Pelvic floor exercises for erectile dysfunction

Abstract

OBJECTIVETo examine the role of pelvic floor exercises as a way of restoring erectile function in men with erectile dysfunction. PATIENTS AND METHODSIn all, 55 men aged > 20 years who had experienced erectile dysfunction for ≥ 6 months were recruited for a randomized controlled study with a cross-over arm. The men were treated with either pelvic floor muscle exercises (taught by a physiotherapist) with biofeedback and lifestyle changes (intervention group) or they were advised on lifestyle changes only (control group). Control patients who did not respond after 3 months were treated with the intervention. All men were given home exercises for a further 3 months. Outcomes were measured using the International Index of Erectile Function (IIEF), anal pressure measurements and independent (blinded) assessments. RESULTSAfter 3 months, the erectile function of men in the intervention group was significantly better than in the control group ( P < 0.001). Control patients who were given the intervention also significantly improved 3 months later ( P < 0.001). After 6 months, blind assessment showed that 40% of men had regained normal erectile function, 35.5% improved but 24.5% failed to improve. CONCLUSIONThis study suggests that pelvic floor exercises should be considered as a first-line approach for men seeking long-term resolution of their erectile dysfunction.

The CopenHeartSF trial—comprehensive sexual rehabilitation programme for male patients with implantable cardioverter defibrillator or ischaemic heart disease and impaired sexual function: protocol of a randomised clinical trial

“…However, due to the limited power of the sample in this trial, it did not allow the detection of significant effects. The role of pelvic floor exercises as a treatment of erectile dysfunction is not tested on patients with heart disease, but in the general population 40–47% had regained normal erectile function after 3–4 months of training the pelvic floor muscles 41 42. As the condition of sexual dysfunction often includes both physical and psychological components, it is plausible to believe that patients with heart disease and sexual dysfunction benefit from a comprehensive rehabilitation intervention43 44consisting of a psychoeducational component and an exercise training component including pelvic floor exercises.…”

Complex pelvic floor failure and associated problems

“…Both men and women, without neurological disease, benefit from pelvic floor exercises [81] and electrical stimulation feedback with cognitive therapy [82]. However, this type of intervention appears not to be as effective in neurogenic sexual dysfunction.…”

Lifestyle and metabolic approaches to maximizing erectile and vascular health

“…20 In a randomized, crossover study, pelvic floor exercises also reduced ED, most likely by reducing venous outflow from the penis. 21 A sedentary lifestyle increases ED by 2-10-fold, 22-24 whereas 'moderate' activity has been reported to reduce ED by two-thirds and 'high' activity by over 80% (unfortunately, these degrees of activity were not defined). 25 Because penile blood flow presumably does not increase with physical exercise, the principal mechanism whereby physical exercise improves ED may be the pronounced effect of increased systemic NO on glucose disposal and insulin sensitivity (reviewed above).…”