One exercise that targets the pelvic floor muscles is the glute bridge, as seen here. — Filepic
Most people don’t give their pelvic floor a thought until it acts up.
For women, this often happens during pregnancy and after childbirth, when coughing, sneezing or laughing can cause urine to leak – a sign of weakened pelvic floor muscles due to overstretching.
But men too would do well to give some love to their pelvic floor – a dome-shaped sheet of muscles and connective tissue forming the base of the abdomen in both men and women.
“A male’s pelvic floor is constructed completely differently than a female’s” though, says German urologist and andrologist Dr Wolfgang Bühmann.
“An integral pelvic floor organ in men is the prostate, while in women, it’s the uterus.”
Potential problems
The prostate – a walnut-sized organ that sits below the bladder, very close to the pelvic floor – plays a key role for the muscle sheet, he explains.
“If it has to be removed due to cancer, the pelvic floor loses an essential buttress that’s important for urinary continence,” he says.
According to Dr Bühmann, about 10-15% of men who have their prostate removed develop urinary incontinence, i.e. the unintentional passing of urine, and should therefore, do special exercises to strengthen their pelvic floor.
“For the others, the pelvic floor causes no problems after surgery and exercises aren’t necessary.”
The risk of post-operative problems depends on various factors, he says, “including the size of the tumour, how much of the pelvic floor was damaged and how well the tissue was able to be stitched back together”.
Hamburg-Eppendorf University Medical Centre Men’s Health Division director Dr Frank Sommer notes that the pelvic floor, along with other core muscles, “is important not only for continence and sexuality, but also overall stability”.
A weak pelvic floor can cause back pain, says the German Society for Men and Health (DGMG) president, as well as “lead to abnormal curvature of the spine and herniated spinal discs”, not to mention erectile dysfunction.
“The duration of erection capability depends on the pelvic floor, as does men’s ability to control their ejaculatory reflex and prevent premature ejaculation,” he points out.
Dr Sommer emphasises, however, that erectile dysfunction isn’t always due to a weak pelvic floor.
The possible causes are many, so a precise diagnosis is necessary.
“Only then can it be determined whether the pelvic muscles are involved and should be targeted for strengthening.”
Besides erectile dysfunction, potential signs of a weak pelvic floor include involuntary loss of urine, back pain and poor posture.
If you have any of these problems, it may be a good idea to discuss your pelvic floor with a urologist or proctologist.
Helpful exercises
Before you can do exercises to strengthen your pelvic floor muscles, you have to learn how to tense and relax them, which isn’t so easy.
“The inlying muscles, which you can’t see, are especially important in this regard,” Dr Sommer says.
“They’re all striated muscles, which means you can voluntarily control them, in contrast to smooth muscles – found, for example, in the penis – which you can’t.”
To get a feel for your pelvic floor muscles, the Cologne-based Institute for Quality and Efficiency in Health Care (IQWiG) advises stopping urination in midstream.
By clenching your urethral sphincter – a muscle that controls the exit of urine from the bladder – you also tense your pelvic floor muscles.
As an alternative, squeeze and try to “lift” your perineum – the area between your anus and scrotum.
This too will work your pelvic floor muscles.
Another way to strengthen your pelvic floor is an exercise called a glute bridge.
Lie on your back with your knees bent and about shoulder- width apart, and your feet flat on the floor.
Slowly raise your hips into a straight diagonal line from your shoulders to your knees.
Hold for a few seconds, slowly lower your hips and repeat. – By Julia Felicitas Allmann/dpa
