The Mysterious Pelvic Floor: Why Both Sexes Should Pay Attention

Yes, we’re going there. Why not? If we can talk about adult diapers and potty time, why can’t we talk about all the delicate parts supported by the pelvic floor? If you’re a woman, you’ve probably heard about Kegel exercises and strengthening the pelvic floor, especially if you’ve had children. As for the men reading this (yeah, we know you’re there), you probably haven’t heard a thing about this topic unless you joined your wife in birthing classes.

But ladies and gentlemen, that’s about to change. Let’s get down to the nitty gritty and understand what the pelvic floor is and how it impacts continence and sexual health – two things you care deeply about.

The Trampoline in Your Abdomen 

No kidding. The pelvic floor is often described as a trampoline stretched from your tailbone to your pubic bone (front to back) and then from one sit bone to another (side to side). So it effectively sits at the very bottom of your pelvis acting like a stretchy, muscular floor – hence the term pelvic floor.

This pelvic trampoline is made of layers of firm, thick muscle that keeps important pelvic organs well supported and in their proper place.

The Bladder Connection 

Your bladder is one of the organs supported by the pelvic floor. Other organs include the uterus and bowel in women and the bowel in men (the prostate is also involved but is considered a gland not an organ).

Here’s where it gets interesting! Your urethra runs from your bladder through the pelvic floor where it’s surrounded by the urethral sphincter. When you tighten your pelvic floor muscles, they in turn activate the urethral sphincter, allowing you to close off the flow of urine. This basic concept of the pelvic floor initiating sphincter contraction also applies to the anus and vagina that run through the pelvic floor as well.

In short, you can control the flow of pee, poo, and vaginal contractions by tightening and relaxing the pelvic floor muscles and thereby the appropriate sphincter.

Bladder Problems and the Pelvic Floor

You can already see the problem coming, can’t you? When your pelvic floor muscles become weakened or loose, your sphincters also don’t function properly. This means you have less control over the flow of urine and bowel movements causing varying degrees of incontinence.

After considering this, you might think that a tight pelvic floor is the key to health and happiness. It’s a logical conclusion, but that’s not how it works. According to wellness and fitness guru Lauren Roxburgh, a resilient pelvic floor should be your goal. You not only want these muscles to contract at the right time, but you also want them to relax when necessary. Pelvic health requires balance.

If your pelvic muscles become too tight, your sphincters partially or completely close off, and you either can’t pass urine at all or can’t empty completely. This is often accompanied by pressure and bladder pain or discomfort.

Keep in mind, at this point, you can no longer tell if your pelvic floor muscles are sufficiently relaxed: the tight muscles feel normal to you. So, you believe you emptied your bladder – but didn’t – and then must return to the bathroom an hour or two later. For information about incomplete bladder emptying, check out our article Help! Why do I have Frequent Bladder Pain and Pressure?

Overly tight muscles indicate a shortening of the fibers, and when a muscle can’t lengthen it’s basically useless. For your pelvic floor to be effective, it must contract and relax. This means a tight pelvic floor might be mistaken for a weak one.

What Weakens These Muscles? 

Anything that strains or puts too much prolonged pressured on the pelvic floor muscles can stretch and loosen these muscles. Other than a couple exceptions, men and women are about equally prone to this condition.

Pregnancy/Childbirth (large babies, multiple deliveries, vaginal trauma) Prostate Cancer Surgery Obesity Chronic constipation High-impact exercise Aging Heavy lifting Chronic cough Systemic disease (especially autoimmune) 

What Tightens These Muscles? 

Pain and stress are the top causes of a tight pelvic floor. In both cases, you instinctively and unconsciously tense your body – including your pelvic floor muscles. If pain or stress keep you tense frequently or for long periods, then these muscles don’t have time to relax. As a result, they’re trained to stay in the tense position and lose the ability to relax.

Other causes include working out a lot (with tight core muscles) and having a long-time habit of holding bladder or bowel movements.

Sexual Problems and the Pelvic Floor 

In Men

The pelvic floor plays two key roles in your sexual ability. It’s what allows the penis to fill with blood during an erection and pump during ejaculation. If your pelvic floor is weak, blood flow to the penis is interrupted, and the outcome isn’t favorable for an erection. You’ll also experience less intense orgasms as ejaculation isn’t as forceful or complete.

On the other hand, when a man has a tight (hypertonic) pelvic floor, he might experience painful erections. This is because when muscles are tight for too long, they become tender and painful. In the case of an erection, further demands are made on the overtaxed pelvic floor muscles, causing pain. A hypertonic pelvic floor might also cause other erectile dysfunction problems like those of weakened muscles.

Guys, you might want to check out this article from Men’s Health about pelvic pain (written just for you).

In Women

When you squeeze healthy pelvic floor muscles during sexual intercourse it increases sensation. Additionally, women hear a lot about how these muscles make childbirth easier. There’s no shortage of yoga and Kegel exercise workouts aimed at preparing pregnant women for labor and delivery.

Conversely, if a woman has a tight pelvic floor, she might experience pain during or after sexual intercourse, because a portion of the vagina runs through the hypertonic pelvic floor muscles. When these muscles are tight and unable to relax, the vagina is also constricted.

How to Have a Strong (and Resilient) Pelvic Floor 

Pelvic floor dysfunction wreaks havoc on your bladder, bowel, and sex life, which means you’ll want to address issues as soon as possible.

Pelvic floor muscle training (PFMT). For both weak and tight muscles, PFMT is a non-invasive option that gets results. It involves Kegels and other pelvic floor exercises, and depending on the severity of your problem, you can do these on your own. You’ll learn to both relax and tighten muscles. If your issues are more severe, you might benefit from a pelvic floor therapist who uses biofeedback.

Other treatments include:

Reverse Kegels Treating constipation Avoiding pushing or straining during urination Regular deep breathing Warm baths twice daily Good posture to keep pressure off pelvic organs Yoga or stretching Stress management Sometimes doctors prescribe compounded medication for the vagina or rectum that acts as a localized muscle relaxant.

Pelvic Floor Dysfunction and Urine Leaks 

Healing the pelvic floor takes time. So while you’re working toward building resilient muscles, you might need some leak protection. The need is different for everyone, which is why we have light protection for those occasional dribbles and maximum protection to give you security day or night.

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