Picture a hammock stretched from your pubic bone at the front to your tailbone at the back. That's the pelvic floor: layers of muscle and connective tissue that close off the bottom of the pelvis, with openings for the urethra and the back passage.
In men these muscles do more than most people realise. They support the abdominal contents, are active during breathing, keep you continent of urine and stool, increase local blood supply, and are active during sex.1
Like any muscle group, the pelvic floor can be weak or poorly coordinated. Because it sits out of sight, few men know it exists until something goes wrong, which is exactly why we wrote the pelvic floor guide nobody gave you.
What does the pelvic floor do during sex?
It's active throughout sex, and weakness in these muscles has been linked with erection problems. Training them has improved erectile function in randomised trials.
A review of randomised trials concluded that weak pelvic floor muscles compromise normal function and are linked with urinary incontinence and erectile dysfunction, and that strengthening them improves erectile function.1
In one trial, 55 men who'd had ED for at least six months were taught pelvic floor exercises by a physiotherapist, with biofeedback and lifestyle advice, and compared with men given lifestyle advice alone. After three months the exercise group was significantly better; after six months, 40% of men had regained normal erectile function and a further 35.5% had improved.2
Can pelvic floor training help premature ejaculation?
Possibly. A small study found most men with lifelong premature ejaculation gained better control after 12 weeks of pelvic floor rehabilitation, but it had no comparison group.
Of 40 men with lifelong premature ejaculation, all ejaculating within a minute of penetration, 33 gained control of the ejaculatory reflex after a 12-week programme, with an average time to ejaculation of about two and a half minutes.3
Without a control group, some of that improvement could reflect attention, time or expectation. It's best seen as a low-risk option to try alongside others, not a guaranteed fix.
What other problems involve the pelvic floor?
Leaking urine, especially after prostate surgery, and dribbling after you've finished peeing are the classic ones. Strengthening the pelvic floor has been shown to help both.
Trials reviewed by Dorey found that pelvic floor strengthening significantly improved continence after prostate removal and reduced post-micturition dribble, the few drops that escape after you've zipped up.1 If you're facing prostate surgery, ask whether a physiotherapy referral is available.
Pain is a different story. If you have ongoing pain in the pelvis, perineum or genitals, get assessed by a GP or pelvic health physiotherapist before starting a strengthening routine, because more squeezing isn't always the answer.
How do I know if my pelvic floor is weak?
Leaking when you cough or lift, dribbling after urinating and weaker erections can all point to it. A pelvic health physiotherapist can assess it properly.
Weak pelvic floor muscles have been linked with both leaking and erection problems.1 You can get a rough sense yourself by trying to tighten the muscles you'd use to stop passing wind while lifting the base of the penis. If you can barely feel anything happening, or can't hold it, that's worth working on. Kegel exercises for men explains how.
Common questions
Do men have a pelvic floor?
Yes, everyone does. In men these muscles support the abdominal organs, help control the bladder and bowel, and are active during sex.1
Can pelvic floor exercises improve erections?
They can. In a randomised trial, men taught pelvic floor exercises had significantly better erectile function after three months than men given lifestyle advice alone.2
What is the PC muscle?
PC stands for pubococcygeus, one of the pelvic floor muscles that runs from the pubic bone towards the tailbone. People often use 'PC muscle' as shorthand for the whole pelvic floor.
Read more on this
Sources
- Dorey G. Restoring pelvic floor function in men: review of RCTs. Br J Nurs. 2005;14(19):1014-8, 1020-1. PubMed
- Dorey G, et al. Pelvic floor exercises for erectile dysfunction. BJU Int. 2005;96(4):595-7. PubMed
- Pastore AL, et al. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Ther Adv Urol. 2014;6(3):83-8. PubMed
Not medical advice. Written by Eric Stephens from the research cited above; not reviewed by a doctor. If something worries you, see a GP.