More young men are seeking care for pelvic floor disorders

Clinicians across the U.S. are reporting more young men coming in with pelvic pain, urinary symptoms, constipation, and sexual health issues tied to pelvic floor dysfunction. Experts say earlier evaluation could speed treatment for a condition that often goes unrecognized.

Why it matters: - Pelvic floor disorders are increasingly showing up in young men, not just in women after childbirth or older men after prostate surgery. - Earlier diagnosis may matter because these conditions are often highly treatable before symptoms become chronic. - Athletes and active adults may be especially affected because sports and training place stress on the core, hips, spine, and pelvic floor.

What happened: - Healthcare professionals across the United States are seeing more young men seek care for pelvic floor related symptoms. - Reported symptoms include pelvic pain, urinary urgency and frequency, constipation, painful ejaculation, erectile dysfunction, and chronic groin or testicular pain. - Dr. Philippe Schafer, a New York City physical therapist who specializes in men’s pelvic health, said many young men are surprised that urinary frequency, pelvic pain, erectile dysfunction, or pain during exercise may have a musculoskeletal component.

The details: - The AMA Journal of Ethics reports that about 3% to 16% of men in the U.S. experience prostatitis-like symptoms that overlap with pelvic floor dysfunction. - Chronic prostatitis/chronic pelvic pain syndrome, or CP/CPPS, is described as the most common diagnosis in this category and the most frequent urologic diagnosis in men under 50. - Chronic pelvic pain syndrome can involve musculoskeletal, neurological, and psychosocial factors. - Symptoms may include pelvic pain, urinary difficulties, sexual dysfunction, bowel dysfunction, and pain during or after exercise. - Research has found men with chronic pelvic pain often show pelvic muscle abnormalities, increased muscle tenderness, and musculoskeletal dysfunction compared with healthy controls. - Athletes are a key subgroup, including people in running, cycling, weightlifting, hockey, soccer, and other high-performance sports. - A recent international study of youth athletes found nearly one-third of male athletes reported pelvic floor symptoms. - Clinicians are also seeing a link between lumbar spine injuries and pelvic floor disorders. - Some young athletic men with lumbar disc herniations later develop urinary urgency, pelvic pain, constipation, erectile dysfunction, or other pelvic floor complaints. - The nerves controlling bladder, bowel, sexual, and pelvic floor function originate from the lower spine. - Research has shown lumbosacral disc pathology is among the most common causes of neurogenic urologic dysfunction. - Investigators are focusing on the connection between disc herniation, pelvic floor muscle dysfunction, constipation, urinary symptoms, and sexual dysfunction. - Schafer said some patients have already seen multiple providers, had imaging, taken medications, or received repeated courses of antibiotics before anyone evaluates the pelvic floor, hips, spine, breathing mechanics, and movement patterns together.

Between the lines: - The shift suggests male pelvic floor symptoms may be more common than public awareness and routine screening would suggest. - The condition is increasingly being treated as a broader pelvic health issue rather than a narrow urology problem. - A multidisciplinary approach now often includes urologists, gastroenterologists, physical therapists, pain specialists, and mental health professionals. - That approach targets muscular dysfunction, movement impairments, nervous system sensitization, lifestyle factors, and psychological stressors.

What's next: - Clinicians hope more young men will seek evaluation earlier instead of waiting until symptoms become persistent. - More patients may benefit from coordinated pelvic health care as awareness improves among athletes, primary care providers, and specialists. - More information is available from Schafer Physical Therapy or from a healthcare provider experienced in men’s pelvic health.

The bottom line: - Young men with pelvic pain, urinary problems, or sexual dysfunction may have a treatable pelvic floor disorder that needs earlier recognition and a broader care approach.