Erectile and Sexual Dysfunction
What is Erectile Dysfunction?
Simply put, erectile dysfunction (ED) is the inability to achieve or maintain an erection for satisfactory sexual performance.
Estimates of erectile dysfunction are as high as 40% of men by the age of 40, and often men present with various degrees of ED before that age.
Erectile dysfunction (ED) can be complex and multi-factorial. There are many possible causes of ED:
pelvic floor muscle dysfunction
cardiovascular disease or diabetes
lifestyle factors like inactivity, smoking and obesity
psychological factors like anxiety and depression
neurological conditions like Parkinson's and Multiple Sclerosis, spinal cord and brain injuries
Pelvic floor muscles play an essential role in producing full functional erections. In particular, the ishiocavernosus and bulbospongiosus muscles help facilitate and maintain erection by increasing intracavernosal pressure and restricting venous drainge of the penile tissue resulting in an erection.
Rhythmic contraction of the bulbospongiosus propels semen through the urethra during ejaculation.
Pelvic Floor muscle dysfunction can impact both erection and ejaculation.
With erectile dysfunction, there can be full or partial ability to attain and maintain an erection, and there may or may not be pain during or after sexual activity.
Pelvic Floor Training
Pelvic floor muscle exercises can help resolve pelvic floor dysfunctions that are associated with erectile dysfunction.
Often, pelvic floor muscles are either:
Underactive (too weak), or
Overactive (turned on too much)
Your physiotherapist can determine if your pelvic floor muscles are too weak or too active and develop a treatment plan based on what is happening in your specific situation.
Pelvic floor muscles can be assessed for strength, endurance and over-activity using:
real-time ultrasound imaging to observe the muscles contract and relax
surface EMG with electrodes placed on the skin to record both voluntary and involuntary musucle activity
digital rectal palpation to grade the strength and assess the endurance of the pelvic floor muscles and assess for painful trigger points.