An important topic in men’s health, and specifically men’s pelvic health, is erectile dysfunction. Erectile dysfunction, or ED, is the inability to sustain an erection firm enough for sexual intercourse. Research shows that thirty-five percent of men aged 60 will have ED and the number jumps to 50% in men older than 70.
Your Erection Muscles
But before we go further into ED causes and treatments, let’s look at erections in general. What muscles are involved in getting and maintaining an erection?
The male pelvic floor stretches from the pubic bone in the front to the tailbone in the back. Its purpose is to support your organs from falling out, control your bowel and bladder function, and play a role in intercourse and pleasure. The two superficial pelvic floor muscles include the bulbocavernosus muscle (which controls erection, orgasms, and ejaculation) and the ischiocavernosus muscle (which assists in maintaining rigidity during erection). If these muscle groups become overactive or underactive, your ability to have an erection and maintain it becomes compromised.
Erectile Dysfunction Causes
Depending on circumstances, ED is not unusual, as it can occur during times of high stress or fatigue. If an erection cannot be held firm enough for more than half of the time you attempt penetrative sex, you should seek professional help.
The following list is not exhaustive, but other common underlying causes of ED include:
- Alcohol
- Tobacco
- Medications
- Hormones
- Trauma
- Diabetes
- Obesity
- High Blood Pressure
- Heart Disease
- Muscular Dystrophy
Your ED can also result from difficulty lengthening or relaxing your muscles for arousal. If this is the case, you may experience increased tension or discomfort in your testicles or penis before, during, or after an erection. Inadequate erection or premature ejaculation can occur. You may even notice an increase in urinary frequency and constipation.
Sciatica and Erectile Dysfunction
Sciatica is radiating pain that runs from your lower back and can continue down into either side of your buttocks or legs. Literally, it is a pain in the butt. Due to a variety of causes, it often results in numbness, tingling, weakness, or pain that can be mild or excruciating. It can also cause erectile dysfunction.
The sciatic nerve is the largest nerve in your body and, if irritated, can interfere with your ability to maintain an erection. Further down the nerve chain, you can find the cavernous nerves, which help facilitate penile erection, and the pudendal nerves. The pudendal nerve is a major nerve that provides sensory and motor control in your saddle region.
Treating Erectile Dysfunction
Treatment for ED will depend on the cause of ED and can include oral medications, vacuum pumps, implants, sex therapy, and exercise. Regular exercise helps with sexual health and performance. And a physical therapist can assess your musculoskeletal system to find the best course of action for you.
Erectile Dysfunction And Your Pelvic Floor
When your pelvic floor muscles cannot hold a contraction when needed, the muscles cannot generate enough force to keep blood in place to maintain an erection. You will have difficulty with penetrative sex, maintaining an erection to climax, stopping your urine stream, and even urinary incontinence.
The only way you will know if your pelvic floor muscles are involved is to have a pelvic floor physical therapist assess you. They can evaluate your musculoskeletal system, including your pelvic floor, and look for ED associated with tight, overactive muscles or weak, underactive muscles. Treatment can include pelvic floor muscle training, biofeedback, manual therapy, and education on lifestyle modification.
Exercises to Treat Erectile Dysfunction
There are several pelvic floor exercises you can use to treat your ED. A pelvic floor physical therapist can design a specific program for you based on your evaluation. Pelvic floor strengthening exercises, such as Kegels, are appropriate for underactive pelvic floor muscles but detrimental to sufferers of overactive pelvic floor muscles.
You will benefit more from down-training muscles, learning breathing and relaxation techniques, and receiving manual stretching or exercise to lengthen your pelvic floor muscles. Exercises to increase cardiovascular endurance help to bring more blood flow to your pelvic area.