Erectile Dysfunction (ED) and Pelvic Floor Therapy

By Shannon Strauch, PTA, STMT-1 on 7/10/2024

erectile dysfunction

Erectile function involves a complex interplay of vascular, neurological, hormonal, and psychological factors. When a man becomes sexually aroused, signals from the brain trigger increased blood flow to the penis, leading to an erection. This process involves the relaxation of smooth muscles in the blood vessels of the penis and the trapping of blood in the erectile tissues.

Pelvic floor muscles play a crucial role in erectile function as well. These muscles support the pelvic organs, help control bladder and bowel functions, and are involved in sexual function, including maintaining penile rigidity during erection and controlling ejaculation.

  • Vascular Component:

    • Blood Flow:

      Sexual arousal leads to the dilation of arteries in the penis, increasing blood flow into the corpora cavernosa (two sponge-like regions of erectile tissue).

    • Blood Trapping:

      The veins that usually drain blood from the penis constrict, trapping blood within the corpora cavernosa, causing the penis to become rigid.

  • Neurological Component:

    • Nerve Signals:

      Sexual stimulation triggers nerve signals from the brain to the pelvic region via the spinal cord. These signals release nitric oxide in the penile arteries, which relaxes smooth muscles and allows blood to flow in.

    • Nerve Pathways:

      The autonomic nervous system (sympathetic and parasympathetic) and the somatic nervous system (pudendal nerve) are involved in initiating and maintaining erections.

  • Hormonal Component:

    • Testosterone:

      This hormone, produced by the testes, is essential for sexual desire and erectile function.

    • Other Hormones:

      Hormones like prolactin, thyroid hormones, and cortisol can also influence erectile function.

  • Psychological Component:

    • Mental State:

      Psychological factors such as stress, anxiety, depression, and relationship issues can significantly impact erectile function.

    • Arousal:

      Sexual arousal starts in the brain and is influenced by thoughts, emotions, and sensory experiences.

Pelvic floor therapy can help with erectile dysfunction (ED) through several mechanisms:

  • Muscle Tone and Blood Flow:

    Pelvic floor exercises can improve muscle tone and blood circulation in the pelvic region, enhancing the ability to achieve and maintain erections.

    • Pelvic Floor Exercises:

      Also known as Kegel exercises, these strengthen the pelvic floor muscles. Improved muscle tone enhances blood flow and helps maintain erections by supporting the vascular mechanisms involved. Sometimes ED may be stemming from muscles that are too tight or have trigger points, therefore requiring a Reverse Kegel. Pelvic Floor Therapists are trained in determining whether an individual would benefit from strengthening or stretching

    • Targeted Strengthening:

      Specific exercises target the bulbocavernosus and ischiocavernosus muscles, which play direct roles in erection and ejaculation.

  • Nerve Function:

    • Neuromuscular Training:

      Therapy includes exercises and techniques that enhance the coordination and function of nerves in the pelvic area.

    • Sensory Improvement:

      Improved nerve function can increase penile sensitivity, contributing to better erectile function.

  • Coordination and Control:

    Strengthening and coordination of pelvic floor muscles can improve the ability to control erection and ejaculation.

    • Muscle Coordination:

      Strengthened and well-coordinated pelvic floor muscles improve the control over erection and ejaculation, reducing issues like premature ejaculation.

    • Biofeedback:

      This technique helps individuals gain awareness and control over their pelvic floor muscles, enhancing the effectiveness of exercises.

  • Posture and Alignment:

    Addressing pelvic floor muscle imbalances and posture issues can alleviate pelvic pain and improve overall pelvic health, indirectly benefiting erectile function.

  • Psychological Factors:

    Pelvic floor therapy may include techniques to reduce stress and anxiety related to sexual performance, which can contribute to ED.

Pelvic floor therapy offers a holistic and non-invasive approach to managing erectile dysfunction, addressing both physical and psychological factors to improve sexual health and overall well-being. Looking to optimize your sexual well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at

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