Erectile dysfunction (ED) or impotence is the inability to achieve or maintain an erection that allows penetrative sexual activity. It is not a disease, but a symptom of another problem (physical, psychological or a mixture of both). For men to maintain good penile health, they need to get erections. Occasional failure to get/keep an erection is normal, however if the problem persists, you should seek medical advice.
Most men will experience episodes of ED in their lifetime. It can have a significant negative impact on them and their partners but can be treated successfully. One in five men suffer from ED in the UK (approximately 20% of men under 40 years and 50% of men over 40 years old). A shocking estimate is that only 33% of men who have ED seek help and advice about their problems.
ED can also be a symptom of an underlying condition such as atherosclerosis (narrowing of the arteries), diabetes or high blood pressure. Atherosclerosis increases your risk of heart attacks. Because the arteries in the penis are so narrow, erectile problems can be one of the first warning signs of heart disease. Half of all men who have diabetes, suffer from ED and if you smoke more than 1 packet of cigarettes per day, you have a 50% higher chance of erectile problems than a man who is a non-smoker. If you notice symptoms, it is important to see you GP for a consultation.
Common causes of ED are stress and other psychological factors, lifestyle issues, prostate surgery, vascular disease, hormonal problems, and pelvic floor dysfunction. Treatment of ED is based on the underlying cause. Treatment options include:
- Lifestyle changes such as losing weight, getting enough sleep, drinking less, and stopping smoking
- Physiotherapy to address pelvic floor dysfunction
- Use of a penile vacuum device
- Talking therapies
- Medication
The Role of Pelvic Floor Muscles in Erectile Function
Pelvic floor muscles can become weak or they can have a higher resting tone or overactivity. Both can affect erectile function in different ways. Pelvic floor muscles can weaken with age, inactivity and following prostate surgery. When this happens, the muscles don’t engage enough to maintain an erection and may have weakened contraction during ejaculation.
Pelvic floor muscles can become overactive in men with chronic pelvic pain or prostatitis. This results in a ‘tight’ pelvic floor which may restrict blood flow into the shaft of the penis and put pressure on nerves that supply sensation to the penis, thereby causing ED.
How Can Physiotherapy Help?
A detailed assessment by a qualified physiotherapist will determine if the pelvic floor muscles are playing a role in the ED and whether the muscles are overactive or underactive. Weakened pelvic floor muscles need strengthening. You may also need to be taught how to use a medical grade penile vacuum pump. Overactive pelvic floor muscles need relaxation.
Pelvic physiotherapy includes pelvic floor exercise, breathing exercises, manual therapy (to the pelvic floor, lumbar spine and hip joints/muscles), education and advice on lifestyle modifications and strategies on self-management.
Our Barnes Clinic
Our clinic is located in Barnes, South-West London and is easily accessible by public transport.
For more information including parking and other practicalities see our Barnes clinic page
Book an Appointment
Booking an appointment with one of our therapists is quick and easy. There is no long waiting time and you don’t need a referral from your GP.
