh, I’m just, you know, a little bit weak because I’m going to the doctor’s’: young men’s talk of self-referral to primary healthcare services. Psychol Health. 2012;27(8):898-915. doi: 10.1080/08870446.2011.631542. Epub 2011 Dec 12. PMID: 22149462.
- Conservative management for postprostatectomy urinary incontinence. Campbell SE, Glazener CMA, et al. The Cochrane Library; 2012.
Are you unable to come see us in person? We offer virtual physical therapy appointments too!
Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online.
Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.
In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page.
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