Last month I mentioned that statistically women seek and use healthcare more than men, but men are hospitalized more and often die unexpectedly / younger than women. Good or bad, I think we can all learn from both sides of this equation. If I’m going to live longer then I want those years to be healthy and functional, and I’d like my husband to join me. It’s interesting to me that similar to the topic of “Women’s Health,” when talking about “Men’s Health” many in mainstream healthcare focus on the pelvic floor. Certainly this is an element, but for this blog (and in practice) I’m talking broader. For the sake of brevity I am not going to rewrite the problem list I gave last month for the women. Men are subject to many of the same maladies, just less so. Here I want to highlight some issues frequently encountered by men.
Prostate Health
Statistics show that 50% of men 51-60 years of age will experience enlargement of the prostate, known as benign prostate hyperplasia (BPH), with numbers increasing to 70% for those 61-70 years of age. As with many health issues, the cause of BPH is not known, but hormonal changes are thought to be a factor. Symptoms typically include difficulty initiating urination as well as urinary frequency. When occurring at night, known as nocturia, sleep can be disrupted by multiple trips to the bathroom (0 -1 is normal). BPH may be diagnosed by digital rectal examination (DRE), urinalysis, bloodwork, and ultrasound. Treatment is dictated by the severity of symptoms and traditionally includes monitoring status, medications, and surgical procedures that vary from minimal to extreme.
Prostate cancer is the second most common cancer afflicting men worldwide, surpassed only by skin cancer. In the US one in every eight men is afflicted with prostate cancer. As with many cancers, initially there may be no symptoms. But with progression symptoms can mimic BPH with urination, as well as the presence of blood in the urine or semen, bone pain, and erectile dysfunction. Diagnosis can be made with DRE, analysis of urine and blood, tissue biopsy, and imaging. As with any cancer, treatment is based on severity and early detection / intervention yield the best outcome.
“Recent advances in cancer biology are underscoring the importance of connective tissue in the local tumor environment. Inflammation and fibrosis are well-recognized contributors to cancer, and connective tissue stiffness is emerging as a driving factor in tumor growth. Physical-based therapies have been shown to reduce connective tissue inflammation and fibrosis and thus may have direct beneficial effects on cancer spreading and metastasis.”
Langevin, Helene M., et al. "Connecting tissues: how research in fascia biology can impact integrative oncology."Cancer research 76.21 (2016): 6159-6162.
While men with BPH can develop cancer, statistically BPH does not increase cancer likelihood. Multiple factors may contribute to both prostate issues (lifestyle, nutrition, medications, co-morbidities, and genetics). Yet one factor frequently not considered is the integrity and health of the fascial network. Research and clinical practice have long supported that manual therapies, yoga, and acupuncture can play positive roles in the recovery of cancer survivors. But fascinating research is emerging showing the role these therapies can play in actually preventing cancer as well as the overall health of organs like the prostate, ovaries, and uterus.
Pelvic / Groin Pain
Pelvic pain afflicts 2-16% of men of all ages. There can be many causes such as infection, cancer, and other disease. When these have been ruled out it is reasonable to explore the possibility that the pain is stemming from the connective tissues, which are highly innervated, subject to overload, and very capable of exerting extreme pain and dysfunction that many classical tests (lab work, imaging) do not detect. While the pelvic floor may be a factor, I have never treated a lower back or pelvic problem (male or female) that did not have some contributing factors stemming from lower limb dysfunction: past ankle sprains, plantar fasciitis, shin splints, leg cramps, and restless leg syndrome are common culprits that need to be considered as influencing pelvic pain. Research shows that movement in the calf muscle creates movement in the connective tissues of the pelvis, highlighting the presence of a relationship between these two seemingly remote regions.
Erectile Dysfunction (ED)
I liken ED to urinary incontinence (UI) for women: both are very common, and typically considered to be “normal” with aging. But I would suggest that common does not equate with normal, and we should not accept UI or ED as inevitable aspects of aging. Penile erection is driven mainly by muscles and blood vessels of the penis becoming engorged with blood. Simply put, when blood circulation to the penis is obstructed then erection can also be impeded. Research shows there is a relationship between ED and cardiovascular disease, hence the warnings associated with many ED prescriptions about making sure your heart is healthy. The blood vessels of the lower limbs and pelvic region are embedded in a fascial environment. Fascial densifications in the pelvic region and lower limbs can serve to obstruct blood flow and lead to hypertension, leg cramps, heart disease, bladder issues, and ED.
I’m not trying to scare anyone: I’m trying to educate everyone as to possible sources of dysfunction and solutions for these problems that are seldom promoted. Interventions such as Fascial Manipulation – Stecco ® are very plausible, researched, and have the potential to act on the source of the problem and elicit a positive change, as opposed to manipulating symptoms. Consider that there are options beyond supplements, prescriptions, tests, surgeries, and simply enduring symptoms. Please give me a call, send a text, book an exploratory session, or schedule a consult to learn more. You have options – act on them!
Quick Tips: break up periods of sitting by standing / walking; include stretching and mobility elements in an exercise program especially for the hips - loss of hip mobility is hard on the pelvis!
Wishing You Health & Joy,
Colleen
References:
- McVary KT. BPH: Epidemiology and comorbidities. Am J Manag Care, 2006; 12, 5 Suppl:S122-8.
- Miah, Saiful, and James Catto. "BPH and prostate cancer risk." Indian Journal of Urology 30.2 (2014): 214-218.
- Stretching, Connective Tissue, Chronic Pain, and Cancer. Dr. Helene Langvein, MD. https://www.youtube.com/watch?v=7Gcl7BN6-38. May 2, 2016.
- Langevin, Helene M., et al. "Connecting (t) issues: how research in fascia biology can impact integrative oncology." Cancer research 76.21 (2016): 6159-6162.
- Gandaglia, Giorgio, et al. "A systematic review of the association between erectile dysfunction and cardiovascular disease." European urology 65.5 (2014): 968-978.
- CruzâMontecinos, Carlos, et al. "In vivo relationship between pelvis motion and deep fascia displacement of the medial gastrocnemius: anatomical and functional implications." Journal of anatomy 227.5 (2015): 665-672.
- Pirri, Carmelo, et al. "Blood supply to the superficial fascia of the abdomen: An anatomical study." Clinical Anatomy 36.4 (2023): 570-580.
