Erectile Dysfunction and Pelvic Physical Therapy

By Dr. Zarina Vitebsky, DPT, MSPT, PRPC, TPS, LPF, DN on 9/20/2023

Erectile dysfunction (ED) can be defined in many ways. Erectile dysfunction (ED) is popularly known as difficulty initiating or sustaining an erection, but a holistic interpretation of erectile dysfunction (ED) often involves one’s subjective experience. Since each individual's experience with erectile dysfunction (ED) is unique, rehabilitation requires a comprehensive and tactful approach as the diagnosis is woven into aspects of relationship dynamics, self esteem, and one can reflect on moral/cultural values.

The categories of erectile dysfunction (ED) are listed below:

1. Psychogenic

2. Organic (Neurogenic-nerve dysfunction, Vasculogenic- cardiovascular involvement (Consider arteriosclerosis or tobacco use), Myogenic-smooth muscle dysfunction, Hormonal)

3. Mixed - a combination of the above

Erectile dysfunction can be a symptom of another underlying pathology such as diabetes or heart disease, so it is important to consult a medical doctor prior to pursuing alternative forms of treatment. Once medically clear, treatment options for erectile dysfunction include hormonal support, medication, intracavernosal injections, vascular surgery, vacuum devices, psychosexual counseling, and of course, pelvic physical therapy. Pelvic physical therapy is a non-invasive, conservatory approach to address myogenic and even neurogenic erectile dysfunction.

The pelvic floor muscles involved in erection are the ischiocavernosus and bulbospongiosus, both of which assist in creating an increase in penile pressure. When the bulbospongiosus muscle contracts, it compresses the deep dorsal vein in the penile shaft to prevent blood from leaving the engorged penis. The sustained pressure allows the penis to remain erect. Any muscular dysfunction in these pelvic floor muscles may disrupt the ability to have or maintain erectile properties. It is also noted that general pelvic floor hypertonicity (high tone that can be associated with pelvic floor “tightness”) can occlude the pudendal artery which is the vascular supply for erectile hardness.

Pelvic physical therapy can address erectile dysfunction through soft tissue mobilizations, electrical stimulation, stretching, breathing techniques, position modification, relaxation methods, and more. Pelvic physical therapy for erectile dysfunction can treat the patient and train the partner to optimize the sexual experience and promote healthy conversations regarding the matter.

If you’re looking for treatment for erectile dysfunction and are medically clear to begin PT, please reach out to us here at the Pelvic Health Center in Madison, NJ to set up an evaluation & assessment!

Feel free to call us 908-443-9880 or email us at contact@pelvichealthnj.com.

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