Physiotherapy can be helpful in providing people with the tools to regain erectile function.

Naturally, most people have a lot of questions about what pelvic health physiotherapy is and what to expect from pelvic health physical therapy. We hope the following will be helpful in determining if pelvic health physiotherapy is a good fit for you!

It's time to talk Erectile Dysfunction: Do you know what to look for?

Erectile dysfunction can present in many different ways.

The following are all forms of erectile dysfunction:

· Inability to achieve an erection

· Inability to achieve an erection in a timely way

· Inability to maintain an erection

· Pain with an erection

· Persistent unwanted erections

· Persistent “partial” erections

What happened? Factors that can contribute to erectile dysfunction:

· Surgeries (including radical prostatectomies or gender affirming surgeries)

· Stress

· Pelvic trauma

· Pain

· Nerve injury (e.g., prolonged time on a bike seat)

· Changes in testosterone levels

· Depressions or other changes in mood

· Certain medications such as anti-depressants

· Neurological conditions such as Parkinson’s Disease

· Smoking

· Obesity

· Diabetes

· High blood pressure

· Aging

· Size enhancement techniques

What does a pelvic health assessment for erectile dysfunction look like?

Medical History: This step is very important. This allows our therapist to understand how other health conditions may be impacting your current concern.

Orthopedic Assessment: Some may think of this part as “what typical physiotherapy” may look like. In this part, your physiotherapist will examine areas commonly linked to your pelvic health including your back, hips, posture and movement.

Breathing Assessment: Since our Pelvic Floor is impacted by our diaphragm it is important to looking at how you breath.

Optional Internal exam: This is the most novel part of the exam for most people. We only perform this when we feel it is highly indicated and the patient is agreeable. A lot of people find they can still show improvements without this component of the exam if they don’t feel this is for them.

The Bottom Line

While sometimes there is helpful additional information to be gained from a physical examination, it is never mandatory. It is possible to treat ED with a consultative approach, by educating our patients on the cause of their concerns and giving them tools to try on their own at home.

What does treatment look like?

Retrain the Pelvic Floor Muscles

Yes, we all have a pelvic floor and while the penis is NOT a muscle it sure is surrounded by a lot of them. These muscles surrounding the penis play a huge role in erectile function. Depending on what is going on, sometimes we need to teach the pelvic floor how to contract more efficiently and other times we need it to relax.

Retrain the Nervous System

Think of the nerves and the nervous system as the messengers that make things go or not go. If the nervous system has it signals crossed, sometimes we can have erections when we don’t want them and other times, we cannot get them at all. The nervous system includes our brain, spinal cord and nerves. It can be impacted by a wide variety of things from a bike seat pushing too hard on a nerve or stress sending the nervous system in a state of fight or flight.

Lifestyle Modifications

What we do in our day to day lives can be impacting other physiological processes. Sometimes changes in our daily routine can make a meaningful impact.

Address other Contributing Factors

Sometimes there are other factors such as medications, pain or other health conditions that impact our erectile function. By taking a thorough history we can identify these early and either treat these contributing factors or connect you with the appropriate health care provider that can support you.

Create a Custom Plan for You.

Everyone has different needs and different comfort levels. The most important part of the assessment is making sure it works for each patient. At the end of the session, you can expect a clear plan of care including explanation of your symptoms, treatment options and alternatives.

Next Steps

We understand that asking for help with erectile dysfunction can feel difficult and we congratulate you for getting this far. It is important to us that our patient’s feel safe and comfortable. Our pelvic health physiotherapist, Amanda, offers a free 15-minute phone call for anyone looking to learn more about whether pelvic health physiotherapy is right for them. To book an appointment you can call us, email us or book online.

This is a place where human rights are respected and where Two Spirit, lesbian, gay, bisexual, trans and queer people, and their friends and allies, are welcomed and supported.

Breaking down a touchy subject: The Pelvic Floor and Erectile Dysfunction