Men’s pelvic floor problems are common, yet most men never give their pelvic floor a second thought. It rarely comes up in conversation, and the topic has long been associated almost exclusively with pregnancy and women’s health. But men have a pelvic floor too. When it isn’t working well, the effects on bladder control, bowel function, and quality of life can be significant.
If you’ve noticed changes in your bladder or bowel control – your pelvic floor could well be the cause. Here’s what you need to know.
What is the pelvic floor, and what does it do?
The pelvic floor is a group of muscles forming a hammock-like base to your pelvis. They stretch from your tailbone to your pubic bone. In men, these muscles sit below the bladder, bowel, and prostate, and they do several important jobs:
- Bladder and bowel control – they contract to keep you continent and relax to allow full emptying
- Sexual function – they contract during erection and ejaculation, and need to relax afterwards
- Core stability – they work alongside your deep abdominal and back muscles to support your pelvis and spine
Just like any muscle group, the pelvic floor can become too weak, too tight, or poorly coordinated. Any of these states can cause men’s pelvic floor problems.
Signs of men’s pelvic floor problems
Bladder urgency and frequency
Do you rush to the toilet? Go more than seven or eight times a day? Wake once or more during the night? These are signs the bladder and pelvic floor aren’t working in sync. An overactive bladder and a poorly coordinated pelvic floor often go hand in hand.
Leaking urine
Leaking when you cough, sneeze, lift, or exercise is called stress urinary incontinence. The pelvic floor isn’t generating enough pressure to handle the sudden increase in abdominal load. This isn’t just a problem for older men or men who’ve had prostate surgery. It can affect younger, active men too.
Poor bladder emptying or a stop-start stream
A hesitant or interrupted stream, difficulty emptying fully, or a feeling of incomplete emptying can relate to pelvic floor tension rather than a prostate problem. A tight pelvic floor can interfere with the normal relaxation needed to empty.
Bowel issues
Constipation, straining, a sense of incomplete emptying, or difficulty controlling wind or bowel movements can also involve the pelvic floor. These are under-discussed but very common pelvic floor problems – and they respond well to the right treatment.
Is your pelvic floor the problem – or is it something else?
Men’s bladder and bowel symptoms are often attributed to the prostate. Sometimes that’s correct. It’s always worth seeing your GP to rule out prostate issues, urinary infection, or other medical causes.
But pelvic floor dysfunction is frequently involved – and frequently missed. Many men hear that their symptoms are normal for their age, or that nothing can be done. In many cases, pelvic floor physiotherapy can make a significant difference.
A prostate issue and pelvic floor problems in men can also coexist. Treating the pelvic floor alongside any medical management often produces better outcomes.
How we treat men’s pelvic floor problems
The first appointment is an hour long. We take time to understand your symptoms, your history, and what you want to get back to. We explain what we find and why, and we build a treatment plan together.
Assessment includes observing how you breathe and move. We also assess the pelvic floor muscles directly. With your consent, this can involve an internal examination. It allows us to assess muscle tone, strength, and coordination accurately. Many men find it far less daunting than they expected – and it gives us the information we need to treat you properly.
Treatment is individualised. A pelvic floor that is too tight needs a very different approach from one that is too weak. We guide you through the right exercises for your situation, make sure you do them correctly, and progress your programme over time. We also address contributing factors such as fluid intake, bladder habits, lifting technique, and stress.
You’re not alone – and you don’t have to just manage
Men are often slower than they should be to seek help for pelvic health issues. Leaking, rushing to the toilet, or getting up twice at night can feel like something to put up with quietly. However these are treatable problems. You deserve the same quality of care as anyone else.
We see men of all ages at Pelvic Health Physiotherapy in Wellington – younger men with urgency or exercise-related leakage, men in mid-life managing bladder changes, and men recovering from prostate surgery. Whatever your situation, we treat you with straightforwardness and respect.
If any of this sounds like you, get in touch. You don’t need a referral. You might also find our blogs on bladder leakage and ED after prostate surgery and pelvic pain in men helpful.
Frequently asked questions
Do men really have a pelvic floor?
Yes – men have exactly the same pelvic floor muscles as women. They sit at the base of the pelvis, supporting the bladder, bowel, and prostate. They play an important role in bladder and bowel control, sexual function, and core stability. Men’s pelvic floor problems are very common – and often underdiagnosed.
Why do I need to rush to the toilet so urgently?
Urinary urgency often signals that the bladder and pelvic floor aren’t working in sync. An overactive bladder can develop when the pelvic floor loses coordination. A pelvic floor physiotherapist can assess what’s happening and build a programme to retrain both the muscles and the bladder.
Is it normal for men to leak urine?
Leaking is common – but you don’t have to accept it. Men of all ages can experience urinary leakage during exercise, coughing, sneezing, or with urgency. It signals the pelvic floor needs support. It responds well to targeted physiotherapy in most cases.
Could my bladder symptoms be a prostate problem rather than a pelvic floor problem?
Possibly – always check with your GP to rule out prostate issues or urinary infection. But pelvic floor dysfunction frequently causes men’s bladder symptoms and is frequently missed. The two can coexist. Treating the pelvic floor alongside any medical management often produces better results.
What is a stop-start stream and should I be worried?
A hesitant or stop-start stream has several possible causes. An enlarged prostate is one. A tight or poorly coordinated pelvic floor is another. If your GP has ruled out prostate issues and you’re still having trouble emptying fully, a pelvic floor assessment is a sensible next step.
What exercises are best for men with pelvic floor problems?
That depends on what your pelvic floor is doing. If it’s weak, strengthening exercises help. If it’s too tight – common in men with urgency, pelvic pain, or stop-start flow – kegel-style exercises can make things worse. An assessment first is important. We’ll tell you exactly what your pelvic floor needs and how to train it correctly. Healthify has more information on the pelvic floor.
Do I need a referral to see a pelvic health physiotherapist?
No – you can book directly without a GP or specialist referral. Your first appointment is an hour long. It covers a full assessment, an explanation of what we find, and a personalised treatment plan.
Pelvic Health Physiotherapy Wellington is Wellington’s only clinic dedicated solely to pelvic health. We see people of all genders and ages, with specialist expertise in men’s pelvic health. Visit us at pelvicphysio.co.nz.
