“Can pelvic floor physical therapy benefit men/penis owners as well?”

This is one of the most common questions I get as a pelvic health physical therapist. When we see people talking about pelvic health physical therapy, it is usually in preparation for and/or recovery from birth. Because of this, pelvic floor services seem to be reserved for those with a vagina.

Pelvic Health for Penis Owners

Before we get too far into pelvic health for “penis owners” I want to explain what I mean when I use this term, and why it matters. One of my goals is to improve the language around gender, sex, and sexual orientation. As a pelvic health PT, many people I work with come to me with sexual dysfunctions. So, knowing and understanding their sexual and gender identities is vital! When I say “penis owner”, this includes everyone such as cis men (those who were assigned “male” at birth and identify as such), trans women who have not had bottom surgery, and non-binary individuals who have a penis. By using this simple term, we are able to reach and include all individuals who have a penis; but I digress.

Why is Pelvic Therapy for Men Different?

There are a few differences with the anatomy of a penis owner that makes pelvic floor physical therapy unique when compared to traditional “women’s health” issues. It’s important to find someone with experience in treating “men’s health” as most postgraduate education for pelvic health PTs is focused on treating people with a vagina.

What is Unique:

The average pelvic floor of a vagina owner looks and functions a little differently than that of a penis owner. While we all have the same pelvic floor structures, the “setup” and the organs are not all the same. One major difference is the prostate–a walnut shaped organ found in those with a penis. The prostate surrounds the urethra (the tube that we pee out of) and has many functions, but primarily helps form and eject semen out of the penis.

What are the Common Things we Treat:

When I work with someone who has a penis, their complaints usually involve things like pelvic/abdominal pain, urinary retention, urinary hesitancy, constipation, erectile dysfunction, etc.

  • Chronic Pelvic Pain Syndrome (AKA: Type 3 Prostatitis): 90% of those diagnosed with “prostatitis” fall into this category. The important thing to understand about this diagnosis is that the prostate is not at fault, and antibiotics won’t help solve the problem. Pelvic Health PT has been shown time and time again to be the best treatment for this condition.
  • Pre/post-prostatectomy: Since the prostate sits between the bladder and the pelvic floor and surrounds the urethra, removing the prostate can influence these surrounding structures, often leaving you with symptoms such as erectile dysfunction and urinary incontinence. Seeing a pelvic health PT before and after surgery can drastically improve outcomes and quality of life.
  • Erectile dysfunction [ED]: The pelvic floor muscles play an integral part in your ability to initiate and maintain an erection. While medications such as Viagra or Cialis are now well known, pelvic floor physical therapy has been shown to be the most effective first line treatment at addressing ED.
  • Hard Flaccid: This is a type of chronic pain syndrome and dysfunction that presents as change/difficulty with erections, penile pain, numbness, ED, pain with ejaculation/urination, and shortening/cramping of the penis. Much like the other syndromes listed, pelvic health physical therapy has been a game changer for those experiencing hard flaccid.
What else can be addressed with Pelvic Health Therapy

While these are the most common things we treat as pelvic health physical therapists, this is by no means an exhaustive list. There are many possible causes to the symptoms you are experiencing, but the underlying commonality is dysfunction within the pelvic floor and related structures.