Erectile Dysfunction and the Pelvic Floor: Breaking the Silence on Men’s Sexual Health
Erectile Dysfunction (ED) is the consistent or recurrent inability to attain and/or maintain penile erections sufficient for sexual satisfaction. There can be a number of causes for ED including cardiovascular disease, psychosomatic factors, musculoskeletal issues, and tissue injury. Regardless of the cause, ED has a profound impact on physical function, psychological function, and quality of life, making this an important symptom to treat and something that Pelvic Floor Therapy can really help with. It’s also worth mentioning that ED is not an “old man’s problem.” In fact, most men who come to me with ED are in their 20s-40s.
Penis 101
The average length of an erect penis is 5.1-5.5in. Why does this matter? - Many men wrongly believe their penis size to be smaller than average, which can play a huge role in confidence and performance.
There is a wide range of “normal” angles that the penis makes when erect. With age, tissues become looser and this angle can change. This change in angle is nothing to worry about and does not mean someone is losing an erection.
While the penis is not a muscle, it has several muscles in and around it that helps with function (more on that in the next section). There are also ligaments around the penis that help anchor it and provide stability for sexual activity. Damage to the supporting ligaments can certainly affect erection quality, as well as comfort.
Injury aside, with age, it is common to experience erectile changes and challenges. In fact, 40% of men in their 40s experience ED, 50% of men in their 50s, 60% of men in their 60s, and so on. But just because something is common, does not mean we can’t work toward a solution to make it better!
The Role of the Pelvic Floor
There can be different causes for ED. Some organic causes include heart disease, neurological disorders, and medication induced ED. But men can also suffer from ED due to Pelvic Floor Dysfunction.
The pelvic floor muscles can be found under your pelvis, running from the tip of your tailbone, to the base of your penis and pubic bone, and between your two sit bones. While there are a number of muscles in this region, two in particular are especially important for penile function - Bulbospongiosus and Ischiocavernosus.
If you’re still unsure of where your pelvic floor is, try standing in front of a mirror and contract your pelvic floor slowly (think “squeeze and lift”). You should notice that first your penis lifts, then your testicles rise, and finally your anus tightens.
These muscles muscle be able to relax, to allow blood to flow into the chambers of the penis. This is how an erection starts. Once blood enters, the muscles contract which puts pressure against the arteries carrying the blood, preventing backflow of the blood and helping to maintain the erection.
When someone has pelvic floor dysfunction, the muscles don’t contract and relax as they should. It can be due to a muscle coordination issue, an issue with strength, or a problem with too much tension in the muscles. Of note, pelvic floor dysfunction often also include other symptoms that many men don’t realize are related.
A Team Approach to Erections
The pelvic floor muscles don’t work in isolation. In fact, your spine and pelvis needs to move freely and this movement (or lack there of) will have an affect on your pelvic floor muscles and rigidity of your erection.
When the spine is stiff and rigid, the pelvic floor muscles will often tense up and can’t contract well. This negatively affect sexual function. It’s not a coincidence that men with lower back pain often have associated ED and other sexual issues.
When the spine moves well, there is more blood flow to the pelvic floor and genitals. This is associated with more pleasant feelings and arousal, as well as decreased discomfort during sex.
Movement at the spine affects movement at the pelvis. If the spine is stiff, oftentimes the pelvis will not move as well. Men may be stuck in a position where their pelvis is tilted back in a tucked position. This puts the pelvic floor muscles in a shortened position, which makes it difficult for them to contract and relax well for bloodflow.
Natural Ways to Improve Erections
I always suggest seeing a physician to rule out any underlying organic causes to ED, such as heart disease. Other things you can do to help your sexual function include:
Optimize sleep - The average person requires 7-9hrs of quality sleep. Among other things, sleep helps with muscle recovery and hormone regulation.
Hone in on nutrition - Protein is essential for muscle strength and health. Getting enough fiber can mean better bowel movements and less straining. This is important, as chronic straining weakens the pelvic floor.
Exercise - This is useful to improve blood flow throughout your body. Movements of your spine, pelvis, and hips, will also help reduce stiffness and maintain mobility at your pelvic floor muscles.
Work on stress reduction - stress increases your fight or flight response and elicits tension throughout the body. Finding ways to reduce stress will translate to fewer physical symptoms that develop as a result.
Pelvic Floor Therapy for Men’s Pelvic Health
Men’s pelvic health is an ever growing specialty. A Pelvic floor therapist who specializes in this area can help get to the root cause of the issue and work alongside your physician for a more comprehensive treatment plan.
Pelvic floor therapy uses manual therapy techniques, postural corrections, and movements, to allow all areas of your pelvic floor to function optimally. Old hip or back injuries are often part of the issue that leads to pelvic floor dysfunction over time. A structured home program that is tailored to your specific needs can be very helpful for regaining strong and lasting erections. If you’ve gone down the path of medical test and are still struggling with unexplained erectile concerns, reach out and learn how pelvic floor therapy can help.
I hope this information was helpful and maybe caused you to look at symptoms you have been ignoring. If you need help finding a pelvic floor therapist in Florida, we hope that you will consider us for either in-person or virtual appointments.
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