Happy Pride Month! Let’s Talk Treating & Examining Males
By: Nataliya Zlotnikov, MSc, HBSc ∙ Estimated reading time: 5 minutes

Happy Pride Season!

Did you know that in Canada, Pride Season (yes season, not month), actually spans June-September?

The many celebrations of June

June kicks off a month of many celebrations! This month we celebrate and pay homage to a few profoundly important subjects.

National Indigenous History Month, Pride Month, perhaps the little less known, Men's Health Month, and my birthday. 

Self-glorification aside, In this blog, we will not be addressing Indigenous History Month. This subject deserves a complete blog and much much more, and we will not do it justice by speaking about it in brief. 

This blog will however touch on Pride Month and several issues related to men's** health.

The health content of this blog is derived from Dr. Holly Herman's very entertaining and informative online healthcare course on Embodia, Highlights of Examining and Treating Males. 

**We understand that the binary terms male/female and men/women are imperfect concepts and don't accurately reflect the diversity of gender-diverse individuals' bodies or identities. In the absence of more appropriate terminology, these terms are used here when necessary.   

This blog discusses: 

1. Brief History of Canadian Pride
2. Male Anatomy Review
3. About the Course
4. Testicular Pain, Football, Rockclimbing & More  
5. Tucking: What Is It and How to Do It Safely
6. The Prostate, It's Really Important
7. Prostatitis: What Happens When Things Go Wrong?
8. Climacturia
9. Additional Resources
10. Laugh a Little!
    

     

I. Brief history of Canadian Pride

2022 - Pride Toronto turns 41!

Happy Anniversary, Pride!! You've come a long way. 

To all those, both present and past, who have championed this cause over the past few decades, thank you. Your unrelenting efforts have brought the 2SLGBTQ+ community to where it is now.

Here is a brief timeline of notable events in Canadian Pride history.

A more complete timeline can be found here. 

 

II. Male anatomy review

As I mentioned above, I find Dr. Herman to be a real pleasure (and riot) to listen to. I wanted to give you all the pleasure of listening to her speak (in case you have not yet had that pleasure). So whenever I could, I put in little video tidbits from her course. I had to exercise some restraint and stop at 2. 

Here is the first little snippet of Dr. Herman discussing the male anatomy. 

Click here for the full course

III. About the course:

This online physiotherapy course highlights important issues to cover when examining and treating males.

This course is a highlight course and therefore does not delve too deeply into the topics, however, it does provide an excellent overview and is a great place for clinicians to start.

Some specific topics in this course include:

• Pre and post-prostatectomy
• Erectile dysfunction
• Premature ejaculation
• Peyronie's disease
• Hard/flaccid conditions
• Testicular pain
• Ejaculatory pain
• Urinary frequency and retention
• Constipation
• Anal fissures
• How orthopedic impairments throughout the body can influence these conditions
• And more

IV. Testicular pain, football, rock climbing & more  

Now, that you know what's in the course, let's briefly discuss a few of the above topics starting with testicular pain.

(Aljumaily et al., 2017) 

Not only is there little written about its impact on quality of life but there has also been little written on the subject as a whole. A PubMed search for "chronic scrotal pain" yielded only 318 results in 2021 when this blog was first written and 339 results in 2022; not a very hot topic it seems.   

As physiotherapists, there is so much that we can do to help those suffering from testicular pain. 

Here is another snippet from the course in which Dr. Herman discusses football, rock climbing, testicular pain, and more. 

V. Tucking: what is it and how to do it safely

Switching our gears a little, let's discuss tucking.

What is tucking?

Tucking is defined as ways one can hide the penis and testes, such as moving the penis and scrotum between the buttocks or moving the testes up into the inguinal canals. 

Tucking can lead to some painful problems because of the suspensory ligament.  

The suspensory ligament is highlighted in the image below:

Image source: Mayo Clinic

Why? Well, you can visualize that tucking can pull on the suspensory ligament and lead to quite a bit of injury.

When palpating, you want to palpate for that and there should be no pain or discomfort.

Beyond palpating, we can also provide education and teach how to tuck safely.

Here is a wonderful resource that I stumbled upon from the Gender Clinic of the Doernbecher Children’s Hospital in Portland Oregon which discusses safe tucking and provides some local as well as online resources.  

Click here to continue learning
with Dr. Holly Herman

VI. The prostate, it's really important

Back to Anatomy 101.

What does the prostate do?

"The prostate’s most important function is the production of a fluid that, together with sperm cells from the testicles and fluids from other glands, makes up semen.

The muscles of the prostate also ensure that the semen is forcefully pressed into the urethra and then expelled outwards during ejaculation." (NCBI, 2020).

Those are big roles!

Look below for a refresher on this important gland:

Image source: WebMD

VII. Prostatitis: what happens when things go wrong?

Prostatitis, along with prostate cancer and non-cancerous prostate enlargement make up the three most common forms of prostate disease (Better Health Channel, 2020). 

Let's talk prostatitis, what is it?

Prostatitis refers to four different conditions that affect the prostate gland

Men with prostatitis may have infection, inflammation and/or pain. Adult men of any age can get prostatitis (Cleveland Clinic, 2021).

Classifications of prostatitis

There are 4 classifications of prostatitis:

• Category I: Acute bacterial 
• Category II: Chronic bacterial
• Category III: Chronic prostatitis/chronic pelvic pain syndrome (CPPS)
• Category IV: Asymptomatic
  
  
  

Learn more about prostatitis
with Dr. Holly Herman

VIII. Climacturia

Let's discuss yet another prevalent yet often under-discussed issue affecting male health - climacturia. 

Climacturia is defined as orgasm-associated urinary incontinence. It often affects men following prostatectomy (partial or complete removal of the prostate).

(Mykoniatis et al., 2021)

Often, males feel very nervous and anxious about it. 

But guess what, physios can help!

Physios for climacturia

It has been found that men who underwent a 3-month pelvic floor muscle training (PFMT) program saw greater improvements in climacturia and erectile function compared to men who received no treatment.

IX. Additional resources

Here is a great clinician resource from the Government of Canada containing excellent up-to-date information on various sexually transmitted and blood-borne infections. 

More courses & blogs 

If you'd like to see more courses on the subject, take a look at 

• CPA Congress 2021 Opening Keynote Presentation - Two-Spirit Resilience: The James Makokis Story with Dr. James Makokis
• Cultural Competencies in Pelvic Health

X. Laugh a little!  

Thank you for joining us!

What better way to finish off this blog than an entertaining video about what gay guys think about vaginas. 

Happy Pride Season, Canada!

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Date written: 23 June 2021
Last update: 24 July 2024