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Men’s Pelvic Physical Therapy: Why Sexuality Counselors Play a Critical Role in Men’s Sexual Health

Men’s pelvic health has long been overlooked, misunderstood, or minimized in both healthcare and education. For decades, conversations about pelvic floor dysfunction, sexual pain, and bladder or bowel issues were framed as “women’s health” topics—leaving men without clear pathways to care or providers trained to support them.

In a recent Sexual Health Alliance (SHA) expert interview, Dr. Susie Gronski, PT, DPT, CSC, CSE, offers a powerful and much-needed perspective on men’s pelvic physical therapy. As a doctor of physical therapy and a certified sexuality counselor, Dr. Gronski bridges two worlds that are often unnecessarily separated: physical rehabilitation and sexual health counseling.

Her work highlights not only why men’s pelvic physical therapy matters—but also why sexuality counselor certification is becoming an essential credential for professionals working in this space.

Understanding Men’s Pelvic Physical Therapy

Pelvic physical therapy focuses on the muscles, nerves, connective tissues, and systems that support bladder, bowel, and sexual function. While pelvic floor therapy is now widely recognized for women, men have pelvic floors too—and they can experience significant dysfunction that impacts quality of life.

Men seek pelvic physical therapy for concerns such as:

  • Urinary incontinence or post-void dribbling

  • Urinary urgency and frequency

  • Constipation or anal pain

  • Erectile dysfunction and ejaculatory disorders

  • Genital or pelvic pain

  • Chronic pelvic pain syndrome

  • Pain during urination, defecation, or sexual activity

These concerns are not rare, and they are not “just part of aging.” They are often treatable when addressed by providers trained in pelvic health and sexual function.

How Dr. Susie Gronski Entered Men’s Pelvic Health

Dr. Susie Gronski’s career began in women’s pelvic health—a path that was common at the time. When she opened her practice in 2012, men began reaching out after seeing that she treated 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 that time, there was no standardized curriculum for men’s pelvic health. Dr. Gronski learned directly from her patients—listening to their experiences, validating their concerns, and adapting her clinical approach to meet a population that had been largely ignored.

What she discovered was a significant gap in care—and an urgent need for advocacy, education, and interdisciplinary collaboration. That realization shaped her work and continues to influence how she trains and mentors professionals today.

The Role of Stigma in Men’s Pelvic Health

One of the greatest barriers men face when seeking pelvic physical therapy is stigma. Conversations about peeing, pooping, erections, ejaculation, and pelvic pain are deeply taboo—particularly for people socialized as men.

Dr. Gronski emphasizes that men often delay seeking care until symptoms significantly disrupt daily life. Many have already been told that “everything looks normal” after medical testing, even while pain and dysfunction persist. Without providers trained to ask the right questions, these individuals are left feeling dismissed or misunderstood.

This is where trauma-informed, sexuality-affirming care becomes essential.

Men Have Pelvic Floors Too

One of Dr. Gronski’s most important educational messages is deceptively simple: men have pelvic floors too.

The pelvic floor in people with penises contains muscles, vasculature, erectile tissue, and nerves that function similarly to those in people with vulvas—just organized differently. These structures are responsible for:

  • Urinary and bowel control

  • Sexual function and sensation

  • Pelvic stability and support

When dysfunction occurs, the impact extends far beyond the pelvis. It affects confidence, 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 Must Address Sexual Health

Pelvic physical therapy is not just musculoskeletal care. It is inherently intimate, relational, and psychologically informed. Providers work directly with the genital-pelvic region and must navigate conversations about sex, pleasure, pain, and identity.

Dr. Gronski stresses that pelvic therapists are trained to treat the whole person, not just isolated body parts. This includes:

  • Nervous system regulation

  • Trauma-sensitive care

  • Brain-body connection

  • Functional impact on daily and sexual life

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 Sexuality Counselor Certification Matters

This is where sexuality counselor certification becomes a game-changer.

Dr. Gronski explains that while pelvic physical therapists receive extensive anatomical and functional training, sexuality education is not typically included in male pelvic health curricula. Without additional training, providers may feel uncertain about how to conduct a sexual health intake, discuss sexual behaviors, or create a therapeutic container where men feel safe enough to open up.

Sexuality counselor certification equips professionals with:

  • Language and frameworks for discussing sexual health

  • Skills for validating sexual concerns without shame

  • Trauma-informed approaches to intimate care

  • Ethical boundaries and professional confidence

  • A deeper understanding of sexual behavior, identity, and function

For Dr. Gronski, becoming a certified sexuality counselor fundamentally transformed her clinical work. It allowed her to address not just 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:

  • Pelvic physical therapy

  • Sexuality counseling

  • Urology

  • Mental health therapy

  • Nutrition and lifestyle medicine

Sexuality counselors play a vital role in bridging these systems—helping clients make sense of 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 Men’s Pelvic Health

One of Dr. Gronski’s strongest messages is that sexual and pelvic health are deeply influenced by lifestyle.

Exercise and nutrition are not optional add-ons—they are foundational to pelvic function, erectile health, and overall wellbeing. Regular physical activity supports cardiovascular health, muscular strength, nervous system regulation, and hormonal balance.

General adult guidelines include:

  • Resistance training 2–3 days per week

  • Cardiovascular activity 3–4 days per week for 20–30 minutes

  • Starting small and progressing gradually

For professionals, this reinforces the importance of education, prevention, and early intervention—core principles within sexuality counseling.

Why SHA’s Sexuality Counselor Certification Is Essential

Sexual Health Alliance trains professionals to meet the realities of modern sexual healthcare. SHA’s sexuality counselor certification program provides comprehensive, evidence-based education designed for clinicians, educators, coaches, and healthcare providers working with diverse populations.

Through SHA, professionals gain:

  • Foundational and advanced sexuality education

  • Trauma-informed, inclusive frameworks

  • Clinical confidence in discussing sexual health

  • Ethical decision-making skills

  • A global professional community

For those working in men’s pelvic physical therapy—or alongside it—sexuality counselor certification is not just beneficial. It is essential.

The Future of Men’s Pelvic Health

The field is changing. More practitioners of all genders are becoming trained and confident in working with men. More men are seeking care. More conversations are happening 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

Men’s pelvic physical therapy sits at the intersection of anatomy, psychology, sexuality, and lifestyle. Sexuality counselors play a critical role in this work—supporting not only physical function, but dignity, agency, and confidence.

If you are a professional committed to advancing sexual health, sexuality counselor certification through Sexual Health Alliance is a powerful step toward ethical, inclusive, and impactful practice.

Want to become an in-demand sexual health professional? Learn more about becoming certified with SHA!