The muscles involved

Two muscles at the base of the penis do real mechanical work during an erection. The ischiocavernosus muscle compresses the crura, raising intracavernosal pressure above what blood flow alone can achieve. The bulbospongiosus contributes to rigidity and to ejaculation. Both are skeletal muscle — voluntary, and trainable.

If these muscles are weak, blood entering the penis is not held under pressure efficiently. That is the mechanism behind the pattern many men describe as 'I get hard, then lose it within a minute or two' — often called venous leak.

The evidence

The most cited study is a UK randomised controlled trial in which men with ED were assigned to pelvic floor muscle training with biofeedback and lifestyle advice, or to lifestyle advice alone. After three months, roughly 40% of the training group had regained normal erectile function and a further third had improved. The control group did substantially worse, and many crossed over to training afterwards.

Subsequent studies have been smaller and more variable, and pelvic floor training is not a replacement for medication in significant ED. But for a free intervention with no side effects, the evidence is respectable — and it is routinely recommended after prostate surgery for continence, where the erectile benefit comes along with it.

How to do it correctly

A workable starting programme

  1. Long holds: contract and hold for 5 seconds, relax fully for 5 seconds. Repeat 10 times.
  2. Quick contractions: contract and release rapidly, 10 times.
  3. Do both sets three times a day. Lying down is easiest at first; progress to sitting, then standing.
  4. Build the hold gradually towards 10 seconds as strength improves.
  5. Give it a genuine 12 weeks before judging the result.

One caveat: not every pelvic floor problem is weakness. Some men have an over-tense, overactive pelvic floor — often alongside pelvic pain — and for them, strengthening exercises make things worse. Relaxation and down-training is the correct approach instead. If you have pelvic, perineal or post-ejaculatory pain, get assessed before you start.

FAQ

Frequently asked questions

How long until I notice a difference?
Most studies report improvement between six weeks and three months of consistent daily practice.
Can I do them at work?
Yes — that is one of the main advantages. Nobody can tell. Just avoid doing them by repeatedly stopping your urine flow, which can cause bladder problems.
Do they help premature ejaculation too?
There is trial evidence that pelvic floor training improves ejaculatory control as well, which makes it a useful option when both problems coexist.
Should I use a device or app?
Biofeedback devices can help confirm you are contracting correctly, but they are not necessary. A single session with a pelvic floor physiotherapist achieves the same thing more reliably.
Sources

What this is based on

We link to primary sources — clinical guidelines, regulator publications and peer-reviewed research — wherever possible. Links open on third-party sites we do not control.

  1. [01]American Urological Association. Erectile Dysfunction: AUA Guideline (2018).
  2. [02]National Library of Medicine. PubMed — search the primary literature.
  3. [03]Urology Care Foundation. What is Erectile Dysfunction?.