Copyright © 2009 by Amy Stein. Click here for terms of use.
Pelvic floor disorders aren't just a women's problem.
Although women do suffer disproportionately from pelvic floor disorders, dysfunction in this area of the body is by no means a "female issue." The pelvic floor is the pelvic floor, in men as in women. And while the genital anatomy and organs obviously differ between the two sexes, the pelvic floor muscles are the same, have the same purpose, function in almost the same exact way, and can malfunction with the same unhappy results. Moreover, the nerve pathways are the same in both sexes, although the names are slightly different, so nerve-related pain will radiate with the same cascading impact in men as in women.
There is, however, a strictly male-oriented component of pelvic floor disorder, and it is, unhappily, a not uncommon occurrence. That is, studies show that 95 percent of chronic prostatitis, pain in and around the prostate, is nonbacterial and very likely a result of pelvic floor dysfunction. "Nonbacterial" means that the pain is not a result of an infection or disease—and is therefore not treatable by antibiotics. Rather, such chronic nonbacterial prostatitis is a disorder of the muscles, nerves, or tissue; in other words, it is musculoskeletal in origin. It means that the urinary frequency, urgency, retention, and pain that men may feel in the urethra, bladder, abdomen, rectum, thigh, back, or genital region—pain that may afflict them when they walk, climb stairs, sit, lie down, void, or engage in sexual activity—may well be signs of this nonbacterial prostatitis. If that's the case, both the pain and its underlying cause are best addressed the natural way, with the exercises and other therapies detailed in this book—rather than with surgery or antibiotics.
I have treated a number of patients who were diagnosed with prostatitis and were prescribed antibiotics. After months of this pharmaceutical regimen—and no relief—they were finally referred for physical therapy and found both an end to their pain and a cure. Given what we keep learning about diseases that are resistant to antibiotics due to their overprescription and overuse, such experiences underlie the important object lesson of this book: make sure to ask your doctor if there isn't a noninvasive therapy for your pain or discomfort before you accept a recommendation of drugs or surgery. That is certainly the case when nonbacterial prostatitis is the diagnosis; it may well be cured with the exercises and therapies in this book without requiring drugs or the extreme measure of surgery.
Men typically suffer the same two basic categories of disorder that women suffer—namely, those that result from muscles and tissues that are too tight and/or from nerves that are irritated, and those that result from muscles that are too weak. Not surprisingly, the disorders derive from the same basic causes as well.
Maybe it was too many long, fast bike rides on that narrow, high-tech, Italian bicycle saddle. Maybe it was the heavy lifting you did when you helped out on your neighbor's house renovation, or decided you'd like to split the firewood logs yourself, or hauled the summer deck furniture back into the garage in the autumn, or took up weight training at the gym and did it to excess. A simple fall, especially if you landed on the tailbone, or that old sports injury from when you slid into third base last summer and hammered your sacroiliac joint: any and all of these can result, sooner or later, in a pelvic floor disorder.
Of course, acute prostatitis is another cause of pelvic floor disorder in men. A diagnosis of chronic nonbacterial prostatitis is typically the spasming, tightening, and shortening of the pelvic floor muscle. In the case of acute prostatitis when antibiotics are necessary, the irritation and discomfort that it produces can lead to a habitual holding and tightening of the pelvic floor muscles. Result? Pelvic floor dysfunction and its accompanying pain.
One other cause that happens to men only is a prostatectomy—that is, the removal of the prostate—or radiation treatment for prostate cancer or such other reproductive cancers as testicular cancer. As any prostate cancer patient knows, these therapies for the disease can result in problems of incontinence and erectile dysfunction. In such cases, your oncologist may only be able to promise you that function will come back "within a year or so," not a terribly cheerful prognosis. What your doctor may not tell you is that a specialist in pelvic floor dysfunction may be able to help. So will the exercises and other therapies in this book. Follow them, and you may well speed your recovery and avoid problems in the future.
Typically, the disorders deriving from tight, spasmed muscles can cause urinary and bowel urgency, frequency, and retention; tension and pain throughout the pelvic, abdominal, genital, back, and hip regions; and pain and dysfunction associated with urination, defecation, or sexual activity. These disorders can be addressed with the End-the-Pain exercise routine in Chapter 3 along with the massage therapies in Chapter 5.
Men also suffer from pelvic floor weakness and may experience the incontinence, decreased libido, and erectile dysfunction that may be the result from such weakness. And while we tend not to think of men doing Kegels, they can and do—the same way that women do them with outcomes as beneficial as those women experience. After all, men certainly have sexual muscles—specifically, the PC muscle—and strengthening it through Kegels and other exercises can greatly enhance sexual activity, pleasure, and longevity in men as in women. Refer to Chapter 4 for those exercises.
In addition to the exercises, men will also benefit from following the recommendations in these pages for self-care, nutrition, and other natural healing therapies.