Erectile vs Pelvic Floor Dysfunction

For a while now I have been convinced that I caused damage to my penis through PE in some way. Erections are hard to gain and are hard to maintain. These symptoms of traditional ED seem parallel to symptoms of ED caused by pelvic floor dysfunction. So how do you know the difference? I have a referral to a urologist to cover all my bases but that will likely be a long waiting time. Does anyone know ways to differentiate between the two causes of ED?

Pelvic floor muscles are a complex system. Here’s an interesting thread discussing this issue:

Pelvic Floor Explained

Thanks 32quarters, in your opinion, do you think this pelvic floor dysfunction would effect nocturnal erections? I’m thinking it’s not like your pelvic floor magically fixes itself when sleeping, 🤷‍♂️

First off, not an expert, but pretty educated on general issues. I’m learning along with everyone else. So take this for what it’s worth.

Do you get nocturnal erections? Is your sex drive normal? Do you respond to viagra or cialis?

What kind of PE exercises do you think could be the culprit? There are two possible pelvic floor issues, flaccid muscles and tight muscles, both of which would have a range of other symptoms related to bladder and bowels, at least for most people.

Based on mechanism of PE exercises and penile anatomy I think it is fairly unlikely that it is a pelvic floor issue caused by PE.

A flaccid pelvic floor musculature would come from the muscles being flaccid or overstretched. Reportedly this can cause venous outflows related ED. A flaccid pelvic floor means either muscular atrophy (from aging or immobility) or stretch muscles from chronically increased intra-pelvic pressure, like long-term severe constipation or heavy powerlifting where you wear a belt and hold super high intra-abdominal pressure. For most people, there is never anything that extreme to cause problems, even for constipated powerlifters.

I can’t think of a PE exercise that causes that kind of intra-abdominal pressure (think of straining at the toilet; it’s called a valsalva maneuver). Even heavy weight hanging is limited to external pelvic attachments, like the base of the CC and the suspensory ligament anchored to the superficial portion of the pubic bones. There isn’t really an attachment to the involved pelvic floor muscles.

So I think if you do have a flaccid pelvic floor issues then it is probably unrelated to PE. But I’m interested to hear your theory and could be wrong.

But, if your pelvic floor muscles are just generally weak and you think there is a venous outflow issue then you can strengthen them doing pelvic floor muscle exercises like kegels. There are whole yoga practices related to the pelvic floor, which is called the mula bandha. You can look up yoga routines under that name, if you like.

I think a tight pelvic floor is less likely, since a tight pelvic floor compresses the arteries that lead to penile inflow, and the fact that you can get an erection makes that seem less likely. But perhaps you hold a lot of muscular tension in your pelvic floor, maybe as a reaction to some PE exercises and maybe this leads to intermittent arterial compression that results in some ED. There are relaxation exercises and stretches that might help if you’re thinking that is the case. You can also search for them online.

Unrelated to the pelvic floor I think high pressure pumping can theoretically cause some venous outflow issues which could make maintaining an erection difficult, but that is just a theory unless someone here has experienced that or known of it in someone else. But that is unrelated to the pelvic floor.

Whatever the issue, I would consider a mula bandha practice/ kegel exercise routine. A lot of guys, including me, have had firmer, longer lasting erections as a result. It might improve your EQ substantially no matter the cause of ED. I also have increased my ejaculation force and distance substantially from a regular routine, which is nice. So there’s no harm in it unless your issue is a tight pelvic floor.

Some guys find jelqing also helps. Lots of info on this forum about ways to go.

Good luck and keep us posted.

I was composing my response when these other posts went up, so sorry for the redundancy.

This is a good article about overly tense pelvic floor. It seems like this would be a transient, post training issue for most rather than a permanent injury. So it seems to apply to post-workout issues rather than ongoing ones.

Good point about nocturnal erections. That’s why I asked. Nocturnal erections generally exclude physical causes of ED.

My nocturnal erections are very weak, even when taking cialis daily. When it all started i was using a traction device and pumping, if I remember correctly i wasn’t jelqing much at the time. Someone mentioned jelqing upwards can stress the pelvic floor and if i recall this is what i was doing during my prior jelqing phase. I stopped PE for a while then started pumping again and now i have some urinary leakage. I stopped PE again but my boxers are always slightly wet with piss now. I’m thinking that both traction and pumping pulls my penis away from my pelvis and consequently stretches out my pelvic floor muscles.

Sounds like you more likely have a weak pelvic floor rather than a tight pelvic floor and maybe pelvic floor strengthening exercises could help.

My knowledge of pelvic floor issues is negligible. I’m aware that one needs to keep their pelvic muscles balance, meaning if you kegel regularly you also need to reverse kegel to keep the balance.

I can tell you that I take Cialis and on the days that I take it and I don’t exercise and I relax my pelvic floor, the erections are worse no matter how much Cialis I take. The pelvic floor is very very important, especially having it relaxed.

Hmm ok ok very interesting. If I start screwing around with my pelvic floor i’m going to get a physio first, because I think it’s more complicated then kegels and reverse kegals otherwise these pelvic floor physios would be out of work. Knowing my luck i will probably make it worse… Tightening it when it needs loosening or loosening when it needs tightening… Youtube physios mention working on your core your hips your posture and so on. Also someone mentioned pelvic floor dysfunction and low libido, does anyone know how that would work?

Do you think doing too many kegels and held for too long can cause ED (mostly temporary, I guess)?

I am having my first life ED episode (I’m 35) and trying to figure out the cause.

Started PE 2 weeks ago, but also did like 50 x 5sec hold kegels daily. No reverse kegels since I am not sure how they are done, so far.

Last sets of kegels felt difficult to hold, like I was feeling the muscle "shaking", struggling to be held. Last set was usually 10 x 10 sec hold

You’ve probably just over worked your pelvic muscles. Take a couple days of rest and see if that makes a difference.

The kegel muscles are those that you use to stop urinating mid stream.

Reverse kegels are the muscles you use to push the urine out faster. When starting out it is sometimes difficult to isolate just those muscles as stomach and others join in. I have found that by the time I get to 25-30 RK’s I am able to focus on the proper ones. After a few days of doing them, you’ll be able to get the right muscles at the start.

Oh, all right then. So I guess I am doing it right, but I just don’t feel it since my abdominal muscles feel so tense. It’s like I am tensing abdominal muscles while "inflating" or pushing out the BC muscle. Does this sound right? Just a relaxation feeling in the BC.

So you are saying that when relaxing your pelvic muscles you get worse erections?

Having your muscles relaxed is very important. If you inadvertently contract them, that can cause you to have bad erections. If you are doing it well at first, it will always cost you more and you will put your abdomen into play, but over time you will learn to isolate the muscles better.