Don’t Ignore These Symptoms: Pelvic Floor Therapy Can Help Men, Too

When people hear “pelvic floor therapy,” they often think of pregnancy or postpartum recovery. But pelvic health is just as important for men, even if it’s talked about far less.

For many men, symptoms like pelvic pain, urinary issues or sexual dysfunction can feel confusing, frustrating and deeply personal. Because these conditions aren’t visible, they often go unspoken and untreated for months or even years.

“Pelvic health therapy applies to all people, regardless of gender,” says Carole High Gross, DPT, a Lehigh Valley Health Network pelvic health therapist. “It has to do with pain, urinary dysfunction, bowel dysfunction and sexual dysfunction. There are muscles, nerves and connective tissue everywhere in every body, including the pelvic floor.”

Pelvic floor dysfunction doesn’t always look the way people expect. Symptoms can vary widely and often overlap. Some of the most common concerns include:

• Pelvic, groin or tailbone pain (aching, pressure, burning or throbbing)
• Urinary issues, such as urgency, leakage, difficulty starting a stream or post-void dribbling 
• Bowel dysfunction, including constipation or pain with bowel movements
• Sexual dysfunction or pain during or after sexual activity

“Bowel, bladder and sexual function all go together,” Gross says. “If someone presents with one issue, we’re asking about the others too.” 

In some cases, men are diagnosed with chronic pelvic pain syndrome, where symptoms persist despite normal test results. Others seek care after prostate surgery, when urinary leakage can significantly impact daily life. “Up to 85 percent of individuals experience some sort of leakage after a prostatectomy,” she says. “That can be very overwhelming and distressing.” 

Despite how common these concerns are, they’re often underrecognized and undertreated.

One of the biggest challenges in pelvic health is simply getting to care. “Often, people are hopeful the pain will just go away,” Gross explains. “It’s a hard thing to talk about. There can be fear of judgment or assumptions.” 

Instead of seeking help early, many men go through a long cycle of appointments, tests and treatments before finding pelvic health therapy. By the time they arrive, symptoms may have been present for months or years.

That delay can complicate recovery. “When pain lasts longer than three months, the brain starts to process signals differently,” she says. “The longer it takes to get help, the more sensitive the nervous system can become.”

Because pelvic floor issues aren’t outwardly visible, their impact is often underestimated. “It can affect self-esteem, relationships and increase depression and anxiety,” Gross says. 

Over time, symptoms can start to shape everyday decisions. Some men stop exercising or avoid social activities. Others feel anxious about leaving the house, traveling or even spending time with family. “I’ve had patients worried about going on a family vacation because of urinary issues or pain,” she shares. “It really can affect every aspect of their life.”

Pelvic health therapy is often more approachable and comprehensive than people expect. “We don’t just address the pelvic box,” Gross says. “We look at the whole person – how the diaphragm, abdominal wall, pelvic floor, hips and back move, as well as posture, body mechanics and pressure management.” 

At your first visit, you can expect a personalized, step-by-step approach that may include:

• A detailed conversation about your symptoms, health history and lifestyle
• An assessment of movement, posture, breathing and core function
• Discussion of bowel, bladder and sexual health
• A collaborative plan tailored to your goals and comfort level

Treatment may involve exercises, breathing techniques, biofeedback or education on daily habits such as fluid intake and body mechanics.

Importantly, therapy is always collaborative. “Not all pelvic health assessments and treatments need to be internal,” Gross says. “We provide options and make the individual the captain of their ship.” 

Pelvic health therapy often works best as part of a broader care plan. Patients may be referred by primary care clinicians, urologists or gastrointestinal specialists, and, in some cases, even mental health clinicians or fitness professionals.

“It’s a multidisciplinary approach,” Gross says. “We’re part of the puzzle, but we’re not the only member of your clinical team.” This whole-person perspective is key. Pelvic health is influenced by physical, emotional and lifestyle factors, and addressing all of them can lead to better outcomes.

For many men, starting the conversation is the hardest step. But those who do often feel a sense of relief. “Patients are usually extremely grateful to finally have a safe space,” Gross says. “They’ve often been searching for help for a long time.” 

And the impact can be life-changing. With the right support, many men can find relief, regain confidence and get back to the activities that matter most.