For years, men’s pelvic health has flown under the radar — often ignored by both patients and providers. But growing evidence reveals that pelvic floor dysfunction in men is not only real, but common, misunderstood, and undertreated.
Dr. Chad Woodard, an assistant professor of physical therapy at Hunter College, discovered this firsthand in his 30s while training for an Ironman triathlon in New York City.
Despite his extensive fitness regime, he began experiencing unexplained pelvic pain and erectile dysfunction. It wasn’t until a urologist raised the question of pelvic floor dysfunction that he connected the dots — and realized his own pelvic muscles were part of the problem.
The pelvic floor is a complex network of muscles, ligaments, and nerves at the base of the torso that supports essential functions like urination, bowel movements, and sexual performance. When these muscles become either too tight or too weak, it can result in chronic pain, incontinence, and sexual dysfunction. Yet, for many men, this region of the body remains a mystery.
Pelvic floor dysfunction is often misdiagnosed because its symptoms overlap with more familiar conditions like prostate issues, infections, or even cancer, according to Dr. Amin Herati of Johns Hopkins Medicine. But as awareness grows, experts are calling for more attention to this overlooked men’s health issue.
In fact, the American Urological Association recently issued new guidelines urging physicians to consider pelvic floor dysfunction in male patients and to refer them to specialized physical therapists when appropriate. These recommendations are part of a larger shift toward recognizing the importance of men’s pelvic health.
Physical therapist Jacob Bartholomy notes that for many male patients, the emotional toll of pelvic dysfunction can be devastating. “Men still place so much of their self-worth around their pelvis,” he says. Struggles with bathroom habits or sexual performance often lead to shame and silence — making professional treatment even more essential.
Tight pelvic floor muscles are more common in men and often result from chronic stress, constipation, prolonged sitting, or intense physical activity like cycling or weightlifting. Over time, these factors can trap the muscles in a state of near-constant tension, reducing their ability to function properly.
Conversely, overly lax pelvic muscles are most often seen after prostate cancer surgery, which can damage the muscles supporting bladder and sexual function. These men are especially prone to incontinence and erectile difficulties.
While education on pelvic floor therapy is still limited in many physical therapy programs, clinicians like Dr. Woodard are leading the charge to bridge that gap. After using pelvic floor exercises to heal himself, he now specializes in treating men with similar issues — helping them restore their health and dignity.
Men who once struggled to function are now able to reclaim their lives through physical therapy. As awareness spreads and new guidelines support earlier diagnosis and treatment, pelvic floor care is finally earning its place as a vital component of men’s health.
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