Pelvic floor muscles in men

What are the pelvic floor muscles?

The floor of the pelvis is made up of layers of muscle and other tissues. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in front. A man’s pelvic floor muscles support his bladder and bowel. The urine tube and the back passage all pass through the pelvic floor muscles. Your pelvic floor muscles help you to control your bladder and bowel. They also help sexual function. It is vital to keep your pelvic floor muscles strong.

Why should I do pelvic floor muscle training?

Men of all ages need to have strong pelvic floor muscles. Pelvic floor muscles can be made weaker by:

• surgery for bladder or bowel problems;
• constipation;
• being overweight;
• heavy lifting;
• coughing that goes on for a long time (such as smoker's cough, bronchitis or asthma); or
• not being fit.

Men with stress incontinence – that is, men who wet themselves when they cough, sneeze or are active – will find pelvic floor muscle training can help in getting over this problem.

Pelvic floor muscle training may also be of use for men who have an urgent need to pass urine more often (called urge incontinence).

Men who have problems with bowel control might find pelvic floor muscle training can help the muscle that closes the back passage. This muscle is one of the pelvic floor muscles.

Where are my pelvic floor muscles?

The first thing to do is to find out which muscles you need to train.

• Sit or lie down with the muscles of your thighs, buttocks and stomach relaxed. It may be useful to use a hand mirror to watch your pelvic floor muscles as they pull up.

• Squeeze the ring of muscle around the back passage as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks.

• When go to the toilet to empty your bladder, try to stop the stream of urine, then start it again. Do this to learn which muscles are the right ones to use – but only once a week. Your bladder may not empty the way it should if you stop and start your stream more often than that.

If you don’t feel a distinct “squeeze and lift” of your pelvic floor muscles, or if you can’t slow your stream of urine as talked about in Point 3, ask for help from your doctor, physiotherapist, or continence nurse. They will help you to get your pelvic floor muscles working right. Men with very weak pelvic floor muscles can benefit from pelvic floor muscle training.

How do I do my pelvic floor muscle training?

Now that you can feel the muscles working, you can:

• Squeeze and draw in the muscles around your urine tube and back passage at the same time. Lift them UP inside. You should have a sense of “lift” each time you squeeze your pelvic floor muscles. Try to hold them strong and tight as you count to 8. Now, let them go and relax. You should have a distinct feeling of “letting go”.

• Repeat “squeeze and lift” and let go. It is best to rest for about 8 seconds in between each lift up of the muscles. If you can’t hold for 8, just hold for as long as you can.

• Repeat this “squeeze and lift” as many times as you can, up to a limit of 8 to 12 squeezes.

• Try to do three sets of 8 to 12 squeezes each, with a rest in between.

Do this whole training plan (three sets of 8 to 12 squeezes) each day while lying down, sitting or standing.

While doing pelvic floor muscle training:

• keep breathing;
• only squeeze and lift;
• do NOT tighten your buttocks; and
• keep your thighs relaxed.

Do your pelvic floor muscle training well

Fewer good squeezes are better than a lot of half hearted ones! If you are not sure that you are doing the squeezes right, or if you do not see a change in symptoms after 3 months, ask for help from your doctor, physiotherapist, or continence nurse.

When to seek professional help

Like all exercises, pelvic floor exercises are most effective when individually tailored and monitored. The exercises described are only a guide and may not help if done incorrectly or if the training is inappropriate.

Continence and men's health or pelvic floor physiotherapists specialise in pelvic floor muscle exercises. They can assess your pelvic floor function and tailor an exercise program to meet your specific needs. They can also prescribe other treatment options such as biofeedback and discuss relevant lifestyle factors with you.

Visit the Pelvic Floor First website for more information about pelvic floor exercises..

You can search for a list of continence and men's health or pelvic floor physiotherapists on the Australian Physiotherapy Association website. Or call the National Continence Helpline on 1800 33 00 66.