Question from Marc: I have premature ejaculation. It has been part of my life since I was sexually active at 16 years old and I am now 33. Is this something that can be helped by pelvic floor physical therapy?
Answer from Becca: Marc, I would imagine that you may have been treated by psychotherapists for your issue. In the last century, many specialists have placed premature ejaculation into the category of a problem of the brain. However, pelvic floor physical therapists now treat your particular diagnosis in an entirely different manner. What we have discovered in treating men like you, is that those who experience early climax often have tight musculature in their saddle muscles (the muscles of your body that would be in contact with the saddle of a horse, were you seated upon one). In the ideal situation of arousal, these saddle muscles should expand and allow blood to flow into the penis and testicles. This blood should be retained in this saddle area to allow for an adequate time span during arousal and penetrative sex before ejaculation. In the case of premature ejaculation, the muscles of this saddle region are taut and cannot allow accumulation of blood to pool in the testicles and penis, which then creates an emergency expulsion of the seminal fluid from the penis.
This condition of premature ejaculation is treated in pelvic floor physical therapy. We assist men in reaching longer time durations of their erections by teaching them to lengthen their pelvic floor (saddle) muscles. We also instruct patients and their partners to increase the time of arousal and defer climax, thereby encouraging the blood flow necessary to prolong the sexual experience. In answer to your question, Marc, you can find help with a pelvic floor physical therapist.
Question from Steve: I suffer from chronic constipation. While that is terrible by itself, I also find that I cannot get fully hard during sex when I am constipated. Am I imagining this, or is there a correlation between constipation and erectile dysfunction?
Answer from Becca: Steve, I wish that more of our patients made this connection between the bowel and sexual function. The organs that sit within the relatively small cavern of the bony pelvis in men are the bladder, prostate, and the end of the colon (rectum). These organs are crammed into a very tight space. Which means that when one of these organ systems is a little bit off, the other systems invariably feel askew as well!
When the bowel is impacted with stool, as it is with constipation, this organ presses on the prostate and then the bladder. Also, the pressure on the perineum (the saddle region we discussed in Marc’s case), is created by too much fecal matter accumulating in the bowel. This excess pressure inhibits a full sexual response and limits full erections in men. The long-term discomfort associated in prolonged constipation can also distance a man from wanting to engage in sex.
The solution: pelvic floor physical therapists treat bowel dysfunction. We educate our patients in how to improve bowel regularity with stretches, exercise and lengthening of the pelvic floor muscles. What we find in treating patients like Steve is that when regular bowel movements are achieved, more satisfactory sex follows!
Question from Chen: I have trouble urinating from time to time. Sometimes, I think I am done peeing, I pull up my pants, and then I dribble urine. I am only 25 years old. Why is this happening and what can help?
Answer from Becca: Chen, I wish that you would start an online social media feed about your problem! Because it is so common and so very easily addressed. Many men come to pelvic floor physical therapy with complaints of leaking after peeing, or what we refer to in our line of work as “the post-void dribble.” Guys think there is something terribly wrong when this occurs, and because they won’t talk about it, they don’t know that many other guys have exactly the same problem!
Many men stand up to pee in urinals. This is the cultural norm in our society. But for men with tight pelvic floor muscles, or even men with moderate anxiety in a public restroom, the bladder cannot completely empty when a guy is in a standing position or when there are other men around him. What happens in this case is that the bladder cannot fully relax and the urine within it will not completely drain from the pelvis. Many guys shake their penises to try to get excess pee out of it. But this technique doesn’t always work to sufficiently drain the bladder. Hence, the dribble occurs after you think you are done peeing, Chen, and so many other men like you leave the bathroom to return to the tavern or sports arena, because they never allowed their bladders to fully empty.
Here is what a pelvic floor physical therapist may tell you, Chen.
Finally, for Chen and the vast number of guys like him, view this PDF for the technique on how to avoid the post-void dribble.
By Karen Bruno, PT, DPT
According to a recent article published in the American Journal of Physical Therapy, “Research continues to reveal that sleep is not a period of physiologic inactivity; rather, it represents a critical period of recovery that supports cardiovascular, neurologic, and other life functions. Sleep is a basic human need, and recent attention on sleep by researchers and media are changing sleep attitudes and behaviors. Sufficient sleep was often viewed as a luxury, and reduced sleep time was often equated with increased productivity; however, attitudes are shifting to prioritize sufficient quality sleep. Quality sleep is recognized as a positive health behavior, and it has been recommended to consider sleep as another vital sign, as sleep can give insight into the functioning and health of the body (3)."
You may have noticed that getting a good night’s sleep helps you to feel better both physically and mentally and this helps you function better during your waking hours. Basically, getting a good night’s sleep is a game changer that enhances the quality of your life. “Sleep is critical for the proper functioning of the body, including immune function, tissue healing, pain modulation, cardiovascular health, cognitive function, and learning and memory. Impaired sleep can lead to obesity, mood disorders, constipation and heart disease” (3).
Tips for Healthy Sleep
There is good news! There are many natural ways to improve the quality of your sleep and restore your sleep health. Scroll through the list below and try one or more of the tips, and see how they work for you.
Energy medicine is a safe and natural way to manage your energies to meet the stresses and anxieties in your life by optimizing your energies to help your body and mind function at their best. This approach acknowledges your unique complex nature and how your whole body is connected. From the energy medicine perspective, sleep problems are seen as an energetic imbalance that can be resolved by activating the body’s natural healing ability to restore balance.
I hope you will join me on Wednesday, March 20, 2019 at 6 pm in our Hamilton office to learn some of these easy and gentle self-care Energy Medicine techniques. Get a jump start and sign-up by calling 609-584-4770 for this free presentation.
Written by Michelle Dela Rosa, PT
So what’s the answer ladies? Water and mild soap. That’s it! The perineum can be patted dry afterwards. Read more to learn about conditions that can influence pH.
Adding fiber too quickly into the diet can cause discomfort, bloating, and abdominal gas. A fine balance is important for people with bowel dysfunction.
Eswaran S, Muir J, Chey WD. Fiber and Functional Gastrointestinal Disorders. Am J Gastroenterol. 2013 Apr:108:718-727.
Experts recommend drinking 1600 mL of liquid (~ 54 oz) every 24 hours, requirements that may vary according to a person’s size and activity level. Water is preferred, with other liquids substituted in moderation. Other signs of dehydration may include: headaches, muscle and joint soreness, dark urine, constipation, and kidney stones.
(The Importance of Water. Wilmette, Illinois: The Simon Foundation for Continence, 2014. Print.)
More than half of women with symptoms of vulvodynia do not seek medical care. Of those that do, less than 2% of them are given an accurate diagnosis.
(Harlow BL, Stewart EG. A population-based assessment of chronic unexplained vulvar pain: have we underestimated the prevalence of vulvodynia? J Am Med Womens Assoc. 2003 Spring;58(2):82-8.
Reed BD, Harlow SD, Sen A, Edwards R, Chen D, Haefner HK. Relationship between vulvodynia and chronic comorbid pain conditions. Obstet Gynecol. 2012;120:145-51.)
The NVA, or National Vulvodynia Association, has a free tutorial for Women with Vulvodynia. It reviews anatomy, normal and abnormal symptoms, and vulvar self-examination, for starters. Check it out at www.nva.org.