Sexual function is an essential and critical part of mental and physical health and wellness for men. Therefore when a problem arises it is often distressing. Male sexual dysfunction has been linked to a reduced quality of life, as well as negative interpersonal relationships. As men grow older, sexual dysfunctions become increasingly prevalent.

To learn more about problems that affect the male pelvic floor, visit our page.

What are Erectile Problems?

Erectile problems are extremely common, particularly in men aged over 40. The two most prominent problems that are associated with erections are:

  • Erectile Dysfunction - The inability to gain and maintain an erection that is rigid enough for sexual intercourse.
  • Premature Ejaculation - Ejaculation that always, or nearly always, occurs prior to or within 1 minute of vaginal penetration. Or, the inability to delay ejaculation on all or nearly all vaginal penetrations.

What Causes Erectile Dysfunction?

Erectile dysfunction is a problem for more than 1 in every 10 men in the UK. The arousal of the male sexual organ is a complex process; it involves the functions of the brain, hormones, emotions, muscles, nerves, and blood vessels. Problems with these physical components can prevent erections from occurring entirely.

Physical Causes

  • High blood pressure
  • Hormone problems
  • High cholesterol
  • Diabetes
  • Obesity
  • Prescribed medication side effects
  • Multiple Scelerosis
  • Parkinson's Disease
  • Substance abuse (drug, alcohol, or tobacco)
  • Treatment for prostate cancer, or an enlarged prostate

Emotional Causes

  • Stress
  • Tiredness
  • Anxiety, depression, or other mental health problems
  • Relationship issues
  • Poor communication

If you are experiencing erection problems frequently, see your GP or visit a sexual health clinic. It could possibly be a sign of an underlying health condition.

What Are the Symptoms of Erectile Dysfunction?

Erectile dysfunction symptoms may include:

  • Failing to gain an erection
  • Trouble in maintaining an erection
  • Reduced sexual desire

How Can You Prevent Erectile Dysfunction?

To prevent erectile dysfunction before it has developed, you must ensure that you make healthy lifestyle choices, and manage existing health conditions. These are the best ways to do so:

  • Do your Kegels (strengthening your pelvic floor muscles can lead to stronger erections)
  • Lose weight
  • Eat well
  • Exercise regularly
  • Avoid excessive alcohol use
  • Quit smoking
  • Visit your doctor for frequent checkups
  • Regulate blood sugar
  • Maintain a healthy level for blood pressure
  • Manage your cholesterol level through diet, and medication if needed
  • Don't neglect your mental health, get help if needed
  • Engage in open and honest communication with your sexual partner

Erectile Problems and Your Pelvic Floor

The relationship between male sexual function and the pelvic floor is complex. The male pelvic floor muscles are responsible for supporting the internal organs of the abdomen and pelvis; it also supports the voluntary closure of the urethral and anal sphincters.

Male pelvic floor disorders have been linked to erectile dysfunction, as well as the dysfunction of ejaculation and orgasm. However, improvements in erectile function have been demonstrated with the implementation of male pelvic floor treatment plans. Male pelvic floor muscle training has been shown to increase the rigidity and hardness of the penis in some men who suffered with erectile dysfunction.

The muscles within the male pelvic floor are also associated with coordinating ejaculation. Premature ejaculation is one of the most common male sexual dysfunctions, and can negatively impact on the enjoyment of sexual activity for men and their partners. Pelvic floor therapy can improve the control over ejaculation.

A focus on improving your pelvic floor can result in significant functional improvement of your sexual health. To learn more about the male pelvic floor, visit our page.


Althof, S.E. (2006) Prevalence, characteristics and implications of premature ejaculation/rapid ejaculation. Journal of Urology. 175, p.842.

Claes, H. and Baert, L. (1993) Pelvic floor exercise versus surgery in the treatment of impotence. British Journal of Urology. 71, p.52.

Feldman, H.A., Goldstein, I., Hatzichristou, D.G., Krane, R.J., and McKinlay, J.B. (1994) Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. Journal of Urology. 151, p.54.

La Pera, G. and Nicastro, A. (1996) A new treatment for premature ejaculation: the rehabilitation of the pelvic floor. Journal of Sex and Marital Therapy. 22, p.22.

Mayo Clinic (2018) Erectile Dysfunction [online] Mayo Clinic [viewed 03/08/2018]. Available from

McMahon, C.G., Althof, S.E., Waldinger, M.D. et al. (2008) An evidence-based definition of lifelong premature ejaculation: report of the International Society for Sexual Medicine (ISSM) Ad Hoc Committee for the Definition of Premature Ejaculation. Journal of Sexual Medicine. 5, p.1590.

McNaughton Collins, M., Pontari, M.A., O'Leary, M.P. et al. (2001) Quality of life is impaired in men with chronic prostatitis: the Chronic Prostatitis Collaborative Research Network. Journal of General Internal Medicine. 16, p,656.

NHS (2017) Erectile Dysfunction [online] NHS [viewed 03/08/2018]. Available from

Porst, H., Montorsi, F., Rosen, R.C., Gaynor, L., Grupe, S., and Alexander, J. (2007) The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. European Urology. 51, p.816.

Rosenbaum, T.Y. (2007) Pelvic floor involvement in male and female sexual dysfunction and the role of pelvic floor rehabilitation in treatment: a literature review. Journal of Sexual Medicine. 4, p.4.

Smith, K.B., Pukall, C.F., Tripp, D.A., and Nickel, J.C. (2007) Sexual and relationship functioning in men with chronic prostatitis/chronic pelvic pain syndrome and their partners. Archives of Sexual Behavior. 36, p.301.