Pelvic floor and erectile dysfunction: how to get it up and keep it up

Is your pelvic floor letting you down in the bedroom?

Is your stamina just not what is used to be?

Help is at hand and even better, it won’t cost you a cent! Thank you the wonderful readers at Starts at 60 for your great response to my last article for women on vaginal dryness. This time I’m writing for the gentlemen (or women who feel their partner could benefit from a nudge along).

Read on now to learn:

• What is an erection?
• What causes erectile problems?
• Signs of pelvic floor weakness?
• How to do pelvic floor exercises that strengthen your erection
• How long to notice and improvement?

What is an erection?

We all know what an erection looks like but have you ever wondered what happens for the penis to become erect? Is it a bone? Is it a muscle that springs to life when you’re aroused? None of the above, in fact the penis consists of 3 tubular chambers containing sponge-like tissue that is filled with spaces. During sexual arousal blood rushes into these chambers which become engorged causing an erection. The length and the girth of the penis are both increased when blood rushes into these chambers. Blood needs to be trapped in the tissue spaces for an erection to be maintained. If the blood freely drains away the erection is lost and the penis becomes flaccid.

What provides the stopper force retaining the blood in these chambers? Your pelvic floor muscles!

When the pelvic floor muscles contract they help to retain blood within the chambers of the penis keeping it erect.

What causes erectile problems?

Being unable to have an erection or maintain an erection can be caused by medical issues including diabetes, kidney disease, neurological problems or blood vessel disease.

Some men suffer from erectile dysfunction because they lack sufficient pelvic floor muscle strength and endurance to maintain their erection.

Pelvic floor muscles can lose their strength with:

• Increasing age
• Lack of pelvic floor exercise
• Constipation and straining
• Carrying too much abdominal weight
• Spinal surgery
• Surgery for prostate cancer
• Prolonged heavy lifting
• Chronic coughing

What are the signs of pelvic floor weakness?

Signs of weak pelvic floor muscles include:

• Difficulty getting or maintaining an erection
• Bladder leakage with coughing, sneezing or with a strong urge to empty
• Loss of urine after bladder emptying (post-void dribble)
• Inability to stop or slow the flow of urine
• Poor control of wind or bowel movements

How to do pelvic floor exercises that strengthen your pelvic floor

Step 1: Find your pelvic floor muscles

Your pelvic floor muscles are located in and around where you sit. They are like a hammock running from your tail bone to your pubic bone (behind your penis) and side to side between the bones you sit on.
Try not to confuse your pelvic floor muscles with your buttocks – your buttocks are on the outside, your pelvic floor muscles are inside your body and can’t be seen with the naked eye.

Step 2: Feel your pelvic floor exercises

Pelvic floor exercise feels like an inward lift of the testes towards your body lift and squeezing/lifting sensation around your anus.

These simple techniques can help you find and feel your pelvic floor muscles working:

1. Try to stop or slow the flow of urine once it’s started using a lift and squeeze of your pelvic floor muscles. Use this technique only once a week as a test, not as a regular exercise.
2. Lift and squeeze the ring of muscles around your anus as if trying to avoid passing wind. You should feel a definite squeeze and lift. Sometimes this can be easier performed lying down when first starting out.
3. Stand side on to a full length mirror – you should see your scrotum lift and a drawing inwards or retraction of your penis when your pelvic floor muscles contract.
4. Squeeze out remaining urine when you finish emptying your bladder by contracting your pelvic floor muscles

Pelvic floor training guidelines

When starting out

• Position your body where you can best feel your pelvic floor muscles contracting (lying down, sitting or standing)
• Start out by doing the number of exercises you can comfortably manage up to 10 seconds using the correct exercise technique – it doesn’t matter how long you can maintain your contraction for start with what is manageable even if it’s for a second or two, just do what you can manage.
• Lift and squeeze the pelvic floor muscles in and around your urine tube and your anus.
• Try to breathe normally and keep your buttocks relaxed as you do so.
• Relax and lower your pelvic floor muscles back to their original resting position.
• Rest and recover before your next exercise.

When your pelvic floor strength improves

• Try to maintain the lift and squeeze of your pelvic floor muscles up to 10 seconds.
• Relax and rest your pelvic floor muscles between every effort.
• Repeat this exercise again for up to 8 seconds for up to 8-12 consecutive contractions to complete one full set (group) of exercises.
• Aim to perform 3 sets of pelvic floor exercises.
• Practice your exercises daily.

Tips for successful pelvic floor strengthening

• Focus on getting your technique correct when starting out – you can increase the number of exercises you do later when you’ve perfected your technique.
• Pelvic floor exercises are often easier performed lying down initially, before progressing to sitting and standing with improved strength and control.
• Increase the strength of your exercises as your pelvic floor fitness improves over time – this is a key point for training strong pelvic floor muscles.
• Contract your pelvic floor muscles before and during any increased effort or exertion including cough, sneeze and lift.

How long until you notice an improvement?

Like any muscle strengthening, training your pelvic floor requires patience and commitment. Some men notice improvements in the first 3-4 weeks of commencing their exercises.

If your pelvic floor muscles are weak or if you’ve never exercised them before, it can take up to 5-6 months of regular exercises to strengthen your pelvic floor.

When and where to access more help?

If you’re still unsure or if you can’t notice an improvement after 3 months of training, help is at hand. Many of the large Australian hospitals have Pelvic Floor Physiotherapy services (you will need a doctor’s referral and treatment is free of charge).

Pelvic floor physiotherapists also work in private practice and no referral is required – just check that the Physiotherapist you contact works in the field of pelvic floor health as this is an area of specialised Physiotherapy service.

The Continence Foundation Hotline can provide you with the name of a Continence Nurse Advisor or a Pelvic Floor Physiotherapist near you (free call 1800 33 00 66).

I hope that these Pelvic Floor Physiotherapy exercises will give you better strength, control and stamina – please feel most welcome to ask your questions below or visit me at my Pelvic Exercises website for more information.

Do you have any questions for Michelle about your pelvic floor and erectile dysfunction? She will answer them in the comments.