A recent wave of medical research and professional guidelines is bringing long-overdue attention to an often overlooked health issue for men: pelvic floor dysfunction. Once thought of as a women’s health topic, experts now warn that many men—potentially one in six—experience pain, sexual dysfunction, urinary problems, or incontinence linked to the muscles and nerves at the base of the pelvis. For Thai readers, traditionally less familiar with pelvic floor issues in men, these findings carry exceptional relevance for both aging men and younger athletes.
Historically, pelvic floor problems have been much more closely associated with women’s health, particularly after childbirth. However, new findings reported in the New York Times and supported by recent research and clinical guidelines suggest that men face a substantial risk of similar issues. Medical specialists now recognize that symptoms like pain, erectile dysfunction, incontinence, and even chronic constipation can be linked to the pelvic floor—a sling of muscles, ligaments, and nerves that support the bladder, bowels, and reproductive organs.
The shift in understanding is explained by Dr. Woodard, a physical therapy educator in New York, who documented his own struggle with pelvic pain and erectile dysfunction while training for an Ironman competition. Like many men, Dr. Woodard had never heard of “pelvic floor dysfunction” until referred by a urologist. This experience ultimately led him not only to cure his symptoms through specialized physical therapy but to dedicate his practice to educating other men and physical therapists about the issue.
Recent international guidelines now urge male patients and their doctors not to dismiss pelvic pain, incontinence, or sexual problems as inevitable with age or athletic activity. In April 2025, the American Urological Association issued its most comprehensive guideline for chronic pelvic pain in men, highlighting physical therapy as an evidence-based treatment and calling for greater awareness among practitioners across all age groups (AUA Guidelines).
For many men, pelvic floor disorders arise when the supporting muscles are either too tight or too loose. In men, an overly contracted pelvic floor is more common, often associated with high stress, frequent cycling, prolonged sitting, lifting heavy weights, or ignoring the urge to use the toilet for long periods. On the other hand, men treated for prostate cancer can develop weakened, overly lax pelvic floors, resulting in incontinence and sexual dysfunction.
Symptoms can be confusing, often mimicking urinary tract infections, prostate inflammation, or other urological diseases. As Dr. Amin Herati, a urologist at Johns Hopkins Medicine, explains, “Pelvic floor issues can masquerade as so many other conditions,” leading many men to undergo unnecessary tests or treatment for unrelated disorders before the real cause is found.
The evidence for physical therapy is compelling. Landmark studies published in 2025 underscore that targeted pelvic floor physical therapy is a first-line, non-invasive option for many men with chronic pelvic pain or dysfunction (PubMed chronic pelvic pain review). Pelvic floor physical therapists work directly with patients using massage, stretching exercises, diaphragmatic (deep abdominal) breathing, and real-time biofeedback via ultrasound, offering a tailored approach based on whether the problem is too much tension or too little muscle tone.
Yet, pelvic floor dysfunction in men carries a heavy stigma. According to physical therapists, cultural expectations and embarrassment prevent many men from seeking help until symptoms become severe. A leading physical therapist in Seattle notes, “Men still place so much of their self-worth around their pelvis. If they have pain or difficulty with bathroom or sexual functions, they feel like a failure.” The hope is that new professional guidelines and outreach will reduce this shame—especially important in cultures like Thailand’s, where men may feel strong social pressure to remain silent about intimate health concerns.
For men in Thailand, understanding pelvic floor health is crucial across various stages of life. Middle-aged and older men face greater risks after prostate surgery, while younger men may be affected by cycling, weightlifting, or chronic stress—behaviours increasingly common in modern Thai urban life. A study in the International Journal of Impotence Research (IJIR, 2025) found that pelvic pain and dysfunction are rising among young men engaged in endurance sports or highly stressful occupations (IJIR review). Data further suggest that up to 16% of men globally suffer from pelvic floor dysfunction at some point (Wikipedia).
The professional consensus now recommends that any man experiencing unexplained pain, difficulty with urination or bowel movements, or erectile dysfunction should consult a physician with expertise in pelvic floor disorders. A multidisciplinary approach—combining medical investigation to rule out infection or prostate disease, plus referral to a specialist pelvic floor physical therapist—is ideal.
Treatment does not always mean medication or surgery. For most cases of tight pelvic floor muscles, specialists stress the value of deep breathing exercises, guided stretching of the hip and groin muscles, and specialized physical therapy routines. Notably, experts warn against “Kegel exercises” unless evaluated by a therapist, as they can worsen symptoms if the condition stems from excess muscle tension rather than weakness. “Most people don’t do Kegels correctly,” states Dr. Ferriere, a leading pelvic floor physical therapist, “which can exacerbate a tight pelvic floor.”
Prevention and early action are key, especially for Thai men at risk due to lifestyle or occupational habits. Recommended strategies include regular exercise with attention to stretching, avoiding prolonged sitting or straining on the toilet, and integrating stress-reduction techniques, such as diaphragmatic breathing, into daily routines.
Pelvic floor disorders also carry broader implications for well-being: one recent study found that urinary incontinence and pelvic pain have a marked negative effect on quality of life and mental health for men with chronic diseases like COPD (PubMed – urinary incontinence), showing that the impact can extend across multiple domains of physical and mental health.
Thailand has begun to see a growing cadre of physiotherapists and clinics offering pelvic floor therapy for men, especially in major cities. Leading figures in the Thai Physical Therapy Association report a steady trickle of referrals from urologists and surgeons, though numbers are still low compared to Western countries. Cultural reluctance, lack of awareness among general practitioners, and the absence of routine pelvic floor check-ups for men remain significant barriers.
Traditionally, Thai men may turn to herbal medicine or massage for unexplained pelvic pain or sexual dysfunction, sometimes delaying effective treatment. While such approaches are valued culturally, experts emphasize that modern physical therapy is safe, evidence-based, and can work alongside traditional healing when guided by a specialist. As reported by the Thai Ministry of Public Health, patient education—combined with open conversations about male health—will be essential to overcome embarrassment and ensure early intervention.
In the coming years, increasing public awareness, especially through high-profile sports and community wellness campaigns, could dramatically improve men’s quality of life. If Thailand adopts guidelines similar to those issued by American and European professional societies, access to appropriate diagnostics and therapy will become more commonplace, helping to address the real, if invisible, burden of pelvic floor dysfunction among men.
For Thai readers, the call to action is clear: if you or someone you know experiences pelvic pain, urinary difficulties, or unexpected sexual dysfunction, do not ignore the symptoms. Speak discreetly with a doctor or physical therapist who understands male pelvic floor health. Early intervention, lifestyle adjustments, and destigmatization can restore not only physical health but also confidence and quality of life.
For more information, visit the American Urological Association guidelines or consult a certified physical therapist specializing in pelvic health. Sharing knowledge and breaking the silence could be the most powerful medicine of all.