Actually, Pelvic Floor Exercises Are for Men, Too

That doesn’t mean every man should do Kegels, though. A healthy pelvic floor can protect urinary and sexual health; here’s how to care for it.

This one’s for the Super Aging Men: If your pelvic floor is weak — in one of two different ways — you can feel a more urgent need to pee, have softer erections, or experience pelvic pain after sex, premature ejaculation, or erectile dysfunction. A weak pelvic floor can even make you weaker in the gym.

“Your pelvic floor is part of your core,” says Liz Miracle, DPT, a pelvic floor physical therapist, assistant clinical professor at the University of California San Francisco, and a consulting scientist for a pelvic floor trainer company, kGoal. “So anytime you’re using your core in a workout or to lift something heavy, your pelvic floor should be working with your abdominal muscles.”

If it’s not clear yet, pelvic floor issues don’t just impact women. Yet many men, Miracle says, don’t even realize they have a pelvic floor. As it turns out, we have the same musculature down there that women do; the one difference, Miracle says, is ours doesn’t expand in childbirth. 

And because men have a pelvic floor, and its health is important to all the conditions above, we can also benefit from pelvic floor exercises. In studies, squeeze-and-release moves have helped men with erectile dysfunction, improved urinary continence after prostate surgery, and helped guys feel less urgency to urinate all the time.

The tricky part is that your pelvic floor can be “weak” in different, opposing ways, and that can impact how (and if) you should exercise it for strength and control. Here’s a little more about your floor, what makes dysfunction occur, and how to determine the kind of weakness that your pelvic floor might be experiencing. Then, a personalized prescription for what to do about it. 

What Your Pelvic Floor Is, and the Different Ways It Can Be Weak

The pelvic floor is a bundle of muscles in the groin area: the pubcoccygeus, iliococcygeus, puborectalis, bulbocavernosus (BC), ischiocavernosus (IC), and transverse perineal muscles. The one most men are most familiar with is probably the BC: It’s the muscle you use to expel those last few drops of urine, and it squeezes when you ejaculate. The pelvic floor muscles are made up of about 70 percent slow-twitch muscle fibers, like the kind you use when you walk, and 30 percent fast-twitch muscle fibers, which are responsible for more violent contractions. That proportion can get thrown off by aging, prostate surgery, inactivity, or nerve damage. 

When this cluster of muscles becomes dysfunctional, men can suffer from issues that range from inconvenient — like feeling more urgency to urinate, or having a little extra urine leak out after you’re done peeing — to more serious, embarrassing, and devastating conditions like ED. 

Lots of advice you’ll see online say that there’s a single solution: Strengthen your “weak” pelvic floor with Kegel exercises, squeezing and holding the muscles of the pelvic floor. But your pelvic floor may not be “weak” in the traditional sense, says Aaron Frazin, a sex therapist in Chicago and New Orleans.

“Many men don’t have weak pelvic floors [when it comes to contraction]. They have pelvic floors that can’t fully relax,” he says. One metaphor, he says, is a trampoline: Too loose won’t let you bounce. But too tight’s no good, either.

“You can have a loose pelvic floor that’s weak, and you can have a tight pelvic floor that’s weak,” Miracle says. To understand this, she says, think of a broken arm that’s been in a cast with a bent elbow. When the cast is removed, “you’ve put your biceps in a shortened position. Now your arm is not really fully able to straighten out. So you’ve got this tight and weak biceps muscle.”

Your pelvic floor muscles can be the same way: They can be so used to contracting that they can’t really release and relax. This kind of tight, weak pelvic floor can result in bowel leakage, erectile dysfunction, pain with bowel movements, urination, and ejaculation, Frazin says.

Meanwhile, a loose, weak pelvic floor can lead to incontinence, like when going for a fast run and having a little bit leak out. This is what many men experience after prostate surgery.

In the case of tight, weak muscles, focusing on squeezing them more with Kegel exercises isn’t helping. Instead, Miracle and other practitioners think of these moves as pelvic control exercises, with focus on not just the squeeze, but the full release and relaxation of the pelvic floor.

Loose and tight pelvic floors can result in similar symptoms, and it’s not easy for men to determine which is causing their maladies. Women, Miracle says, can test it by inserting something in their vagina.

“We can insert our finger and kind of see, how does it feel? Does it feel like something is gripping around my finger, or is there space in there?” she says. For men, she says, there’s always the anus — but you might need a doctor’s help. “If you haven’t felt 1,000 anuses and know which one is a tight one and which one is a loose one, it might be very hard to do that kind of exam on yourself.”

How to Test Your Pelvic Floor and Work It the Right Way

If you’re feeling pain or experiencing symptoms of erectile dysfunction, it’s a good idea to consult with a doctor about your pelvic floor. They may be able to refer you to a pelvic floor physical therapist. Miracle also works with a device called the “kGoal Boost” from an app called kGoal, where she’s a consulting therapist. This device, which connects to the app, is kind of like a small Bosu ball that you sit on to perform pelvic moves.

But if you’re having some mild symptoms, or just want to see how your pelvic floor’s functioning, you don’t need to start with an apparatus or appointment. You can start simply and safely at home, Miracle says. Do a small test the next time you pee, and then file yourself into one of two groups to start.

To do the test, try stopping the flow of urine, or at least narrowing it, the next time you pee. (Note: Only do this once, not all the time, as it can lead to bladder dysfunction.)

• If you can stop and restart your stream with minimal pain, you most likely have a healthy pelvic floor. File yourself into Group A below. 
• If you can’t stop your urine, you may have a loose, weak pelvic floor. You’re Group B.
• If you can stop it, but can’t get it to come back or you experience pain during the exercise, put yourself in Group C. This also applies, Miracle says, if you’re having trouble starting at all. This group may have a tighter, weak pelvic floor.

Group A: Can Stop and Start Without Pain

If you can stop and start your urine with minimal pain, you probably don’t need to strengthen your pelvic floor with specific exercises, Miracle says, unless you’re experiencing some mild ED symptoms.

In that case, you can join in with the guys from Group B who couldn’t stop their urine and try some pelvic floor exercises. 

Group B: Can’t Stop 

Sit in a chair and contract your pelvic floor muscles — think of making your penis move or “pop” up without your hands — and hold the contraction for up to 10 seconds. For as long as you can hold the contraction, work on relaxing your muscles for an equal amount of time. So if you can squeeze for five, relax for five, trying to completely relax before squeezing again.

If you’re not sure if you’re squeezing in the right place, try placing your hand on your perineum, the space between your scrotum and anus. You should feel this area move when you squeeze.

Do sets of 10 hold-and-release moves, doing this a few times throughout the day, five days per week. You may start to notice a difference in symptoms in six weeks.

Group C: Can’t Start Back Up

If you’re having trouble getting started, you may have a prostate issue, Miracle says. But in the absence of this, you (and guys who can stop, but can’t start again) may have a pelvic floor that’s too tight.

For these men, Miracle suggests trying some diaphragmatic breathing exercises.

Sit with a hand on your chest, and one on your belly. Start breathing in a relaxed manner. Don’t force your breath. As you breathe, feel which hand is experiencing more motion; the goal is to move more of your breathing into your belly, and out of your chest.

“Now the goal is to have your breath go lower. Imagine the bottom of your abdomen is a balloon, and the belly is expanding,” she says. “You want the balloon to start to expand downward between your sit bones into the perineal muscle, the one between your penis and anus.”

If you can’t feel if the breath is going there, remove the hand from your chest, and place your hand down there. See if you can feel the breath relaxing and expanding this area. 

Perform this breathing exercise for five minutes per day. You may not be able to move the breath down that far, or at all, on the first day. But keep practicing, and you may loosen your tight pelvic floor.

All 3 Groups Should Activate Their Pelvic Floor Every Day

One reason our pelvic floors lose function is age, but another is inactivity. We can’t stop aging, but we can keep it active, including every time we’re in the gym.

When you’re lifting something heavy, Miracle says, concentrate on activating your pelvic floor as you set your core: Draw your belly button into your spine, and then flex the pelvic floor before you lift. This will help keep it active, and may also improve your lifts. Miracle says that her patients often experience personal bests once they start activating in this way.

And, to rule out any underlying conditions, be sure to speak with your doctor about any persistent symptoms you may be experiencing. 

Read This Next: