Why Does My Rectum Hurt After Ejaculation and What Can I Do?

By Dr. Christine Martirez PT, DPT on 7/16/2024

Experiencing rectal pain after ejaculation can be distressing and concerning. This discomfort may be related to issues with the pelvic floor muscles, which play a crucial role in various bodily functions, including sexual health. Pelvic floor physical therapy offers a comprehensive approach to managing and alleviating this pain. In this blog post, we will explore the anatomy of the male pelvic floor muscles, how they function during orgasm, the potential causes of rectal pain after ejaculation, and how PFPT can help.

Anatomy of the Male Pelvic Floor Muscles

The male pelvic floor is a complex network of muscles that support the pelvic organs, including the bladder, rectum, and prostate. Key muscles in the male pelvic floor include:

1. Pubococcygeus Muscle:

   • Part of the levator ani group, this muscle supports the pelvic organs and helps control urine flow and ejaculation.

2. Puborectalis Muscle:

   • This muscle forms a sling around the rectum, playing a crucial role in maintaining fecal continence and assisting during bowel movements.

3. Iliococcygeus Muscle:

   • Another component of the levator ani group, it helps support the pelvic organs and maintain pelvic floor stability.

4. Coccygeus Muscle:

   • Located at the back of the pelvic floor, this muscle supports the coccyx and assists with pelvic floor stability.

5. Obturator Internus Muscle:

   • This muscle helps with hip rotation and stabilization and indirectly supports the pelvic floor.

Pelvic Floor Muscle Function During Orgasm

During sexual arousal and orgasm, the pelvic floor muscles play a vital role in several processes:

1. Erection Maintenance:

   • The pelvic floor muscles, particularly the ischiocavernosus and bulbocavernosus, help maintain an erection by constricting the veins that drain blood from the penis.

2. Ejaculation:

   • During ejaculation, rhythmic contractions of the pelvic floor muscles, including the bulbocavernosus and pubococcygeus, propel semen through the urethra.

3. Orgasmic Sensation:

   • The contractions of the pelvic floor muscles contribute to the pleasurable sensations experienced during orgasm.

Hypertonic Pelvic Floor Muscles and Pain After Ejaculation

Hypertonic pelvic floor muscles, also known as pelvic floor muscle tension or overactivity, can cause various symptoms, including rectal pain after ejaculation. Hypertonicity means that the muscles are overly tight and unable to relax properly, leading to:

• Increased Pressure:

  Tight pelvic floor muscles can create excessive pressure on the surrounding nerves and tissues, causing pain and discomfort.

• Restricted Blood Flow:

  Muscle tension can restrict blood flow, leading to poor circulation and tissue irritation.

• Impaired Muscle Function:

  Overly tight muscles may not contract and relax properly during orgasm, leading to incomplete or painful ejaculation.

How Pelvic Floor Physical Therapy Can Help

Pelvic floor physical therapy offers a targeted approach to addressing hypertonic pelvic floor muscles and alleviating rectal pain after ejaculation. Here’s how PFPT can help:

Comprehensive Assessment:

• Evaluation:

  A pelvic floor physical therapist will conduct a thorough assessment, including a review of medical history, symptoms, and a physical examination to identify areas of muscle tension and dysfunction.

Personalized Treatment Plan:

• Manual Therapy:

  Techniques such as myofascial release, trigger point therapy, and soft tissue mobilization can help reduce muscle tension and improve blood flow.

• Pelvic Floor Relaxation Exercises:

  Guided exercises to promote relaxation of the pelvic floor muscles, improving their ability to contract and relax during sexual activity.

• Biofeedback Training:

  Techniques to enhance awareness and control of the pelvic floor muscles, helping to reduce hypertonicity and improve muscle function.

Education and Lifestyle Modifications:

• Stress Management:

  Education on stress reduction techniques, such as deep breathing exercises, meditation, and yoga, to help relax the pelvic floor muscles.

• Postural Training:

  Guidance on maintaining proper posture and body mechanics to reduce strain on the pelvic floor muscles.

• Behavioral Strategies:

  Advice on sexual practices and positions that minimize pelvic floor strain and discomfort.

Pain Management:

• Heat and Cold Therapy:

  Recommendations for using heat or cold packs to alleviate muscle tension and pain.

• Pelvic Floor Downtraining:

  Techniques to reduce pelvic floor muscle overactivity, including relaxation and stretching exercises.

Rectal pain after ejaculation can significantly impact a man’s quality of life, but understanding the role of the pelvic floor muscles and seeking appropriate treatment can provide relief. Pelvic floor physical therapy offers a comprehensive approach to managing hypertonic pelvic floor muscles, reducing pain, and improving overall pelvic health. If you are experiencing rectal pain after ejaculation, consider consulting a pelvic floor physical therapist to develop a personalized treatment plan and start your journey toward recovery and improved well-being.

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