Erectile Dysfunction

Yes. Physical activity improves erectile dysfunction, also known as ED, in men with vascular ED. A physical therapist is an expert in movement dysfunctions and uses physical activity and exercise to treat disease and injury.

Erectile dysfunction affects one out of three men and is the most common type of sexual dysfunction in men. The ability to maintain a penile erection long enough to complete a sexual activity to satisfaction is compromised.

The leading cause of erectile dysfunction is arterial insufficiency, or when blood slows or stops within your arteries. Cardiovascular disease is a common cause of arterial dysfunction.

Risk factors for ED include:

• Increased Age
• Diabetes
• Hypertension
• Physical inactivity
• Obesity
• Metabolic syndrome

Erectile dysfunction is also a warning sign of poor vascular function and is predictive of cardiovascular disease.

Current medications prescribed to treat erectile dysfunction are PDE5 inhibitors. They help increase blood flow to your penis and aids in sexual arousal. The effects can last for up to four hours.

Unfortunately, many men do not find that these vasodilating medications work as expected, as the results are only temporary.

Multiple studies show that physical activity treats arterial erectile dysfunction. However, it is often not the first line of treatment in clinical practice.

Some natural ways to help treat erectile dysfunction include:

• Eating more fruits and vegetables
• Reducing your waistline
• Increasing pelvic floor strength
• Quitting smoking
• Limiting alcohol consumption

Most importantly, you must aim for at least 40 minutes of moderate to vigorous-intensity aerobic exercise four times per week. Finding an activity that can quickly pump blood throughout your body and into your lungs would be best. Your lungs can pump more oxygen to your body for your organs and muscles to use.

Some examples of aerobic exercise include:

• Walking
• Running
• Cycling
• Swimming
• Rowing

If your inability to maintain an erection negatively impacts your life, ED medications are not helping the way you expected, and you have difficulty adding exercise and lifestyle changes to improve your erectile dysfunction, then you should call for a PT consultation as soon as possible.

A pelvic health physical therapist treats pelvic floor dysfunction and identifies and assesses your pelvic floor muscles to help improve your symptoms. You can train several muscles that make up your pelvic floor to reduce ED.

• Ischiocavernosus muscle assists in producing your erection 
• Bulbocavernosus muscle maintains your erection 
• Corpus cavernosum fills with blood to create your erection, and your pelvic floor muscles contract and keeps your blood in place 

Training your pelvic floor muscles can help you increase and maintain the rigidity of your erections. You’ll be able to perform penetrative sex and maintain an erection to climax.

Your physical therapist will take a detailed medical history and complete an orthopedic examination during your first visit. A pelvic health PT will also directly asses your perineum or that area between your scrotum and anus to assess the following:

• Strength
• Symmetry
• Tone
• Reflex
• Pain

Then your PT will design an exercise program to address your pelvic floor dysfunction.

Physical therapists will generally treat two types of pelvic floor dysfunction: 

• Hypertonic, your muscles are too tight
• Hypotonic, your muscles are too loose

If your pelvic floor muscles are too tight, you won’t be able to lengthen your muscles or balloon them out and away from your body. You’ll experience tension and discomfort before, during, and after an erection. You may even experience the following:

• Premature ejaculation
• Urinary incontinence
• Urinary frequency
• Bowel constipation

If your pelvic floor muscles are too loose or weak, you won’t be able to shorten them, or they feel you have no control over them. When it is time to be aroused, your muscles can’t generate enough power to hold blood in your penis long enough to start or maintain an erection. You’ll also notice:

• Urinary incontinence
• Difficulty stopping your urine stream
• Difficulty holding back gas

Your physical therapist can assess your pelvic floor muscles and design an exercise program specifically for the type of muscle activity you present.

If you’re experiencing tightness in your pelvic floor muscles, you should add treatment and exercises to help you relax and lengthen your muscles. A relaxed pelvic floor will allow more blood to pool into your penis. Physical therapy treatment includes techniques to incorporate and improve pelvic flexibility and range of motion with:

• Manual therapy
• Electrical stimulation
• Biofeedback therapy
• Stretching exercises
• Lifestyle management

If you’re experiencing weakness in your pelvic floor muscles, you should add treatment and exercises to help you build strength and endurance. Strong and coordinated pelvic muscles will allow you to initiate and maintain an erection. Your therapist can design a strengthening program to target your pelvic floor muscles.

Kegel exercises are not always the answer to fixing ED. Trying to contract an already tight muscle will only make your symptoms worse. Your physical therapist will determine which exercises best treat the condition of your pelvic floor muscles.

Based on your current movement strategies and the condition of your muscles, your tailored exercise program will help you reach optimal pelvic floor performance quickly.

Relaxation exercises can include:

• Stretching exercises
• Yoga positions
• Breathing exercises
• Visual imagery
• Body awareness exercises

Strength training can include:

• Isolated isometric contractions
• Endurance strengthening
• Speed strengthening
• Functional strengthening

Pelvic health physical therapists specialize in helping you use physical activity as a tool to treat erectile dysfunction. They can create individualized training programs that your exercise preferences can guide.

Reach optimal pelvic floor function with Smart Body Physical Therapy to achieve your performance goals during sex and climax. We offer the best evidence-based treatments to help you improve the quality of your life and your sex life with pelvic floor rehabilitation.