Pelvic floor exercises for men can help with erectile difficulties, mainly by improving the ability to maintain an erection rather than to get one. The evidence is real but modest, and the benefit builds slowly over months of consistent practice. They will not suit every cause of erectile dysfunction, but they cost nothing, carry no downside, and are a reasonable thing to try alongside other measures.
What does the pelvic floor do in men?
The pelvic floor is a sling of muscles at the base of the pelvis. Two of them, the ischiocavernosus and bulbospongiosus, sit around the base of the penis and play a part in erections: they help compress the veins that would otherwise let blood drain away, which is part of how an erection is maintained once achieved. If these muscles are weak, blood can leak away more easily, making it harder to keep an erection even when getting one is fine. Strengthening them targets that specific problem.
Do pelvic floor exercises work for erectile dysfunction?
Trials of pelvic floor muscle training for erectile dysfunction have found benefit for a proportion of men, particularly those whose main difficulty is maintaining rather than achieving an erection, and those with a specific problem of blood draining away too quickly. The best-known UK trial found that after three months of pelvic floor muscle exercises with physiotherapy support, around 40% of men with erectile dysfunction regained normal function and a further third improved. It is honest to describe the effect as meaningful for some men rather than universal; this is not a substitute for medical treatment where a clear cause needs addressing. But it has a real evidence base, which is more than can be said for many things marketed for erections.
How to find the right muscles
The commonest mistake is exercising the wrong muscles. The pelvic floor muscles are the ones you would use to stop the flow of urine midstream, or to stop yourself passing wind: a lifting and squeezing sensation around the back passage and base of the penis. Identifying them by briefly stopping urine flow once is a useful check, but do not make a habit of practising while actually urinating, as that can cause other problems. You should not be clenching your buttocks, thighs or stomach; the movement is internal and subtle. The NHS guide to pelvic floor exercises describes the same technique for men and women.
How to do pelvic floor exercises for men
A typical routine, of the kind used in the trials, combines slow and quick contractions:
- Slow holds: squeeze and lift the pelvic floor muscles, hold for a few seconds (building up to about 10 as you improve), then fully relax for the same time. Repeat several times.
- Quick squeezes: contract the muscles briefly and firmly, then release, several times in a row.
- Do a set of both, a few times a day, most days of the week.
- Breathe normally throughout and keep everything else relaxed; the effort is easy to overdo.
You can do them sitting, standing or lying down, and no one can tell you are doing them, which makes fitting them into the day straightforward once you have found the right muscles.
Common mistakes to avoid
Three errors account for most disappointing results. The first is training the wrong muscles, usually the buttocks or abdomen, which is why the identification step matters more than enthusiasm. The second is holding the breath and straining downwards, which pushes on the pelvic floor rather than lifting it. The third is stopping after a fortnight because nothing has changed yet, when the trials that showed benefit ran for three months or more. Slow, correct and boring beats hard and brief.
The realistic timeframe
Like any muscle training, this takes time. Most men who benefit notice changes over a period of weeks to a few months of consistent practice, not days. It is easy to give up before the point where benefit would appear, so treat it as a slow habit rather than a quick trial. If after a few months of genuine, regular practice there is no change, it may simply not be the right approach for your cause of erectile difficulty; the broader picture is mapped in erectile dysfunction causes.
Benefits beyond erections
Pelvic floor exercises for men were used for bladder problems long before erectile dysfunction, and the same muscles are involved in urinary control, dribbling after urination and ejaculation. Men who train them sometimes notice better control over premature ejaculation and fewer leaks after the toilet, which is a reasonable bonus from the same few minutes of daily effort. If bladder symptoms are the main issue, or you cannot tell whether you are contracting the right muscles, a GP can refer you to a pelvic health physiotherapist for individual assessment.
Where they fit
Pelvic floor exercises sit best as one part of a broader approach: alongside aerobic exercise, sensible drinking, good sleep, and medical treatment where it is needed. They are particularly worth trying for men whose difficulty is holding an erection rather than getting one. The aerobic side, which carries the strongest evidence of all the lifestyle measures, is covered in exercise and erectile function.
They also combine well with medication rather than competing with it. Tablets such as sildenafil manage the symptom now, while the muscle training builds over months; many men use both, then reassess. If erectile difficulties persist or arrived suddenly, see a GP as well, since ED can be an early sign of cardiovascular or metabolic conditions that deserve a check in their own right.
