Pelvic Floor Physical Therapy for Male Sexual Dysfunctions

The pelvic floor is a hammock-like structure of muscles that holds the pelvic organs in place. Sometimes, these muscles can become too tight or too loose, which can contribute to sexual health problems. Fortunately, pelvic floor physical therapy can help.

Often, women are the focus of pelvic floor physical therapy interventions, perhaps because pregnancy and childbirth can have a big impact the pelvic floor muscles. However, pelvic floor physical therapy may also be beneficial for men who are experiencing certain sexual dysfunctions.

Past studies have shown associations between pelvic floor dysfunction and male sexual dysfunctions including erectile dysfunction (ED), ejaculatory dysfunctions, and orgasmic disorders. Accordingly, training the pelvic floor muscles using appropriate physical therapy techniques may improve the sexual outcomes of men with pelvic floor dysfunction.

For example, research has shown that pelvic floor physical therapy can improve the rigidity and hardness of erections in some men. Even when such improvements are modest, they can make a big difference for patients emotionally and sexually. A small change may be the difference between a patient being able to have penetrative sex and not being able to do so.

Additionally, the pelvic floor plays a role in ejaculation, so training the pelvic floor muscles may give a man more control over this process. Men who struggle with premature ejaculation may be able to increase their intravaginal ejaculation latency time (i.e., the time from the start of vaginal penetration to ejaculation) with the help of pelvic floor physical therapy. (Up until now, most research on premature ejaculation has focused on intravaginal ejaculation latency time. Further research on ejaculation times during other forms of penetration could improve the data for all patients who engage in different types of sexual activities.)

Muscle contractions facilitated by the pelvic floor can enhance the pleasure and experience of orgasm. Therefore, doing appropriate pelvic floor exercises may intensify the feelings of pleasure that a person has during orgasm or ejaculation.

Recently, pelvic floor physical therapy has been explored as a treatment option for Peyronie’s disease. Some physical therapists utilize pelvic floor exercises, manual therapy, hip stretching/mobility, neural modulation for balancing sympathetic/parasympathetic activity, and anxiety/stress management for patients who are suffering from Peyronie’s disease. 

Lastly, men with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) often experience difficulties and/or pain during sexual activity, bowel movements, and urination. This pain may be managed in part with a treatment plan that includes pelvic floor physical therapy techniques. Pelvic floor physical therapy can help to release tension in the pelvic floor muscles that may be causing painful sensations during these activities.

Depending on the circumstances, pelvic floor physical therapy may be beneficial for the sexual function of both men and women. As such, pelvic floor training exercises should be considered as part of a treatment approach (when appropriate) for patients who are experiencing sexual pain or a different type of sexual dysfunction.

References:

Cohen, D., Gonzalez, J., & Goldstein, I. (2016). The role of pelvic floor muscles in male sexual dysfunction and pelvic pain. Sexual Medicine Reviews, 4(1), 53-62. DOI: https://doi.org/10.1016/j.sxmr.2015.10.001