Conservative Management of Erectile Dysfunction

Erectile dysfunction (ED) may occur anytime after the age of 20. By age 40, the prevalence increases by 10% each decade. ED can be caused organically such as vascular and neuro dysfunctions, post surgical, post trauma, hormones, and medications. ED can also be due to psychological dysfunction, age, pain-related, activities, situational, and behavior.

While there are many treatment options for ED including medications, injections, and use of external devices, pelvic floor physical therapy is not commonly mentioned as an intervention option for erectile dysfunction. In general, exercise is effective and lower cost to prevent and even improve symptoms of ED. Pelvic floor physical therapy should be considered one of the first treatment options for management of ED.

So what does a pelvic floor physical therapy session look like to address erectile dysfunction? First, the PT will gather any current and past medical history including surgeries, medications, current and previous diagnoses. The PT will also ask relevant questions regarding sexual function that is related to erectile dysfunction to determine what may be the driving and contributing factors to guide treatment, education, and potential referrals if needed. The objective examinations are person dependent but generally the spine and pelvic floor are both assessed.

Treatments and interventions are also person dependent and will be focused on what is found during the subjective and objective exam of the physical therapy evaluation. Below is what may be addressed with physical therapy treatment for ED. Exercises are provided based on the information found from these four areas.

• Spinal: addressing spine mobility and posture can create positive and long lasting effects
• Muscular: the ability for muscles to contract and relax in various positions
• Neural: the somatic and autonomic nervous systems have a major role in mediating conscious and unconscious activities
• Tissue: restriction in erectile tissue, ligaments, and fascia can decrease neural and blood circulation

Erectile dysfunction is becoming more common in the United States and other nations and while there are options to address and improve ED, physical therapy is a more conservative option and alternative that is highly effective, lower cost, and without any additional side effects.