Having a hard time getting hard?
One of the most common sexual dysfunctions in persons with a penis is erectile dysfunction.
Erectile dysfunction is the inability to reach or maintain an appropriate erection for sex, and usually at least 50% erection is required for penetration. This inability can be due to a variety of systemic and local disorders, and even a side effect from some medications. You can read more about this in our blog titled Sexual Dysfunction in Men.
Managing Erectile Dysfunction
In some conditions, like heart disease, effectively managing the disease with your cardiologist can alleviate sexual symptoms and research suggests that 3-6 months of cardiac rehabilitation can be effective to manage ED caused by Ischemic Heart Disease (IHD). But in some others, like clinical depression, sexual dysfunction can be a side effect of the medication and so, where medication is unavoidable, erectile dysfunction just remains as an unfortunate side effect. In such cases, pelvic floor PT can be a valuable adjunct to manage this side effect. Here’s a short list of some conditions that can cause/contribute to ED and that may benefit from Pelvic Floor PT:
| Surgical | Medical | Medications | Other |
| Post prostatectomy surgery | Diabetes | OTC Antihistamines – for allergy | Chronic pelvic pain |
| Spine, hip and pelvic surgery | Prostate cancer | SSRI – for depression and generalized anxiety disorder | Hip pain |
| Abdominal surgery | Other cancers | Antihypertensives- for high blood pressure | Low back pain |
Normal sexual function is a biopsychosocial process, so it is often impacted by a combination of physical, psychological and social factors. When ED also has psychological causes, it may be beneficial to work with a talk therapist and/or a sex therapist in addition to Pelvic Floor Physical Therapy.
Pelvic Floor Physical Therapy for Erectile Dysfunction
This starts with finding the source(s) of ED (if unknown) and addressing both the primary cause and the secondary cause (penile and pelvic floor muscle). Penile rehabilitation includes:
Lengthening/releasing tight muscles
Muscles in the pelvic floor, hip can be tight causing restrictions and may or may not be painful. These can be released with a variety of stretches, manual techniques done by a Pelvic Floor Physical Therapist both externally and internally (through rectum), using tools such as foam rollers, wands to assist self release, and even gentle breathing and positioning exercises.
Penile Strengthening
Your penile erector muscles originate at your pelvic floor (usually palpated externally and through rectum), and form the base (20-30%) of your penis. Research supports strengthening these muscles using biofeedback, rehabilitative ultrasound to be an effective conservative tool for improving penile strength.
Physical Activity
Research shows that regular physical activity including aerobic exercise may be effective in improving sexual function.
We Can Help!
Body Harmony Physical Therapy offers one pelvic health physical therapist to one patient evaluation and treatment sessions. Our treatment sessions last up to one hour in a private treatment room. We provide individualized home programs to every patient. We offer a quick call back option for potential patients who have questions or concerns related to physical therapy.
References:
- https://api.research-repository.uwa.edu.au/ws/portalfiles/portal/54573972/THESIS_DOCTOR_OF_PHILOSOPHY_MILIOS_Joanne_Elizabeth_2019.pdf
- https://www.termedia.pl/The-role-of-physiotherapy-in-the-treatment-of-men-s-sexual-dysfunction-erectile-dysfunction-and-premature-ejaculation-a-review,128,45000,0,1.html
