Erectile dysfunction (ED) can have many causes, including problems with blood circulation, diabetes, certain medications, stress, hormonal changes, nerve problems, and other health conditions. But one area that is sometimes overlooked is the pelvic floor.
The pelvic floor is a group of muscles located at the bottom of the pelvis. In men, these muscles help support bladder and bowel control and also play a role in sexual function.
Pelvic floor exercises—often called Kegel exercises—strengthen these muscles. They are not a guaranteed cure for erectile dysfunction, but pelvic-floor muscle training may be helpful for some men, particularly when it is performed correctly and consistently.
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How Can the Pelvic Floor Affect Erections?
Several pelvic-floor muscles are involved in male sexual function. During an erection, these muscles can help support the processes that maintain firmness.
If the pelvic-floor muscles are weak or poorly coordinated, strengthening and learning to control them may improve their function.
It is important, however, to look at pelvic-floor exercises as one part of an overall approach to sexual health, rather than a replacement for medical evaluation or treatment.
Step 1: Identify the Correct Muscles
Before exercising the pelvic floor, you first need to know which muscles you are trying to contract.
Imagine that you are trying to stop yourself from passing gas. The muscles you tighten are part of your pelvic floor.
Another commonly suggested way of recognizing them is noticing the muscles used to interrupt urine flow. However, do not repeatedly practice Kegel exercises while urinating, because regularly interrupting the urine stream is not recommended as an exercise.
Once you recognize the muscles, practice contracting them when your bladder is empty.
Step 2: Start With Slow Pelvic-Floor Contractions
You can begin while lying down or sitting comfortably.
- Relax your abdomen, buttocks and thighs.
- Gently tighten and lift your pelvic-floor muscles.
- Hold the contraction for about 3 seconds.
- Completely relax the muscles for about 3 seconds.
- Repeat several times.
As your muscles become stronger, you may gradually work toward longer contractions and additional repetitions.
The important point is control, not force. Avoid holding your breath or squeezing your buttocks and abdominal muscles unnecessarily.
Step 3: Practice Quick Contractions
Your pelvic floor also needs to contract quickly.
Gently tighten the pelvic-floor muscles and then release them completely.
Repeat several controlled contractions, resting if the muscles become tired.
Slow contractions help develop strength and endurance, while quicker contractions help train the muscles to respond rapidly.
Step 4: Add the Exercises to Your Daily Routine
Pelvic-floor exercises can be performed discreetly while sitting, standing or lying down.
Once you understand the correct technique, you might practice them while:
- Sitting in a chair
- Lying in bed
- Standing at a counter
- Watching television
- Taking a short break during the day
Consistency is more important than performing a large number of repetitions at once.
Step 5: Try a Bridge Exercise
A bridge is a general strengthening exercise that works the hips, buttocks and core and can be combined with awareness of the pelvic floor.
Lie comfortably on your back with your knees bent and feet on the floor.
Gently engage your pelvic floor and abdominal muscles, then slowly raise your hips from the floor. Hold briefly before lowering yourself in a controlled manner.
Do not strain or hold your breath.
If you have significant back, hip or joint problems, ask a healthcare professional or physiotherapist whether this exercise is appropriate for you.
Don't Overdo Kegel Exercises
More exercise isn't necessarily better.
The pelvic floor needs to relax as well as contract. Constantly squeezing the muscles or performing excessive repetitions may cause fatigue, discomfort or increased pelvic tension.
If pelvic-floor exercises cause pelvic pain, urinary problems or other new symptoms, stop and seek professional advice.
A pelvic-floor physiotherapist can also determine whether the muscles are actually weak. Some people have pelvic-floor muscles that are overly tense rather than weak, and strengthening exercises alone may not be appropriate.
How Long Does It Take to Notice Improvement?
Pelvic-floor muscles need time and regular training just like other muscles.
Do not expect an immediate change after a few exercise sessions. Improvement, when it occurs, generally requires consistent practice over a period of weeks or longer.
Results will also vary because erectile dysfunction can have many different underlying causes.
What Research Says
Research suggests that pelvic-floor muscle training may help improve erectile function in some men. One clinical trial found that men who practiced pelvic-floor exercises with professional guidance showed greater improvement in erectile function than men who received lifestyle advice alone.
Reviews of several studies have also found promising results, including for some men recovering from prostate treatment. However, researchers emphasize that pelvic-floor exercises are not a guaranteed cure for ED, and more high-quality research is still needed.
Because erectile dysfunction can also be related to circulation, diabetes, medications, hormones, stress and other health conditions, persistent ED should be discussed with a healthcare professional.
Bottom line: Pelvic-floor exercises may be a useful part of a broader approach to improving sexual health, especially when combined with healthy lifestyle habits and appropriate medical care.
Pelvic-Floor Exercise Is Only One Part of Sexual Health
Healthy sexual function is influenced by more than one group of muscles.
Regular physical activity, adequate sleep, maintaining cardiovascular health, managing diabetes and blood pressure, avoiding smoking, limiting excessive alcohol use, and addressing stress can all be important parts of men's sexual health.
Most importantly, persistent erectile dysfunction should not simply be dismissed as a normal part of getting older.
When Should You Talk to a Doctor?
Consider speaking with a healthcare professional if erectile problems:
- Continue or repeatedly return
- Begin suddenly without an obvious explanation
- Occur along with urinary or pelvic symptoms
- Develop after starting a medication
- Are affecting your quality of life or relationships
ED can sometimes be associated with cardiovascular disease, diabetes, hormonal conditions, medication effects or other health problems. Identifying the underlying cause is therefore more important than simply treating the symptom.
The Bottom Line
Pelvic-floor exercises are simple, require no special equipment and can be performed at home. For some men, properly performed pelvic-floor muscle training may be a useful part of managing erectile dysfunction and improving bladder and pelvic-floor control.
The goal isn't to promise a quick cure. It is to strengthen and improve control of an important group of muscles while also paying attention to the other factors that influence sexual health.
Medical note: This information is for general education and is not a substitute for diagnosis or treatment by a qualified healthcare professional.
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