Erectile Dysfunction: Can Pelvic Floor PT help?
What is Erectile Dysfunction
Erectile dysfunction is when a person cannot achieve or maintain an erection, or when the erection is not as firm as it once was. Other symptoms may occur along with these symptoms such as UTI symptoms, painful ejaculation, or poor orgasms. Four main factors can influence erections: psychological well-being, blood flow, nervous system integrity, and pelvic floor muscle function. Any of the above signs or symptoms can be influenced based on the factors that are affecting erectile dysfunction.
Other Conditions Associated with Erectile Dysfunction (ED)
- Hypertension
- Cardiovascular disease
- Diabetes
- Obesity
- Low testosterone
- Anxiety/depression
- Stress
- Alcohol/drug/cigarette use
What a PT will Look For
A physical therapist will look for the cause of the erectile dysfunction. There may be multiple factors leading to the ED such as anxiety, depression, blood flow, nervous system integrity, or pelvic floor muscle function. The PT will take a thorough history of your past medical history and symptoms. From there, they will screen for red-flag items (these are typically things like cauda equina syndrome). Once that is clear, they will search for the root cause behind your ED. Often people with ED will experience other coincidental findings that should also be addressed. Based on the exam, the PT will either treat what they found or refer you to an appropriate provider to treat the ED.
What Does Treatment Look Like?
Treatment will consist of manual therapy, which can include manipulation, massage, and cupping, among other techniques. It should also consist of activity modification as appropriate such as posture habits, exercise habits, or diet habits. Exercise programs will also be included that should address the relaxation, coordination and strength of the muscles. This is a non-inclusive list of interventions that your therapist may use. Each therapist may be trained in different techniques, and they may employ other interventions to best address your situation.
What are Some Other Options for Treatment?
Not every person with ED is appropriate for physical therapy. If someone has such severe blood flow restrictions that they cannot achieve an erection, they might have an underlying cause that needs to be addressed medically. In addition, people with nerve lesions such as cauda equina syndrome should seek emergency care before addressing some of the effects with PT.
In addition, your therapist may treat you alongside another provider. Patients with anxiety or depression may want to see a therapist to address the cognitive side of the disorder. Some patients may also need medication after a trial of physical therapy. In the worst-case scenario, a patient may need an implant if they do not respond to physical therapy treatment. Every patient is different and may have different needs, but physical therapy can be an effective conservative approach.
Sources
- Yu, C., Yao, J., He, Y., Huang, J., Chen, M., Qian, M., … & Chen, F. (2023). Effects of surgery versus radiotherapy in patients with localized prostate cancer in terms of urinary, bowel, and sexual domains. Cancer Medicine.
- https://www.physio-pedia.com/Physiotherapy_Management_for_Sexual_Dysfunction_in_Men
- Yaacov D, Nelinger G, Kalichman L. The Effect of Pelvic Floor Rehabilitation on Males with Sexual Dysfunction: A Narrative Review. Sex Med Rev. 2022;10(1):162-167.
- https://urologyaustin.com/physical-therapy/erectile-dysfunction-and-pelvic-floor-physical-therapy/