Can Pelvic Floor Exercises Improve Erectile Dysfunction? What the Research Shows
Erectile function is not only a vascular issue. It is also a muscular one. The pelvic floor muscles — especially the bulbocavernosus and ischiocavernosus — help compress penile veins and support the pressure needed to achieve and maintain erection hardness. That is one reason pelvic floor muscle training, often called PFMT, has been studied as a conservative treatment for erectile dysfunction.
What kind of improvement can men expect?
The strongest commonly cited clinical result comes from a randomized controlled trial by Dorey and colleagues in men with erectile dysfunction. After a program of pelvic floor muscle exercises plus biofeedback and lifestyle advice, assessed over 6 months, 40% of participants regained normal erectile function, 35.5% improved, and 24.5% did not improve. That means 75.5% had either recovery or meaningful improvement in erectile function in that study.
That result is important because it gives a simple clinical message: for a substantial share of men, targeted pelvic floor rehabilitation can improve erections without medication being the only option. At the same time, it is worth being precise: this percentage comes mainly from one landmark trial, not from dozens of large identical studies.
What about erectile quality and rigidity?
This is where the evidence becomes more nuanced. Some studies report improvement using erectile function questionnaires such as the International Index of Erectile Function, while others look at erection hardness or related functional outcomes. A 2020 systematic review found that most included studies showed improvement in erectile dysfunction with pelvic floor muscle training, but it also concluded that the overall evidence base was limited by small studies, mixed protocols, and variable quality.
So, in practical terms:
Erectile function: best-supported outcome, with the clearest improvement signal.
Erectile quality and rigidity: often improve clinically, but are less consistently reported as a single clean percentage across studies.
That distinction matters for a blog audience. Saying PFMT “can improve erectile quality and rigidity” is supported. Saying there is one universal percentage improvement for rigidity across all men would overstate the evidence.
Why pelvic floor training can help erections
The pelvic floor contributes to erection mechanics. The bulbocavernosus and ischiocavernosus muscles assist with venous occlusion — in simple terms, they help keep blood trapped in the penis long enough to maintain hardness. Earlier physiological work and later reviews both support this mechanism.
That is why PFMT may be especially helpful in men whose erectile dysfunction has a mild-to-moderate veno-occlusive or pelvic floor component, rather than men whose ED is driven entirely by severe vascular disease, major neurologic injury, or endocrine causes. This is an inference from the mechanism and the study population, rather than a head-to-head proof for every subgroup.
The overlooked issue: high-tone pelvic floor
A pelvic floor does not only cause problems when it is weak. It can also become overactive, high tone, or unable to relax properly. In that state, the muscles may stay guarded or tense, which can interfere with bowel function, pelvic comfort, ejaculation, and erectile response. Cleveland Clinic lists sexual dysfunction, pain with sex, and in men specifically erectile dysfunction or pain with erection or ejaculation among recognized symptoms of hypertonic pelvic floor.
This is clinically important because some men are told simply to “do Kegels,” when the real problem may be too much tension, not too little strength. In those cases, down-training, relaxation, breathing work, and coordination may matter more than repeated squeezing. That treatment logic is consistent with pelvic floor rehabilitation literature, though protocols vary across clinicians and patient groups.
Constipation, straining, and male sexual function
Constipation is not just a bowel issue. Chronic straining can load the pelvic floor, reinforce poor muscle coordination, and coexist with sexual dysfunction. Cleveland Clinic notes that constipation and straining can lead to pelvic floor dysfunction, and pelvic floor dysfunction can also mimic or worsen bowel symptoms.
More specifically, a 2021 cross-sectional study in men with obstructed defecation found that 49.2% had erectile dysfunction. Men with ED in that cohort also showed higher straining anal pressure and more pelvic floor neurophysiologic abnormalities, including pudendal nerve changes and abnormalities involving the bulbocavernosus muscle.
This does not prove that constipation alone causes erectile dysfunction in every case. But it strongly supports a clinical pattern many pelvic health clinicians recognize: when bowel emptying is difficult, straining is chronic, and pelvic floor tone is elevated, sexual function can suffer too.
What clinicians and patients should take from this
The research supports pelvic floor muscle training as a legitimate conservative option for improving erectile function, especially in selected men. The clearest headline number is that, in the best-known trial, 75.5% of men either regained normal erections or improved, while 24.5% did not improve after the 6-month program.
But the bigger clinical point is this: pelvic floor care should not be reduced to strengthening alone. Men with erectile complaints may have:
weakness and poor support,
overactivity and poor relaxation,
constipation and chronic straining,
pelvic pain,
or a mixed picture.
That is why evaluation matters. A man with high-tone pelvic floor and constipation may need relaxation, bowel management, breathing retraining, and coordination work before strengthening becomes useful.
Bottom line
Pelvic floor muscle training can improve erectile function, and the best-known clinical trial showed meaningful benefit in a majority of men. However, the evidence is still not strong enough to assign one universal percentage improvement for erection quality or rigidity across all populations. At the same time, high-tone pelvic floor and constipation are important, under-recognized contributors to male sexual dysfunction and should be part of the assessment whenever erection quality, pain, or pelvic symptoms overlap.
Concerned about erectile function?
Pelvic floor physiotherapy may be able to help.
Book an assessment with GW Pelvic Health to identify whether muscle weakness, overactivity, bowel dysfunction or another pelvic health issue could be contributing to your symptoms.
Dorey G, Speakman MJ, Feneley RCL, Swinkels A, Dunn CDR. Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. British Journal of General Practice. 2004;54(508):819–825.
Wong C, Jiang YH, Chuang FC, et al. A systematic review of pelvic floor muscle training for erectile dysfunction and premature ejaculation. The Journal of Sexual Medicine. 2020;17(4):737–748.
Myers C, Smith M, Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. The Journal of Urology. 2019.
Cleveland Clinic. Hypertonic Pelvic Floor: Symptoms, Causes & Treatment. Updated April 26, 2022.
Cleveland Clinic. Erectile Dysfunction (ED): Causes, Diagnosis & Treatment. Updated August 28, 2023.
Elsawy MS, Sherif H, Elsheikh M, et al. Relation between pelvic floor neurophysiological changes and erectile dysfunction in patients with obstructed defecation: a cross-sectional study. International Urogynecology Journal. 2021.
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