For guys, navigating health problems that involve sexual function and incontinence is complicated and uncomfortable. It can be difficult to discern whether you have an actual health problem or are being misinformed through social media and other influences.
Unfortunately, there is still a cultural stigma about discussing the topic of men’s pelvic health, which affects the bladder, bowel and sexual function. It’s often challenging to find reliable advice.
[READ: How to Cope With Common Sex Problems.]
What Is a Pelvic Floor Problem?
Susie Gronski is a doctor of physical therapy who specializes in male pelvic health. She is certified in pelvic rehabilitation and sexuality counseling. She is also a sex educator with the American Association of Sexuality Educators, Counselors and Therapists.
Gronski says that a healthy pelvic floor for men consists of three functions:
— Urination: the ability to expel and control urine when desired.
— Defecation: control over your gas and bowels.
— Sexual function: ability to achieve an erection and control over ejaculation.
Men who are not experiencing these problems already have a healthy pelvic floor, and it is not necessary to practice pelvic floor exercises. If any of these functions are not working properly or if you are experiencing discomfort with urination, defecation or sex, consider seeking out professional help for an individualized plan of care, and implementing exercises.
[READ: 9 Exercises Men Should Do Every Day.]
What Is the Male Pelvic Floor?
According to Gronski, the male pelvic floor is more than just the pelvic floor muscles. It consists of all of the structures in the region of the pelvis including the genitals, bladder, prostate, rectum, muscles, nerves, connective tissue and their accompanying nerves and blood supply. The pelvic floor musculature consists of a triangle-shaped group of muscles that wrap around the penis, the muscles around the anal sphincter used to hold back gas and bowel continence control and the external urethral sphincter. The musculature also includes the deeper muscles behind the anal sphincter, called levator ani.
Inside the pelvis, organs like the bladder, prostate and rectum are all supported by the pelvic floor muscles, which act like a sling to support pelvic and abdominal organs to accommodate load and pressure changes.
[READ: What Is a Vasectomy? Everything You Need to Know.]
Misleading Messages About Men’s Health
Gronski says that statistics on erectile dysfunction are misleading due to underreporting and discrepancy in defining and measuring erectile dysfunction in scientific literature and the media. Another complication is the fact that a common questionnaire, the International Index of Erectile Functioning, used to determine if you have ED, is based on research supported by a grant from Pfizer, a company that produces the ED medication Viagra. Media may also lead men to believe that they have an ED problem when they actually do not.
“Occasional erectile difficulty is normal for any person that’s getting older,” Gronski says. “It doesn’t necessarily mean it’s pathological, especially if you have no other health comorbidities like diabetes or cardiovascular disease.”
Biological, psychological and sociocultural factors, all intersecting, influence sexual function and perceived satisfaction.
[SEE: 7 Signs of Depression in Men.]
Pelvic Floor Health Is Mental, Physical and Emotional
While physical symptoms are good markers to suggest you may have a problem, the root cause can be as much psychological as it is physical.
“These muscles get signals from your nerves which come from your spine and communicate with your brain,” Gronski says. “And your brain is your biggest sex organ. The muscles themselves are just one little piece of the pie. We really have to think about what’s communicating with these muscles to do their function in the first place. The brain can enhance or dampen what’s happening here.”
In general, all exercise is good for pelvic floor health, especially resistance training. On the other hand, preexisting conditions like cardiovascular disease, high blood pressure and diabetes can make you more at risk of experiencing these changes in your body persistently.
Kegels for Men
You can become aware of your pelvic floor by feeling these muscles on yourself first. Slide a hand underneath the sitz bones. The pelvic floor muscles are located in between those sitz bones, extending from your pubic bone, at the front, to your tailbone at the back. It is helpful to sit on a yoga bolster, towel or blanket to better feel these muscles. There are two sets of muscle groups you can practice isolating and contracting. The first are the group of muscles around the genitals, and the second are located around the anus and the inside of the pelvis. You can focus on either or both muscle groups based on your goals.
Sexual and urinary function exercises
“For men, the cue to engage the front muscles around the genitals, research tells us that the best cue is to ‘stop the flow of urine or shorten the penis,'” Gronski says. “You can also use the cue of ‘drawing your penis inward.’ Imagine those two things and see if you can get those muscles to contract and then let go. Notice what you feel.”
Similar to other muscle groups in the body, the pelvic floor consists of both fast-twitch and endurance muscle fibers. Gronski suggests practicing coordinated contractions, one second on and one second off. This is a similar action that occurs involuntarily during ejaculation, and increasing your awareness of this coordinated muscle activity could help with premature ejaculation and ED. While practicing these contractions during sex is not “bad” or “harmful,” it may shift the focus away from pleasure and reinforce a mechanistic and performative sex mindset
Bowel and gas control exercises
“If you want to engage the levator ani, the innermost layer of the pelvic muscles above the anus, the cue is, ‘”tighten around the anus like holding back gas.'” That would be the cue to engage the back muscles or the deeper muscles. You will feel the anus lift up and close, like puckering your lips, and then relax. In the front, you might feel the genitals move up as well,” says Gronski.
Longer, 10-second holds with 10 seconds off, where you squeeze and lift the sitz-bones, help exercise the slow-twitch muscle fibers used to support bowel continence control.
Gronski says to try these exercises three times throughout the day, ideally in positions that imitate your desired behavioral outcome. Like any exercise, it is individualized. One should ease into a routine and be careful not to overdo it. Be mindful that these muscles may get sore after “working out,” especially if you haven’t done them before.
While pelvic floor health and exercises for men are an emerging field of study, and more research needs to be done, Gronski has an overwhelming amount of success working with hundreds of men seeking non-surgical, non-pharmaceutical ways to help with these issues.
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What Is Men’s Pelvic Floor Health? originally appeared on usnews.com
