Erectile Dysfunction

"Why can't I get an erection or keep an erection?"

In a nutshell, it has to do with a combination of physical and emotional problems. We are specially trained physical therapists that know how to help.

There is a lot of general information on the web already about changing your lifestyle, exercising more, eating a better diet, etc. This is generally great advice, but if you're reading this, then chances are you have already tried some of those tips and yet are still left hanging.

The plan for this webpage is to keep it growing larger and larger and larger... with information. We'll be summarizing recent research regularly to get you the hands on help that you need.

Pelvic Floor Muscle Training & Erectile Dysfunction in Radical Prostatectomy (Milos et al, 2020)

Milios et al (2020). Sexual Medicine. 8:414-421

Radical Prostatectomy (RP) is the gold standard approach to cure prostate cancer. Although 97% of men can expect to survive at least 5 years following surgery, only 16-22% of those men regain their pre-surgery levels of erectile function. That means 78-84% of the men do NOT regain previous penile function. Not a big surprise then that depression, anxiety, and post-traumatic stress occur 4x times more often in men with prostate cancer.

What can we do to increase your success in returning your penis to its full upright position?

Good news - evidence has confirmed a direct link between PFM (pelvic floor muscle) strength and increased rigidity in the erect penis. That means PFM training is recommended as a first line approach for men seeking resolution of erectile dysfunction.

In this study, there were 2 groups of men: we'll call them the "PRO team" and the "others".

"Spring training" = 5 Weeks

Both teams received 2 "spring training" sessions with a physical therapist to learn how to do pelvic floor muscle strengthening exercises prior to surgery.

Team "others" were given the following "spring training" PFM program: 10 repetitions of 10 sec holds, 3 sets per day. One set lying on their back, 1 set sitting in a chair, 1 set standing.

Team "PROs" were given this "spring training" PFM program: 10 repetitions of 10 sec long holds & 10 sec fast holds, 6 sets per day. All sets were done in standing.

"Regular season" = 12 Weeks

Team "others": 10 repetitions of 10 sec holds, 3 sets per day. One set lying on their back, 1 set sitting in a chair, 1 set standing.

Team "PROs": 10 repetitions of 10 sec long holds & 10 sec fast holds, 6 sets per day. All sets were done in standing.

"Superbowl" Results

  • Drastic & immediate reduction in erectile function for both groups following surgery

  • Team "PROs" report significantly less distress in their quality of life scores at 2 weeks following surgery.

  • 74% of the "PROs" team achieved full urinary continence at 3 months whereas only 43% of the "others" did at the same time point

  • the "PROs" reported a faster return to sexual activity

How can you get PFM "spring training" or "regular season" coaching?"

Click the link above to schedule an appointment

OR call us at 803-716-9723

OR email

We can help you.

Pornography and Erectile Dysfunction

Not all erection problems are physical. The brain is actually the biggest sex organ. The brain takes all the sensory information and converts it into a signal for your penis. When you look at pornography, your brain is flooded with powerful chemicals including adrenaline, dopamine, and oxytocin. Oxytocin is the same chemical nursing mothers release when breastfeeding. That means that your brain is literally bonding to the pornography that you are watching.

Why is this a problem and how is it related to erectile dysfunction?

Problem 1: The real-life equivalent to what you are watching doesn't exist. Pornography is fiction - people are acting, pretending, it isn't real. The more pornography you watch, the more your brain gets used to being flooded (and addicted) with adrenaline. Resulting in the need for even greater dosages of the brain drugs. In order for your penis to get aroused you literally have to keep exposing yourself to even more fake pornography.

Solution: find a skilled behavioral therapist. They have techniques to help refresh the mind and restore confidence and satisfaction to unsatisfied penis.

The website of the American Society of Sexuality Educators, Counselors, and Therapists (ASSECT) offers an online locator tool that can help you find qualified therapists where you live.

Problem 2: Adrenaline kills your erection. Yes, adrenaline makes your heart beat faster and your lungs expand, but it also stops the flow of blood to your penis.

Solution: Your body needs to relax so that your parasympathetic system can kick in and allow blood to flow to your fingers, toes, and penis. We at Pelvic Prime, know how to help you learn techniques to relax and stimulate your parasympathetic system.