The Connection Between Erectile Dysfunction and Your Pelvic Floor

Erectile dysfunction is a type of sexual dysfunction where someone is unable to achieve or maintain an erection. Many people mistake this condition as something that only happens when you’re older, but it can actually happen at any point in your life, even if you’d never had previous troubles with erection.

Symptoms of this dysfunction can vary from person to person. Some may be completely unable to achieve an erection, whereas others may require a lot of consistent stimulation and extra effort to keep theirs. In some cases, those with erectile dysfunction may not always have problems achieving their erection, and may only experience difficulties on occasion. For some, they may be able to achieve an erection, but not long enough for successful intercourse. 

Outside of these physical symptoms, erectile dysfunction can also cause anxiety, low body image, frustration, and lowered sexual desire. Erectile dysfunction may seem like a physical condition, but it can be significantly impacted by psychological factors such as these. 

These psychological effects can unfortunately worsen the physical symptoms of erectile dysfunction, and create a cycle of worsened symptoms overall. Therefore, in addition to physical treatment options, your physician may refer you to mental health professionals or similar therapies.

It’s important to note that an occasional instance of erectile dysfunction is not necessarily a need for concern, as certain medications, alcohol, and even being nervous can make achieving one difficult. However, frequent instances of erectile dysfunction or prolonged erectile dysfunction typically require treatment.

Many people avoid treatment for erectile dysfunction out of embarrassment or shame. However, there’s no shame in seeking treatment! Sexual health is completely normal and important—it shouldn’t be associated with shame. Many professionals have helped countless patients with their own sexual dysfunctions, and are here to help you get back to a great sex life!

Erection is possible thanks to many different parts of the body working together. Your hormones signal for an arousal response by stimulating your body’s nerves. Your nerves communicate with the brain to increase blood flow to the genitals, where muscles work to hold that blood—allowing for an erection and firmness.

Because so many structures contribute to erection, there are actually various types of erectile dysfunction, including the following:

• Psychogenic: As mentioned before, psychological factors can significantly impact your ability to have an erection. Anxiety, stress, depression, and things of that nature can interrupt the arousal process.
• Neurogenic: When the nerves are unable to properly signal for arousal, erection can be difficult or impossible.
• Hormonal: Hormones are what signal the start of increased blood flow and arousal. Low testosterone levels can make achieving erection very difficult.
• Vascular: During erection, blood fills the penis to allow for lift and firmness. When this blood flow is interrupted, erection may be difficult to achieve or maintain. This is the most common cause of erectile dysfunction.

There are many different factors and other conditions that can contribute to these types of erectile dysfunction. Underlying conditions such as high blood pressure, heart disease, kidney disease, Parkinson’s disease, or multiple sclerosis can impact erection. Previous surgical procedures near the prostate, bladder, or colon can affect important structures necessary for arousal and erection, too.

One cause of erectile dysfunction that some may overlook is pelvic floor dysfunction. Pelvic floor dysfunction refers to problems with your pelvic floor, which is an important group of muscles found in your pelvis. 

The Pelvic Floor’s Role in Sexual Function

Everyone has pelvic floor muscles, regardless of their genitals. These muscles are important for a variety of functions, and play a major role in sexual function. They help maintain blood flow for erection, and also directly control the contractions and relaxations that occur with orgasm. 

When these muscles are dysfunctional, however, it can impact the blood flow needed for arousal and erection. The pelvic floor muscles can even irritate nearby nerves, such as the pudendal nerve, which plays a major role in sexual function and sensation.

Pelvic floor dysfunction is an umbrella term that refers to a wide range of pelvic floor problems. It can mean that your pelvic floor is too weak, uncoordinated, or tight, and unable to perform its usual functions. The pelvic floor can even have a combination of these issues, which can cause a variety of different dysfunctions. 

For example, when the pelvic floor muscles are weak, they become unable to fully support the bladder or rectum—and can’t control sexual responses during intercourse. This leads to difficulty achieving an erection or maintaining one throughout sex. Additionally, weak pelvic floor muscles can lead to a decrease in sensation during intercourse, making it difficult for both partners to experience pleasure during sex.

Outside of sexual function, pelvic floor dysfunction can also cause urinary and bowel troubles. This can include symptoms like constipation, incontinence, pelvic pain, urinary urgency, and much more. If you experience any symptoms similar to these in addition to erectile dysfunction, you should definitely consider pelvic floor physical therapy.

Pelvic floor physical therapists can help address your pelvic floor health and restore sexual function through a variety of treatments. They’ll determine what sort of pelvic floor dysfunction you may have, and then create a treatment plan according to your individual needs. We’ll talk more about physical therapy treatment below!

Pelvic floor physical therapy is the best form of treatment for erectile dysfunction that is caused or worsened by pelvic floor dysfunction. Pelvic floor dysfunction can vary from person to person, and the symptoms of erectile dysfunction can vary depending on your pelvic floor’s condition, too.

Therefore, when working with me, you can expect a comprehensive and holistic treatment plan that addresses your unique needs and concerns! Your first session starts with a thorough evaluation, which can include things like discussing your medical history, symptoms, and any related injuries, surgeries, or underlying conditions. 

This evaluation may include an examination to check your pelvic floor condition. An examination can provide valuable information about your pelvic floor’s health, which will help better curate your treatment plan.

Examinations can be internal or external, but are only performed with your consent. Don’t avoid treatment for fear of examination! While this process can provide useful information about your pelvic floor to aid in treatment, I can still work with you if you refuse examinations. 

Rest assured that I always work with my patient’s comfort level. I explain each and every treatment beforehand, and always request consent before any examination or treatment. You are in control, meaning you can rescind consent at any time!

Once your evaluation process is complete, I’ll create a unique treatment plan catered to your individual needs and symptoms. This treatment plan will look to improve your pelvic floor strength, mobility, function, and coordination. You can expect to engage in at-home strategies and behavioral modifications, too. Let’s take a closer look at the treatments that may be used to treat symptoms of erectile dysfunction!

Manual Therapy

Manual therapy techniques such as massage or deep tissue pressure release techniques can help address low mobility, tightness, and tension of the pelvic floor. Manual therapies manipulate the tissues such as muscles, nerves, ligaments, and tendons to improve blood flow, range of motion, and mobility. 

Manual therapy can be done in many ways. While trigger point release and massage can be done to the pelvic floor directly with pelvic wands, it is also common to use manual therapies on your abdominals, lower back, or hips. These areas are very interconnected with your pelvic floor, and tension in these areas can create restrictions that contribute to dysfunction. Therefore, it is important to address all areas as needed!

Exercise Prescription

As a part of your treatment, I will create an exercise program that is tailored to your body’s unique needs and current muscle tone. This plan can involve exercises or activities that help strengthen your pelvic floor, as well as the related areas mentioned before. For erectile dysfunction, this can mean exercises that focus on core strengthening and flexibility!

Core strength is very important for erection. The core muscles (abdominals) are directly connected to the pelvic floor, and allow for blood flow and control during erection. Weak core muscles can contribute to poor pelvic alignment and can even negatively impact nerve function. For these reasons, I will assess your core strength and adjust your exercise plan as needed!

Exercise plans are not limited to strengthening. Flexibility and mobility are important for pelvic floor function, too. Therefore, your exercise plan may involve yoga, stretching, and more.

Pelvic Floor Training

Part of your care plan will focus on your understanding of your pelvic floor! More specifically, I’ll lead you through education and activities that will improve your understanding of your pelvic floor’s contractions and relaxations. These activities can include treatments such as neuromuscular re-education and biofeedback training, which allow you to see these important movements in real time as you practice. 

Regaining an understanding of your pelvic floor will help you practice relaxation techniques and strengthening activities at home, too—which is essential to support long-term pelvic floor health. 

Pelvic floor training will also improve the coordination of your pelvic floor, which is important for both erection and orgasm. Coordination refers to your pelvic floor’s ability to contract and relax in coordination with other internal structures to allow for urinary, bowel, or sexual function. Your pelvic floor needs to be able to naturally contract and relax with proper timing, and it needs the strength to support these reflexes, too.

Behavioral Modifications

I don’t want my patients to just “get better.” I want to set them up for long-term success and a better quality of life! One way to achieve long-term results is by implementing preventative care. This means creating at-home strategies that will allow you to maintain great pelvic floor health and prevent a relapse of your symptoms.

Therefore, I will include an important aspect of treatment in your care plan: behavioral modifications! These are modifications to things like posture, form, and habits that could be impacting your pelvic floor health. 

I’ll want to address anything that can put strain on your pelvic floor, so I may examine your posture while sitting, standing, or walking, and your form while lifting or doing other activities. Behavioral modifications can include other things such as restroom habits, diet, fiber or water intake, and more. In addition to exercises and stretches, you should prepare to make changes to these different aspects of your daily life, too.

By reducing the daily strain on your pelvic floor with behavioral modifications as well as engaging in regular exercises and stretching, you’ll have better long-term results and a lower risk of seeing your symptoms once again.

As you can see, pelvic floor physical therapy requires consistency both in the clinic and at home. Don’t worry—I’m here to motivate you and lead you back to optimal pelvic floor health! If you’d like to get started with treatment for erectile dysfunction, make an appointment or explore the discovery call for additional questions.