Defined as the inability to achieve or maintain an erection, erectile dysfunction is a common–but not normal or inevitable! — issue for men. By the age of 40, 40% of men experience erectile dysfunction. That number will increase to 70% of men by the seventh decade.
Creating and maintaining an erection is a complicated process that involves the pelvic floor muscles. First, upon arousal, blood has to be able to flow into the penis. This can be more difficult if the pelvic floor muscles are tight, or in spasm, constricting the blood vessels and slowing blood flow. Then, once the blood is in the penis, the pelvic floor muscles contract. By squeezing tight, they prevent the blood from escaping and increase the pressure within the penis. Again, if these muscles aren’t functioning properly, maintaining an erection throughout intercourse can be difficult.
The typical first choice for complaints of erectile dysfunction are pharmacological. Drugs like Viagra work by opening the blood vessels to the penis and increasing blood flow. However, this method has significant drawbacks. First, it doesn’t address the underlying issue; in many cases, that pelvic floor dysfunction is making an erection difficult to sustain. These drugs have significant side effects, and must be taken repeatedly. In many men, they are only partially effective.
Pelvic floor physical therapy works to identify whether the pelvic floor is the underlying cause of sexual dysfunction and, if so, resolve it. Sexual function is one of the most complex tasks for these pelvic floor muscles, since they need to both relax and contract in rapid succession. Tight muscles within the pelvic floor can inhibit blood from reaching the penis to create an erection, or can prevent the muscles from squeezing tight to maintain it. Restoring normal function to these muscles can also restore healthy sexual function in men.
“We treat many men for pelvic pain and/or urinary symptoms, often diagnosed as chronic prostatitis, ‘cyclist syndrome,’ or levator ani syndrome. It’s common for these men to also be suffering from sexual pain or dysfunction that they may not even realize is related, until it also starts to improve with pelvic floor physical therapy.” — – Dr. Nicole Cozean, PT, DPT, WCS, CSCS
In addition to erectile dysfunction, pelvic floor issues can be responsible for pain with intercourse, pain after ejaculation, low back, hip, or groin pain, or urinary urgency and frequency in men.
Read more in our Erectile Dysfunction Health Center.