Guys, we need to talk about our pelvic floor!

As it is Movember, one of my Cats – Honey – has decided to grow a moustache to raise awareness for Men’s Health. My contribution is to write this blog – to talk about Men’s health and in particular pelvic health.

There’s a memorable scene in the Sopranos where Tony is explaining to his Psychologist his feelings about his doctor giving him a prostate examination. “I mean I don’t even like someone wagging their finger in my face….” This kind of sums up how most of us guys feel about the subject. Women are fairly used to being prodded and poked at the GP practice, for smear tests or examinations around pregnancy or gynaecological issues. But as a bloke, you don’t hear anything about it. When you’re a child, you don’t hear your Dad chatting to his mates about his pelvic floor and you certainly don’t discuss issues like sexual dysfunction, incontinence or pelvic pain with your friends. In fact until very recently, these were issues that I only had a vague notion existed – probably in much older men. However when I began to develop my knowledge in Men’s Health physiotherapy, I began to understand that there is a huge incidence of these problems but that it slips under the radar as generally guys don’t tell anyone about it. The statistics make for stark reading. 52% of men between the age of 40 and 70 suffer from erectile dysfunction. 8% of men have chronic pelvic pain – that is pain in the pelvic area lasting for more than a year! However this figure is likely to be a significant underestimation of the true incidence as there is strong evidence that men don’t disclose pelvic pain. Between 11% and 31% of men suffer from urinary incontinence.

The Movember campaign has been particularly good at promoting awareness of prostate cancer and many of us will now be aware that one in eight men will get prostate cancer and that it is the third most common cause of cancer death in men. The treatments for prostate cancer are improving all the time and save or lengthen the lives of millions of men worldwide every year. However the side effects of these treatments can have a hugely negative impact on quality of life. Urinary incontinence, faecal incontinence and erectile dysfunction are all common side effects with varying incidence and severity depending on the treatment undergone. Unfortunately many men don’t disclose their symptoms or seek help as they don’t realise that in many cases therapy can help significantly.

Men have pelvic floors too!

We hear quite a lot about the pelvic floor in women and most guys will have a vague idea that if these muscles are not functioning correctly that women can suffer from incontinence. That is usually about the limit of most men’s understanding of the area and most guys don’t really think about their own pelvic floor muscles. For example, did you know that correct functioning of the pelvic floor is essential to maintain continence and to get and maintain an erection? The pelvic floor also plays a huge role in male pelvic pain.

So I should just do lots of pelvic floor squeezes right?

Not necessarily. Yes, weakness in the pelvic floor can cause problems with continence and sexual function and exercises to strengthen it can help. However the pelvic floor – like any muscle or group of muscles – needs to be able to shorten and contract and also to lengthen and relax. Often the problem is that it remains contracted or in spasm. This can lead to pain in the penis, testicles or groin area and can also cause problems with continence and sexual function. Therefore, sometimes our pelvic floor doesn’t need to be strengthened at all – it may just need to be released. In some cases, it may be both weak and tense and will need to be released before strengthening. This is where specialist Men’s Health physiotherapy comes in. This is a new and growing specialism within physiotherapy. Men’s Health physiotherapists (or male pelvic health specialists) can assess the function of the pelvic floor and help you to release or strengthen it as appropriate.

The key message that I would like to get across is that if you have symptoms of pelvic pain, sexual dysfunction or incontinence, it is important to get checked out. See your GP for an assessment or find a specialist pelvic health physiotherapist.

If you think that you might need a pelvic assessment, At Evidence-Based Therapy Centre in Galway we have a chartered physiotherapist – Sylvia Farrell who is specialist in this area. You can call the clinic on 091 727777 to book an appointment or get in touch via the contact page.