Understanding Men’s Pelvic Physiotherapy
Pelvic physical therapy focuses on the muscles, nerves, connective tissues, and systems that support the bladder, bowel, and sexual function. While pelvic floor therapy is now widely recognized for women, men also have a pelvic floor—and they can experience significant dysfunction that affects quality of life.
Men seek pelvic physical therapy for concerns such as:
Urinary incontinence or dribbling after urination
Urinary urgency and frequency
Constipation or pain in the anus
Erectile dysfunction and ejaculation disorders
Genital or pelvic pain
Chronic pelvic pain syndrome
Pain during urination, defecation or sexual activity
These concerns are not uncommon and are not “just part of aging.” They are often treatable when treated by providers trained in pelvic health and sexual function.
How Dr. Susie Gronski went into men’s pelvic health
Dr. Susie Gronsky’s career began in women’s pelvic health—a path that was common at the time. When she opened her practice in 2012, men started contacting her when they saw she was treating bowel, bladder, sexual function and pain conditions. They recognized themselves in the descriptions, even though the field was not yet designed with them in mind.
At the time, there was no standardized curriculum for men’s pelvic health. Dr. Gronsky learned directly from her patients—listening to their experiences, validating their concerns, and adapting her clinical approach to meet a largely ignored population.
What she discovered was a significant gap in care—and an urgent need for advocacy, education, and interdisciplinary collaboration. This realization shaped her work and continues to influence the way she trains and guides professionals today.
The role of stigma in men’s pelvic health
One of the biggest barriers men face when seeking pelvic physical therapy is stigma. Discussions about peeing, pooping, erections, ejaculation, and pelvic pain are deeply taboo—especially for people who are socialized as men.
Dr. Gronsky emphasizes that men often delay seeking care until symptoms significantly disrupt daily life. Many have already said that “everything looks normal” after medical tests, even when pain and dysfunction persist. Without providers trained to ask the right questions, these individuals feel rejected or misunderstood.
This is where trauma-informed sexuality-affirming care becomes essential.
Men also have a pelvic floor
One of the most important educational messages of Dr. Gronsky is deceptively simple: Men also have a pelvic floor.
The pelvic floor in people with a penis it contains muscles, vessels, erectile tissue, and nerves that function similarly to those in people with a vulva—just organized differently. These structures are responsible for:
Urine and bowel control
Sexual function and sensation
Pelvic stability and support
When dysfunction occurs, the impaction extends well beyond the pelvis. It affects trust, relationships, identity and mental health.
Recognizing this anatomical reality helps normalize men’s experiences and opens the door to effective treatment.
Why pelvic physical therapy should address sexual health
Pelvic physical therapy it’s not just musculoskeletal care. It is inherently intimate, relational and psychologically informed. Providers work directly with the genital and pelvic area and must navigate conversations about sex, pleasure, pain, and identity.
Dr. Gronski emphasizes that pelvic floor therapists are trained to treat it whole personnot just individual body parts. This includes:
However, many professionals lack formal training in sexual health communication. This gap can lead to avoidance—especially around genital pain, erections, ejaculation, or sexual behaviors.
Why Sex Counselor Certification Matters
Here is where sexuality counselor certification it’s game changing.
Dr. Gronski explains that while pelvic physical therapists receive extensive anatomical and functional training, sex education is usually not included in male pelvic health curricula. Without additional training, providers may feel uncertain about how to make a sexual health intake, discuss sexual behaviors, or create a healing space where men feel safe enough to open up.
Sex counselor certification equips professionals with:
Language and contexts for discussing sexual health
Skills for validating sexual concerns without shame
Trauma-informed home care approaches
Ethical boundaries and professional trust
A deeper understanding of sexual behavior, identity and function
For Dr. Gronski, becoming a certified sexuality counselor fundamentally changed her clinical work. It allowed her to address not just the symptoms, but the lived experience of the people she serves.
The power of interdisciplinary sexual health care
Men’s pelvic health does not exist in isolation. Effective care often involves collaboration across disciplines, including:
Sexuality counselors play a vital role in bridging these systems—helping clients understand their bodies, rebuild trust, and develop agency and confidence.
This integrated approach leads to better outcomes and a more ethical, compassionate standard of care.
Lifestyle, exercise and male pelvic health
One of the strongest messages of Dr. Gronski is it Sexual and pelvic health are profoundly affected by lifestyle.
Exercise and diet aren’t optional extras—they’re fundamental to pelvic function, erectile health, and overall well-being. Regular physical activity supports cardiovascular health, muscle strength, nervous system regulation and hormonal balance.
General guidelines for adults include:
Resistance training 2-3 days a week
Cardiovascular activity 3-4 days a week for 20-30 minutes
Starting small and working your way up
For practitioners, this reinforces the importance of education, prevention and early intervention – key principles in sexuality counselling.
Why SHA Sex Counselor Certification is Necessary
The Sexual Health Alliance trains professionals to respond to the realities of modern sexual health care. SHA’s sexuality counselor certification The program provides comprehensive, evidence-based education designed for clinicians, educators, coaches, and health care providers working with diverse populations.
Through SHA, professionals gain:
Basic and advanced sex education
Trauma-informed, inclusive frameworks
Clinical confidence in discussing sexual health
Ethical decision-making skills
A global professional community
For those working in—or alongside—male pelvic physical therapy, a sexuality counselor certification is more than just beneficial. It is necessary.
The future of men’s pelvic health
The field is changing. More professionals of all genders are training and gaining confidence in working with men. More men seek care. More discussions are held openly.
But progress depends on education.
By combining pelvic physical therapy with sexuality counseling, professionals can help close long-standing gaps in care and offer men the comprehensive, respectful support they deserve.
Final Takeaway
Male pelvic physical therapy is at the intersection of anatomy, psychology, sexuality and lifestyle. Sexuality counselors play a critical role in this work—supporting not only bodily function, but dignity, discretion, and self-confidence.
If you are a professional dedicated to promoting sexual health, sexuality counselor certification through the Sexual Health Alliance it is a powerful step towards ethical, inclusive and effective practice.
Do you want to become an in-demand sexual health professional? Learn more about SHA certification!
