03/28/2026
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𝗧𝗵𝗲 𝗛𝗶𝗱𝗱𝗲𝗻 𝗜𝗺𝗽𝗮𝗰𝘁 𝗼𝗳 𝗛𝗶𝗴𝗵-𝗜𝗻𝘁𝗲𝗻𝘀𝗶𝘁𝘆 𝗘𝘅𝗲𝗿𝗰𝗶𝘀𝗲 𝗼𝗻 𝘁𝗵𝗲 𝗠𝗮𝗹𝗲 𝗣𝗲𝗹𝘃𝗶𝗰 𝗙𝗹𝗼𝗼𝗿
⬛ When we think about pelvic floor dysfunction (PFD) in sports, the conversation almost exclusively focuses on female athletes. However, a recent 2025 scoping review published in the Journal of Science and Medicine in Sport by Myers et al. asks a crucial question: Are male athletes who engage in high-intensity exercise also at risk for pelvic floor issues?
⬛ Here is a deep dive into the findings of this eye-opening review, what it means for male athletes, and why the sports and fitness community needs to start paying attention.
𝗧𝗵𝗲 𝗗𝗼𝘂𝗯𝗹𝗲-𝗘𝗱𝗴𝗲𝗱 𝗦𝘄𝗼𝗿𝗱 𝗼𝗳 𝗘𝘅𝗲𝗿𝗰𝗶𝘀𝗲
⬛ Historically, the medical community has promoted physical activity as a fantastic way to improve male pelvic floor health.
⬛ Moderate-to-vigorous physical activity brings systemic benefits, such as increased nitric oxide production, improved blood flow, and better hormone regulation.
⬛ Because of these systemic perks, the review confirmed that increased physical activity acts as a protective shield against erectile dysfunction (ED) and chronic pelvic pain syndrome (CP/CPPS).
⬛ However, the researchers wanted to know if there is a point where the mechanical stress of extreme exercise starts to outweigh these systemic benefits.
⬛ To find out, they analyzed data from 10 studies involving males participating in high-intensity or high-volume exercise.
𝗦𝘂𝗿𝗽𝗿𝗶𝘀𝗶𝗻𝗴 𝗣𝗿𝗲𝘃𝗮𝗹𝗲𝗻𝗰𝗲: 𝗟𝗲𝗮𝗸𝗮𝗴𝗲 𝗮𝗻𝗱 𝗦𝘆𝗺𝗽𝘁𝗼𝗺𝘀 𝗶𝗻 𝗠𝗲𝗻 🚨
⬛ The review uncovered that lower urinary tract symptoms (LUTS)—which includes issues like urinary incontinence (UI), urgency, and frequency—are significantly higher in male athletes than one might expect.
🏃 High-Impact Sports
⬛ Studies on elite track and field athletes found UI prevalence rates of 17.7% and 18.8%.
⬛ To put that in perspective, the average for 20- to 39-year-old men in the general population is only 2-2.4%.
⬛ Strikingly, up to 37.5% of these symptomatic athletes reported experiencing leakage specifically during training or competition.
🏋️ Heavy Lifting
⬛ One study investigating Olympic weightlifters and powerlifters found a staggering 61.8% experienced anorectal incontinence (AI)—the involuntary loss of gas or stool during exercise.
⬛ Interestingly, despite the high prevalence, the male athletes were largely unbothered by it, reporting an average "bother score" of just 1.2 out of 10.
𝗧𝗵𝗲 𝗗𝗼𝘀𝗲-𝗗𝗲𝗽𝗲𝗻𝗱𝗲𝗻𝘁 𝗥𝗶𝘀𝗸 📈
⬛ One of the most significant findings of the review is the dose-dependent relationship between training volume and urinary symptoms.
⬛ Using MET-minutes per week (a measure of exercise intensity and volume), researchers identified that the more intense and voluminous the exercise, the higher the risk of developing LUTS.
⬛ In simple terms: While moderate exercise protects the pelvic floor, pushing the body to extreme, athletic volumes seems to tip the scale, resulting in acute pelvic floor muscle complications.
𝗪𝗵𝘆 𝗗𝗼𝗲𝘀 𝗧𝗵𝗶𝘀 𝗛𝗮𝗽𝗽𝗲𝗻? 🧠
⬛ The pelvic floor muscles act as a hammock supporting the pelvic organs.
⬛ To maintain urinary and bowel continence, these muscles must rapidly contract whenever there is an increase in intra-abdominal pressure (IAP).
⬛ High-intensity training stresses this system in two main ways:
⚡ High Ground Reaction Forces
⬛ High-impact sports (like sprinting or jumping) create massive downward forces that the pelvic floor must absorb.
💨 Abdominal Bracing
⬛ Heavy resistance training (like squats and deadlifts) requires athletes to brace their core and hold their breath (the Valsalva maneuver), which drives intra-abdominal pressure sky-high.
⬛ The researchers hypothesize that this constant, extreme demand causes the pelvic floor muscles to fatigue.
⬛ Just like your biceps fail after too many curls, a fatigued pelvic floor temporarily loses its maximal contractile speed and strength, leading to leaks.
⬛ Furthermore, this repetitive stress might cause the muscles to maintain a high resting tension, making it difficult for the pelvic floor to relax—a condition required for normal urination and a known risk factor for pelvic pain.
𝗧𝗵𝗲 𝗕𝗹𝗶𝗻𝗱 𝗦𝗽𝗼𝘁 𝗶𝗻 𝗖𝗼𝗮𝗰𝗵𝗶𝗻𝗴 𝗮𝗻𝗱 𝗠𝗲𝗱𝗶𝗰𝗶𝗻𝗲 👁️
⬛ Perhaps the most alarming statistic highlighted in the review is the sheer lack of awareness.
⬛ Between 58.8% and 75% of male athletes were completely unaware that they even had pelvic floor muscles, let alone what their function was.
⬛ Furthermore, exercise professionals and coaches rarely screen male athletes for pelvic floor symptoms because of a pervasive misconception that men simply aren't at risk.
𝗧𝗵𝗲 𝗧𝗮𝗸𝗲𝗮𝘄𝗮𝘆 🎯
⬛ The narrative that pelvic floor dysfunction is strictly a "women's issue" is officially outdated.
⬛ Male athletes, particularly those engaged in high-impact sports and heavy weightlifting, are experiencing significant symptoms that are currently flying under the radar.
⬛ What needs to change?
🩺 Routine Screening
⬛ Coaches, physios, and exercise professionals need to introduce routine screening protocols for pelvic floor symptoms in men.
📚 Education
⬛ Male athletes need to be educated about their anatomy and taught that leaking during a heavy deadlift or a sprint is a sign of muscular fatigue, not an inevitable part of training.
🏋️ Tailored Management
⬛ Recognizing these symptoms early can allow for tailored pelvic floor muscle training and better training load management, helping athletes stay dry, pain-free, and at the top of their game.
