# Pelvic Floor Exercises for ED: Kegels for Men, Done Properly

> Pelvic floor muscle training has randomised trial evidence behind it for erectile dysfunction, and it costs nothing. It is also the treatment most men do incorrectly.

- **Source:** ED Treatment Guides (https://www.edtreatmentguides.com/treatments/pelvic-floor-therapy)
- **Last updated:** 2025-11-18
- **Type:** treatment
- **Category:** Behavioural & lifestyle
- **Prescription:** Available without a prescription
- **Evidence:** Moderate evidence
- **Onset:** 6 weeks to 3 months
- **Duration:** Maintained with continued practice
- **Typical US cash cost:** Free, or $80–$200 per session with a pelvic floor physiotherapist
- **Best for:** Men with mild to moderate ED; Men with venous leak — erections that start well but do not hold; Men recovering from prostate surgery; Men with premature ejaculation alongside ED
- **Not for:** Men who need a solution tonight; Men with an overactive, already-tense pelvic floor without professional assessment
- **Common side effects:** None; Muscle fatigue when starting

## Key points

- The ischiocavernosus and bulbospongiosus muscles compress the base of the penis and help maintain rigidity — they are trainable like any other muscle.
- A well-known randomised trial found that around 40% of men regained normal erectile function after three months of pelvic floor training, with a further third improved.
- It is particularly relevant for venous leak, where the erection starts fine but cannot be held.
- Most men contract the wrong muscles. Getting the technique checked once by a physiotherapist is worth far more than months of guessing.
- It takes six weeks to three months. Consistency matters more than intensity.

## 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

> **Finding the right muscles**
>
> The correct contraction is the one you use to stop urine mid-flow, or to lift the penis slightly when erect. Your abdomen, buttocks and thighs should stay relaxed and your breathing should continue normally. If you are clenching your glutes or holding your breath, you are training the wrong thing.

### 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.

> **Worth one professional session**
>
> A pelvic floor physiotherapist can confirm with biofeedback that you are contracting the right muscles. Studies of self-taught pelvic floor exercise consistently find a large proportion of people doing it wrong. One session can save three wasted months.

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.

## 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

- American Urological Association. [Erectile Dysfunction: AUA Guideline](https://www.auanet.org/guidelines-and-quality/guidelines/erectile-dysfunction-(ed)-guideline) (2018)
- National Library of Medicine. [PubMed — search the primary literature](https://pubmed.ncbi.nlm.nih.gov/)
- Urology Care Foundation. [What is Erectile Dysfunction?](https://www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed))

## Related pages

- [Lifestyle Changes for ED: The Only Treatment That Fixes the Cause](https://www.edtreatmentguides.com/treatments/lifestyle-changes)
- [ED After Prostate Surgery, Radiotherapy and Hormone Therapy](https://www.edtreatmentguides.com/causes/prostate-treatment)
- [Vacuum Erection Devices: How Penis Pumps Actually Work](https://www.edtreatmentguides.com/treatments/vacuum-erection-device)
- [ED Symptoms and How It Is Diagnosed](https://www.edtreatmentguides.com/guides/symptoms-and-diagnosis)

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_This page is general health information, not medical advice. It cannot account for your own history, medications or risk factors. Talk to a licensed clinician before starting, stopping or changing any treatment._

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