Erectile Dysfunction: Causes, Treatment & the Role of Pelvic Floor PT
June is here, which means it’s not just the start of summer and Pride Month—it’s also Men’s Health Month!
When people hear the term pelvic health, they often associate it with pregnancy and childbirth. But the truth is, everyone has a pelvic floor, and pelvic health is an important part of overall health for people of all genders.
Your pelvic floor can play a role in bladder and bowel function, sexual health, pelvic pain, and overall movement and function. Yet, men’s pelvic health is still not discussed nearly enough.
Pelvic floor dysfunction can contribute to a variety of uncomfortable symptoms, including pelvic pain, bladder or bowel concerns, and sexual dysfunction. The good news? Many pelvic floor concerns can be addressed with the help of a qualified pelvic health professional.
If you're wondering whether your pelvic floor could be contributing to your symptoms—or whether it may be playing a role in erectile dysfunction—you've come to the right place.
What Is the Pelvic Floor?
We all have a pelvic floor. The pelvic floor is a group of muscles that stretches from the pubic bone at the front of the pelvis to the tailbone at the back, and from one sitting bone to the other.
You can think of these muscles as forming a supportive hammock at the bottom of the pelvis. They play an important role in supporting the pelvic organs and helping with:
Bladder control
Bowel function
Sexual function
Pelvic stability and support
Pelvic floor problems can develop when these muscles become weak, overly tight, poorly coordinated, or affected by scar tissue or other changes.
For this blog, we're taking a closer look at the connection between the pelvic floor and sexual function—particularly erectile dysfunction.
How Does an Erection Happen?
An erection is a complex process involving the brain, nerves, blood vessels, and muscles.
When you're sexually aroused, your brain sends signals that cause blood vessels in the penis to relax and allow increased blood flow. Blood fills two chambers of spongy tissue within the penis, causing it to become firm. At the same time, the veins that normally carry blood away are compressed, helping trap blood within the penis and maintain the erection.
When arousal decreases, blood flow changes and the penis returns to its resting state.
The pelvic floor muscles can also play an important role in this process. Certain pelvic floor muscles help support erectile function by contributing to the mechanisms that help maintain blood within the penis.
How Can Pelvic Floor Dysfunction Affect Erectile Function?
There are different ways pelvic floor dysfunction may contribute to sexual symptoms.
A Weak Pelvic Floor
When the pelvic floor muscles are weak or not functioning properly, they may not provide adequate support for the mechanisms involved in maintaining an erection. Some research suggests that improving pelvic floor muscle function may help some men with erectile dysfunction.
An Overactive or Tight Pelvic Floor
Pelvic floor dysfunction isn't always caused by weakness. Sometimes the muscles are too tight, overactive, or unable to properly relax.
An overactive pelvic floor can be associated with pelvic pain and sexual symptoms and may affect normal muscle coordination and blood flow. This is one reason why it's important to determine what type of pelvic floor dysfunction is present before beginning a strengthening program.
More Kegels aren't always the answer. Strengthening muscles that are already excessively tight or overactive may not address the underlying problem and, in some cases, may worsen symptoms.
What Can Cause Pelvic Floor Weakness?
Pelvic floor muscles can be affected by a variety of factors. Some potential contributors include:
Pelvic or prostate surgery
Chronic constipation and straining
Being overweight
Frequent or persistent heavy lifting
High-impact exercise
Chronic coughing
Aging
Repetitive increases in abdominal pressure
In addition to sexual concerns, pelvic floor dysfunction may also be associated with symptoms such as:
Urine leakage during activities like running, jumping, coughing, or sneezing
A sudden or urgent need to urinate
Frequent trips to the bathroom
Difficulty completely emptying the bladder or bowel
Bowel leakage
Pelvic pain or discomfort
It's important to remember that these symptoms can have many possible causes, which is why an individualized assessment is so valuable.
Why Work With a Pelvic Floor Physical Therapist?
A pelvic floor physical therapist can help assess how your pelvic floor muscles are functioning and determine whether your symptoms may be related to weakness, tightness, poor coordination, or another contributing factor.
From there, your therapist can create an individualized treatment plan based on your specific needs and goals.
Trying exercises and stretches on your own can sometimes be challenging. First, you need to understand how to properly identify and activate—or, in some cases, relax—your pelvic floor muscles. This can take practice.
You also don't want to automatically strengthen muscles without knowing whether they actually need strengthening. If your pelvic floor is already overly tight or not relaxing properly, a different approach may be more appropriate.
Working with a pelvic health professional can help ensure your treatment plan is tailored to your body and your specific symptoms.
How to Activate Your Pelvic Floor Muscles
If you have been advised by a healthcare professional that pelvic floor strengthening is appropriate for you, there are a few important things to remember:
Try not to clench your buttocks
Keep your legs as relaxed as possible
Don't hold your breath—keep breathing
Think about a gentle squeeze and lift, rather than tightly clenching everything
Getting Started
Gently squeeze and draw in the muscles around the urethra and anus while continuing to breathe normally. You may feel a gentle tightening and lifting sensation as the muscles contract, followed by a release as you relax.
Pelvic floor contractions can involve both longer holds and quicker contractions, depending on your individual needs. Start slowly, and stop if you experience pain or if you're unsure whether you're performing the exercise correctly.
You can practice pelvic floor exercises while lying down, sitting, or standing. Staying in one position while you learn may make it easier to focus on the movement.
Remember: pelvic floor exercises aren't one-size-fits-all. If you're experiencing pain, increased symptoms, or you're unsure whether you're performing them correctly, it's best to speak with a qualified pelvic health professional before continuing.
We're Here to Help
If you're experiencing erectile dysfunction or pelvic floor symptoms that are affecting you sexually, mentally, or physically, you don't have to navigate them alone.
At Arancia Physical Therapy, we specialize in pelvic health and take an individualized approach to help you better understand your body and work toward your goals.
Whether you're dealing with pelvic pain, bladder or bowel symptoms, sexual dysfunction, or simply have questions about your pelvic floor, we're here to help.
Please feel free to contact us online or call us at 401-602-7006 to schedule a free consultation. We look forward to helping you get back to living your best life!