Conservative Management of Erectile Dysfunction

The NICE Guideline tells us that 52% of men aged 40-70 experience some form of erectile dysfunction. This does range from mild, moderate to severe erectile dysfunction (NICE Guidelines).

My advice is always the same when I see a patient in a clinic.

Have you discussed this with your GP/ Urologist?

It’s important to remember that “hard health is heart health”, what I mean by this is that sometimes erectile dysfunction can be an early indication of a vascular disease or some clogging of arteries ( think blood flow) (NHS).

If not, I think it’s important to discuss this with your GP.

There are a number of physiological and psychological causes of erectile dysfunction.

Assuming psychological and hormonal management has taken place or not needed, and that there are no indications of spinal injury.

Some other options may include:

Lifestyle advice

• Weight Loss & Diabetes management

• Exercise/Physiotherapy

• Smoking Cessation

• Reducing Alcohol Intake

  • (NICE Guidelines)

So why would you seek Men’s Pelvic Health Physiotherapy for this?

You may have heard about the pelvic floor, if not… Yes you have a pelvic floor, and pelvic floor muscles. These muscles act as a sling between your tailbone and your pubic bone.

These pelvic floor muscles also support the penis and help maintain rigidity (Schmidt and Schmidt #).

Is there any evidence of using physiotherapy to treat erectile dysfunction you may be asking.

A study of 55 men receiving pelvic health physio for 3 months found that the majority had benefited from the treatment, and recommended pelvic health physiotherapy f a frontline treatment for erectile dysfunction (Dorey #).

For more information see my article on the best exercises for men’s pelvic floor training.

https://delaneyphysio.com/best-exercises-after-prostate-surgery

Works Cited

Dorey, G. “Pelvic floor exercises for erectile dysfunction.” BJU International, vol. 96, no. 4, 2003, pp. 595-597. Pelvic floor exercises for erectile dysfunction, https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/j.1464-410X.2005.05690.x. Accessed 22 01 2024.

NHS. “Erectile dysfunction - Illnesses & conditions.” NHS inform, 12 December 2023, https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/erectile-dysfunction-impotence/. Accessed 22 January 2024.

NICE Guidelines. “Prevalence | Background information | Erectile dysfunction | CKS | NICE.” Clinical Knowledge Summaries, 2023, https://cks.nice.org.uk/topics/erectile-dysfunction/background-information/prevalence/. Accessed 22 January 2024.

Schmidt, M., and H. Schmidt. “The ischiocavernosus and bulbospongiosus muscles in mammalian penile rigidity.” Sleep, vol. 10, no. 1093, 1993, 171-83. The ischiocavernosus and bulbospongiosus muscles in mammalian penile rigidity, https://pubmed.ncbi.nlm.nih.gov/8446838/.