What is a pessary?

Sexual health is an important part of overall wellbeing, yet it is something many men find difficult to talk about. One factor that is often overlooked is the role of the pelvic floor in sexual function. The pelvic floor is a group of muscles at the base of the pelvis. In men, these muscles help support the bladder and bowel, and they also play a key role in erections, ejaculation, and sexual sensation. When these muscles are not functioning well - whether they are too tight, too weak, or not coordinating properly - it can contribute to sexual difficulties. Some men may experience erectile dysfunction, difficulty maintaining an erection, changes in ejaculation, reduced sensation, or discomfort during or after sex. These concerns can occur at any stage of life and are more common than many people realise. There are a range of factors that can affect pelvic floor function. Stress and anxiety can increase muscle tension, while surgery (such as prostate surgery), prolonged sitting, or chronic pelvic pain can also play a role. Often, it is a combination of factors rather than a single cause. It is also important to recognise the role of the mind-body connection. Stress, performance anxiety, and emotional wellbeing can all influence sexual function. Addressing both the physical and psychological aspects of health often leads to the best outcomes. Pelvic health physiotherapy can help identify how the pelvic floor is functioning and guide treatment. This may include exercises to improve strength or relaxation, breathing techniques, and strategies to reduce tension and improve coordination. Education and small changes can often make a meaningful difference. Sexual dysfunction in men is common, and support is available. Understanding the connection between the pelvic floor and sexual health can be an important step toward improving confidence, comfort, and overall wellbeing.

Pelvic Health Is for Everyone Pelvic health is often talked about as a women’s issue, but in reality it affects people of all genders across every stage of life. The pelvic floor is a group of muscles and connective tissues that support the bladder, bowel, and reproductive organs. These muscles also play a role in sexual function and everyday movements like lifting, bending, coughing, or laughing. Because they are involved in so many aspects of daily life, looking after pelvic health is important for everyone. Pelvic health concerns can show up in many different ways. Some people experience bladder leakage, urgency, constipation, or changes in bowel habits. Others may experience pelvic girdle pain, including discomfort around the sacroiliac joints, pubic symphysis, or coccyx (tailbone). Pelvic pain can also occur in the lower abdomen or in the genitals and may affect comfort with sitting, exercise, or sexual activity. These symptoms can affect people of any gender, yet they are often not openly discussed. Pelvic floor challenges can appear at different stages of life. Children may experience constipation, bedwetting, or daytime bladder accidents. Adolescents and adults may notice pelvic pain, bladder urgency, or bowel changes. Men may experience pelvic pain or bladder symptoms, including leakage, particularly after prostate surgery. Older adults may notice changes in bladder or bowel control or pelvic comfort as the body changes with age. While these experiences are common, many people are surprised to learn that help is available. Hormones also play an important role in pelvic health for people of all genders. Changes in hormone levels; during puberty, pregnancy, menopause, or as part of gender-affirming hormone therapy, can influence tissue health, bladder control, sexual function, and comfort in the pelvic region. Understanding these changes and supporting the body with the right care can make a meaningful difference. Pelvic health physiotherapy offers practical support, education, and treatment for many of these concerns. Physiotherapists can help people better understand their pelvic floor, improve bladder and bowel habits, manage pelvic girdle or pelvic pain, and support comfortable movement in daily life. Often, small changes can make a big difference to daily comfort and confidence. Pelvic health isn’t limited to one gender or one stage of life. By talking about it more openly and recognising the many ways it can affect the body, we can make it easier for everyone to seek support and care for their pelvic health.

Understanding Lichen Sclerosis: What You Need to Know Lichen Sclerosis (LS) is a condition we see more often than people realise — yet many individuals go years without the right diagnosis. At Pelvic Health Melbourne, our goal is to make conversations about vulval, penile and anal health easy, accessible and stigma-free. Here’s a clear guide to what LS is, how it’s treated, and how pelvic health physiotherapy can support you. What Is Lichen Sclerosis (LS)? Lichen Sclerosis is a long-term inflammatory skin condition that typically affects the vulva, penis, or the skin around the anus. A few key facts: It’s not contagious. You can’t pass LS on to a partner. It may have a genetic or autoimmune link. People with other autoimmune conditions can be more prone to developing it. It’s more commonly diagnosed in people in their 40s and 50s, though it can occur at any age. Common Signs and Symptoms LS can look and feel different for everyone, but some of the most common symptoms include: Itching, burning or general soreness around the vulva, penis, or anus Skin changes, such as pale or white patches, areas that appear thickened or “crinkled,” or skin that becomes thin and fragile over time Dryness and loss of natural skin oils, leading to cracks, fissures, bruising or even blisters Possible scarring or narrowing of the vaginal or anal openings in long-standing vulval or anal LS In penile LS, symptoms often affect the foreskin and glans (head of penis) If any of these symptoms sound familiar — especially if they’ve been going on for a while — it’s worth discussing LS with your GP or pelvic health clinician. Typical Management & Treatment in Australia The good news: with early diagnosis and treatment, LS can be well managed and long-term complications can be reduced. Common treatments include: Topical steroid ointments or creams to reduce inflammation Topical oestrogen if thinning or hormone-related changes are present (for vulval LS) Gentle skin care routines to restore moisture and protect fragile skin Silicone-based lubricants for comfortable intimacy Vaginal dilators or vibrators to help maintain stretch and comfort if the vaginal entrance has narrowed Your GP or dermatologist will oversee the medical management — but pelvic health physio plays a big role too. How Pelvic Health Physio Can Help Our clinicians at Pelvic Health Melbourne are experienced in recognising LS and supporting you through the often-overlooked side effects of the condition. We can help with: Identifying symptoms early and guiding you to your GP for diagnosis and treatment Addressing secondary pain, such as burning or discomfort caused by pelvic floor overactivity Managing scarring or narrowing at the vaginal entrance using dilators, moisturises and tailored lubrication advice Supporting intimacy goals, helping reduce muscle tightness and improve comfort during sexual activity Easing nerve-related pelvic pain, which can develop from chronic irritation or inflammation Managing LS isn’t just about treating the skin — it’s about restoring comfort, confidence and quality of life. Why Awareness Matters LS is not extremely common, and some practitioners may only encounter it rarely. This means it can sometimes be overlooked or mistaken for recurrent thrush, eczema or dermatitis. Knowing the signs — and knowing to ask the question — can make a big difference. Early treatment helps: Control inflammation Prevent or reduce scarring Maintain skin health Improve long-term comfort and function If you suspect LS, trust your instincts and seek support. You're not alone — and there are effective treatments available. If you’d like guidance, reassurance, or help managing symptoms, our pelvic health physiotherapy team is here to support you every step of the way.