They’re usually only thought to affect women, especially those who have just given birth or are in the throes of menopause.
In fact, as many as one in three women will be diagnosed in their lifetime with pelvic floor dysfunction, a condition that makes it difficult to relax or control the muscles around the bladder, bowels and sex organs.
Though the pelvic floor is most often associated with women, men have this group of muscles as well, which also support their bladder and bowels, as well as their prostate.
And experts warn pelvic floor dysfunction has become increasingly common in men, leaving them prone to incontinence, painful sex, infections and erectile dysfunction.
Urologists and physical therapists told DailyMail.com men are more likely to ignore telltale symptoms like bladder urgency, constipation, bladder and rectal pain and trouble getting an erection.
Age, obesity, recent injuries or surgical trauma have all been linked to the embarrassing condition.
But even otherwise healthy lifestyle habits like heavy lifting could loosen or tighten muscles in young, fit men.
Doctors also told this website while pelvic floor dysfunction is not linked to deadly conditions like cancer, leaving it untreated can severely worsen a man’s quality of life.
Pelvic floor dysfunction has become increasingly common in men, leaving them prone to incontinence, painful sex, infections and erectile dysfunction (stock image)
Dr David Shusterman, a urologist at Modern Urologist in New York City, told DailyMail.com: ‘It’s a quality of life problem, not a quantity of life problem.’
Dr Leia Rispoli, an interventional pain management specialist and physiatrist at DISC Sports & Spine Center in California, told this website: ‘If left untreated, this can obviously lead to not only social and mental health issues for men but also having chronic constipation issues or chronic urinary issues can lead to further organ issues down the road.’
Exact estimates vary, but recent research suggests as many as one in six men in the US – 27million – may suffer from pelvic floor dysfunction. Most of these men are between 30 and 50, Dr Shusterman estimates.
The pelvic floor is a group of muscles and ligaments that support bladder, bowel and uterus in a women and bladder, bowel and prostate in a man.
Men also have a unique set of pelvic floor muscles called the urogenital triangle, which includes the penis, urethra and scrotum. These all help a man achieve and maintain an erection and support healthy ejaculation.
Pelvic floor dysfunction occurs when these muscles can’t properly loosen and relax or contract, leading to trouble passing urine or stool, or, on the flip side, urinary or bowel incontinence.
Men specifically may also suffer pain around their penis, testicles, scrotum, rectum and tailbone due to tension and pressure.
Pelvic trauma, surgery, stress, anxiety and sitting for long periods of time are most likely to weaken pelvic floor muscles over time. Chronic constipation from conditions like irritable bowel syndrome may also lead to excess straining.
Dr Shusterman said: ‘If you’re in the bathroom and you’re just pushing very hard, that would also cause some pelvic floor dysfunction. You’re just kind of overusing the muscles there.’
Minor injuries may also be to blame. Dr Rispoli said even something ‘as small as someone falling onto their buttocks during a snowboard accident’ could be enough to ‘begin the cycle of persistent pelvic pain.’
Intensive exercise also creates pressure in the area. Weightlifting and body weight exercises like squats, for example, push down on the pelvis and lead to pressure.
‘A lot of it just goes straight down to the pelvic floor,’ Dr Shusterman said.
Dr Shusterman notes it’s ‘hard to diagnose’ pelvic floor dysfunction in men because it can masquerade as other conditions like prostatitis – inflammation of the prostate gland – and constipation.
‘It’s a diagnosis of exclusion,’ he said, meaning other conditions have to be ruled out first.
However, pelvic floor dysfunction has become increasingly common in men, which could be due to increased awareness.
Earlier this year, the American Urological Association released new guidelines encouraging doctors to pay more attention to pelvic floor issues in men and refer them to appropriate providers.
Intense exercise can increase pressure around the pelvic area, leading to pelvic floor dysfunction (stock image)
Dr Rispoli said: ‘It’s more common for women to have pelvic issues and feel like they have a gynecologist they can go to or urogynecologist that treats what they have, and men feel a little bit more resistant to be able to get help from the appropriate specialist [for] pelvic floor dysfunction.’
To prevent and improve pelvic floor issues, Dr Shusterman recommends lifting or doing squats from an inclined position to ‘push upward instead of downward.’
Cyclists can also invest in a ‘prostate seat’ for their bike, which has a cutout in the center to take pressure off the perineum, the area between the genitals and the anus.
Treatment is largely focused on long-term physical therapy to work on the muscles rather than medication. Dr Shusterman said: ‘The goal is to try to build up the pelvic muscles a little bit better.’
This is done with biofeedback, which uses sensors to monitor muscle activity and translate it into visual or auditory cues on a computer screen so users can see the behavior.
Shockwave therapy can also help restore blood flow to the pelvic floor, further strengthening it.
‘It’s a longer term issue and whatever the problems are that brought this on need to continue to be treated,’ Dr Shusterman added.
