Neuromuscular and musculoskeletal pelvic floor muscle control have a direct influence over erection and ejaculation function, and are key in correcting erectile dysfunction and premature ejaculation.

Erectile dysfunction (ED) is defined as the inability to develop and maintain an erection for satisfying sexual intercourse or activity. It affects more than 20% of men under age 40, and more than 66% of men over age 70. (Feldman et al., 1994, Heruti et al., 2004)

Premature ejaculation (PE) is defined as ejaculation occurring with minimal stimulation and earlier than desired. It is found in 76% of men age 18-65 (Waldinger et al., 1998).

Conservative management of these complaints includes strength and endurance training of the pelvic floor and the supporting abdominal and hip musculature. The pelvic floor muscles are able to push blood into the erectile tissues during erection, and help prevent it's drainage during intercourse.

Scientific studies looking at motor control in these areas, assisted by EMG Biofeedback and electrical stimulation facilitation, have shown it to be effective.

A 2002 randomized controlled study of 104 men with ED, between the ages of 21-72, were treated for 3 months with either Pelvic Floor Training, PDE5 inhibitor medication (Viagra, Cialis etc) or placebo. In the Pelvic Floor Training group, 80% reported significant improvement. In the PDE5 medication group reported 74% improvement, and the placebo group reported 18% improvement (Sommer et al., 2002)

A study of 18 men with PE, ages 20-52, were all treated with Pelvic Floor Exercises and electrical stimulation facilitation. After 7 weeks of 3x/week intervention, 61% of subjects reported feeling “cured” (Le Pera & Nicastrano, 1996).

**It is important to note that erectile function, in general, is a marker for overall cardiovascular health and erectile dysfunction may warrant a visit to a cardiologist.