In order to see if pelvic floor exercises can help Erectile Dysfunction, we first need to understand the process of erection. This blog will then discuss the correlation between  the pelvic floor and erection and if pelvic floor exercises are helpful for Erectile Dysfunction.

The Physiology of Erection

The erectile tissue of the penis is made up of smooth muscles that we don’t have voluntary control of its contraction. This is also true for the walls of the arteries that are involved in this organ. When the penis is flaccid, these muscles are actually moderately contracted; when sexually stimulated, the nerves release neurotransmitters that cause the relaxation of the smooth muscles of the arteries which causes an increase in blood flow to the penis. This will reduce blood flow in the veins which in turn causes erection.

Causes of Erectile Dysfunction

The causes of Erectile Dysfunction vary and at times, the age of the person adds more options to consider when it comes to treating Erectile Dysfunction. For instance, the following can lead to Erectile Dysfunction no matter how old the person is:

• Excess weight
• Smoking
• Anxiety
• Depression
• Stress
• Alcohol
• Poor diet
• Cardiovascular issues
• Side effects of medication
• Low testosterone
• Lack of physical activity, and
• Sedentary lifestyle

In a younger age category, excess pornography plays a role as well while in older individuals, low testosterone should be considered.

Here, we will evaluate the lifestyle habits from low activity to playing sports and the impact on Erectile Dysfunction. While we understand how a penis goes from being flaccid to hard, we need to understand that the nerves and blood supply are impacted by the health of the pelvis, where they traverse through. While it is important to rule out diseases that may lead to Erectile Dysfunction, the medical community seems to go ‘flaccid’ in the absence of a disease-generated Erectile Dysfunction. Erectile Dysfunction is one of the presentations of Pelvic Floor Dysfunction and as such needs to be treated just as all Pelvic Floor Dysfunction cases are: Stabilize the ‘house’ that the pelvic floor is the ‘floor’ of.

What is Pelvic Floor Dysfunction?

I have written several blogs on pelvic floor dysfunction including:

• Its’ signs and symptoms
• How it can manifest itself
• Who you should see for its treatment
• And the whys behind it all

You can find those blogs on my website so you may better understand how you may have missed its subtle signs and why the current typical treatment cannot work long-term.

In general, if you imagine Pelvic Floor Dysfunction as the title of a book, Erectile Dysfunction (ED) is a chapter of this book. Looking at the problem with a narrow lens will not solve the problem; not looking further once the MAJOR diseases and/or factors that may cause the problem are ruled out is another fault when it comes to treating Erectile Dysfunction. Then there is the whole focus on the pelvic floor, disregarding the ‘house’ that the pelvic floor is the floor of. There is hardly any looking into the lifestyle and how simple daily routines done wrong can complicate the matter.

Pelvic floor dysfunction is the dysfunction of the pelvis and is not limited to just the floor. You can read my blog on pelvic floor dysfunction for a detailed exploration.

What is the Best Pelvic Floor Exercise?

There is not one single exercise that addresses Erectile Dysfunction (ED), or the pelvic floor but if you understand the concept, you can start working on the corrective exercises and lifestyle modifications that are not conducive to ED. Take a look at the picture below:

Front view

It is clear that the spine and hips are connected to the pelvis and that the nerves that supply the pelvic floor and the internal organs of the pelvis come from the lower back spine. There are blood vessels that run through the area while the lower extremity lymphatics drain through the ‘reservoir’ in the groin area which in turn gets pumped to the ‘master septic tank’ right behind the diaphragm higher up where the mid-back gets connected to the lower back.

When we look at, for instance, diseases that can cause Erectile Dysfunction and disregard the mechanics behind erection, from blood flow and the neural path to the mechanism of movement of the body parts that impact the pelvis, there are many simple causes and ‘feeders’  of the cause that are overlooked.

All exercises related to the pelvic floor are to address the weak muscles, however, we have to look further to see why those muscles are weak and what impact have these weak muscles had on our movement. Let me explain some basic facts:

• All babies on this planet have the same developmental process when it comes to movement (with the exception of some diseases).
• There is a map of movement and sensation in the brain called Homunculus that we are born with and gets developed further during the first 2-3 years of age. This map is also the same for all babies.
• This means that we, as human beings, are hard-wired to move a certain way.
• The map gets modified based on lifestyle, habits, environment, and injuries. It can get overemphasized or the metaphoric ‘borders’ of the body part get ‘lightened’ due to its lack of use. We can see what this map looks like through Postural Neurology.
• We can change this map with the right movements (functional movement) and make it worse with the wrong movements (dysfunctional movement).
• If movement was a concert, the brain is the conductor, the musical notes in front of the conductor are the Homunculus, and the body parts are the musicians. If the concert is faulty, we have to look at ALL parts involved vs just the musicians. Let’s not forget that when one ‘musician’ is out of commission, the other musicians (body parts) modify their performance to fill in the gap. When it comes to movement, through a functional movement assessment we can see how functional or dysfunctional you are.

To better understand this, think of a right-handed person with a broken arm that is in a cast for 6 weeks. Once the cast is off, the muscles are atrophied and the person has to re-learn how to write with the right hand. That is because the map got changed and the movement pattern is altered.

When it comes to pelvic floor exercises for Erectile Dysfunction or ANY symptom of pelvic floor dysfunction, we need to first assess the map, then the movement patterns, and finally do the exercises that all babies do to develop from the helpless infant to the running toddler. No bands, weights, gyms, trainers, or outside equipment are used to do this and that is exactly how we, the adults, need to regain what is altered. There is no need to re-invent the wheels but be reminded of what we automatically and innately did as babies and toddlers.

You can visit my Youtube channel full of these exercises to understand what they look like; contact me if you have pelvic floor dysfunction.

Dr. Shakib